Is your hip uncomfortable in sitting or standing positions? Does it pinch throughout your day when you twist or bend in certain ways? You’re probably wondering more about how do I get rid of this uncomfortable feeling in the front of my hip opposed to what’s causing it. Right? But… in order to address that pain and discomfort its important to understand the cause to develop a management plan and solution for your struggles with hip dysfunction.
The hip joint is a ball and socket joint made up of your thigh bone (femur) and the concave socket of the pelvis (acetabulum). Other supporting structures include the acetabular labrum, ligaments and muscles that act upon the hip. Common injury or the source of anterior hip pain may include labral tears, joint surface cartilage wearing; soft tissue sprain, tendinopathy, bursitis; joint osteoarthritis or synovitis; stress fractures and hernias. What’s the root cause then? Why is it leading to hip dysfunction and pain?
Often excessive loading of the hip can be from structural impairments, poor movement and or postures. The head of the femur bone that sits in the acetabulum should ideally glide forward and backwards as we move; with the idea that for the femur head to move efficiently it will centralise within the joint. What can change this are bony constraints on the acetabulum which lead to anterior translation or overload on the front of the hip. With altered biomechanics or force on the anterior hip joint, pain or injury may occur. Hip impingement or a sharp pinching sensation within the joint can be another way to describe this. Other factors contributing to this excessive load on the hip may be postural alignment, poor stability and or control, muscular or structural restrictions around the hip itself or other parts of the body which change the forces on our hip during functional activities. All of which can be assessed and treated by your physiotherapist to alleviate the hip pain and address the underlying cause.
What can Our Physio do about your poor postures or habits which may be causing anterior hip pain? Firstly we need to identify whether there is a postural alignment issue. Observing how somebody stands, joint alignment and postural assessment can give a clear indication as to why they struggle with any sort of lower or upper body musculoskeletal pain or overload. In the instance of the hip, if an individual is standing in an extended hip position we know there will be an increased anterior hip joint force. If you’re struggling with anterior hip pain even just some simple cues such as softening your knees to a slight bend; keeping your two hips facing forward; or gently lifting your chest up and forward so that it’s centred over your pelvis are good tips to try at home to assist alleviate pressure on the anterior hip. Seated postures are just as important when thinking about the hip. If you’re in a sedentary office based job you ought to be aware of your hips being in a flexed position for most the day. Sitting postures can also overload the front of the hip if there is any muscular restrictions acting on the hip preventing its ability to centre in the middle of the joint as we sit.
Common tight or overactive muscles which may cause hip dysfunction include deep posterior hip muscles such as obturator internus and/ or pirifomis; the TFL (tensor fasciae latae) or ITB (Illiotibial band); rectus femoris and adductors. Muscles become overactive in an attempt to compensate for poor lumbar-pelvic stability, can reduce hip joint motion. Thus these restrictions identified for certain individuals are often accompanied by poor habitual movements, poor control and or coordination and weaknesses within the hip, sacroiliac joint, and the lumbar spine. In terms of managing this with your physiotherapist your treatment plan would involve releasing the hyperactive or tight musculature, restoring range of motion of the hip, working on relaxation and correct muscle activation then starting to incorporate core strengthening and addressing other functional limitations which may be contributing to your anterior hip pain. This wholistic approach provides people with a long term solution and prevention to their struggles as opposed to treating the hip locally for a quick fix or pain relief.
Advice provided within this blog is only to address biomechanical dysfunction that may be contributing to anterior hip pain; and may not be suitable for all individuals with hip pain or any associated trauma to the hip. Assessment and judgement on each individuals impairments and suitability for exercises should always be conducted prior to developing a treatment plan and exercise prescription. Should you have any further questions or would like to discuss your hip pain with a physiotherapist, please contact Our Physio Central Coast (02) 4339 4475.
References and Acknowledgments
All content within this blog was developed with reference to:
Hamilton, N. (2015). Anterior hip impingement and labral tears: A case of biomechanical overload?. Retrieved March 2022 from www.clinicaledge.co
Hamilton, N. (2012). Exercises for anterior hip pain. Retrieved March 2022 from www.clinicaledge.co
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