Getting Hip Pains?

You’re not alone. Here’s why it happens and what you may be able to do about it.

Why does my hip hurt?

First of all let’s look at where exactly the hip is. We think of it as the bone we can feel at the top of the thigh on the outer aspect but if you look at the diagram you will see the hip joint is positioned a lot more centrally.

It’s a ball and socket joint.

The long thigh bone (femur) comes straight up the leg and then turns at quite a sharp angle along what’s called the neck. The neck of the femur is the part that is vulnerable to fracture in older people – (called a fractured neck of femur) and part of the reason that it can break is that sharp angle

The ball part of the hip joint is at the top of the femur and this fits tightly into the socket part which is on the pelvis (called the acetabulum).

 

How does it work?

In a healthy hip there is a great deal of movement available. If you think of a ball rolling around in a socket you can visualise the way the hip allows spin as well as movement forwards, backwards and sideways. When you turn your leg in and out that movement is happening at the hip.

Think of the way your knee moves, it’s a hinge joint so all it has is forward and backward movement. The hip is far more mobile and this great mobility combines with great stability because the ball fits so closely in that socket.

The smooth movement is only possible because the joint surfaces are covered in cartilage so there’s no friction – think of super smooth surfaces sliding on each other like ice on ice.

The cartilage is lubricated all the time with a special fluid that keeps everything slippery and friction free, this is called synovial fluid. When you move the hip through its full range you sweep that fabulous lubricant all across the cartilage surfaces and that helps to keep them healthy – use it or lose it!

What goes wrong?

If you hammer that surface too heavily though the cartilage can get eroded. And if you don’t move your hips through all that massive range then the peripheries of the cartilage don’t get so much of that lubrication.

Wear and tear of the joint surfaces happens at the hip just as it does in any weight bearing joint and sometimes that can lead to pain.

Text books will tell you that groin pain is associated with the hip joint and this is often true, it feels like a deep dull ache in the groin with sharp twinges when you go to move – especially after you’ve been sitting for a while. First thing in the morning you may feel the hip is stiff and sore until you get going. Often movements out to the side are particularly difficult.

The pain is usually worse on weight bearing and causes you to limp when you walk. An early warning sign can be a sharp twinge when you push off to run.

Red Herrings

Sometimes it can feel like your hip’s the problem when actually its the soft tissues – the muscles and tendons that surround the hip, supporting it and making movement possible so a careful examination is important.

When the hip joint movement becomes restricted we tend to compensate by adapting the way the back moves, this can complicate matters further. Physiotherapists will always look at the way the back is working in combination with the hip. There’s plenty that you can do to regain range of movement at the hip and unravel any compensatory movements in the back. Once you improve on these you can build up the muscles that support and control the hip.

Sitting is not great for hips because they’re stuck in one place for long periods of time. If you think about it the hip joint is bent up to at least a right angle when you sit, more that than when you’re in a driving seat or a low chair. If you sit with your legs crossed the hip is crammed even more at the front while the structures at the back are relatively overstretched.

Is Victoria Beckham on to something??

If she still uses that treadmill in her office then yes I think she may well be! Hips love walking, it’s excellent exercise and much better than sitting all day. When you walk you are upright so your hip is in a neutral position and those soft tissues across the back of your hip, your gluteal muscles are no longer overstretched. Running is great too because those muscles fire up and stay in good condition.

How can I test my hip?

Here’s a quick test for you: stand in front of a mirror, hands on your waist, with one leg off the ground so that you are balanced on the other leg, watch closely as you dip down a little at the knee. If you can keep control of the leg as it dips then your hip strength is pretty good. If you see your leg drift in towards the middle, so that your knee is no longer ‘in line’, then your hip control is probably a bit weak, you need to strengthen up your gluteal muscles. Get some guidance from a physiotherapist!

What exercise should I do?

Well a bit of advice is always good but if your hips feel fine then keep them that way by doing a yoga class or pilates regularly; that way you get to move your hips through that fabulous range of movement and the strength components such as bridging and plank are really good for core control. Running is great of course and so is any kind of dance class. Cycling is great for all round aerobic fitness. Strength training in the gym with supervision can really help you build up your glutes. If we could all walk three hours a day our hips would be much happier!

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7 Hill Street, Richmond,
London, TW9 1SX

020 8332 1132

clinic@richmondphysio.co.uk