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Runners, Dancers and Yogis Beware: Why You Should Never Ignore Hip Pain [And what to do if you have it]

Posted Apr 03 2014 1:12am

peter-pan-doing-splits

This picture alone is why America needs to have more subways.

Yoga is supposed to be the ultimate non-competitive exercise but if you’ve ever spent time in a “serious” yoga class (or even a not-so-serious one) you’ll discover the Pose Off. I wish I was talking about lining up all the mats like a catwalk and having each yogi do their best Tyra impression. No, I mean the inevitable comparison of who can do which advanced poses and how well. Since overt bragging doesn’t mesh well with the whole yoga vibe, you have to make your stunts look calm and serene. Oh this? I always relax in a fingertip handstand. You can’t do it? Super easy – you just have to focus on tightening your core and you’ll get it!

(Side note: I swear the answer to EVERY tricky yoga pose is always “It’s all in your core! If you just hug your ribs together you’ll pop right up like a beach umbrella, easy peasy lemon squeezie!” Also, why is there no Beach Umbrella Pose? There should be. I don’t care if beach umbrellas didn’t exist in ancient India. Neither did Justin Beiber and yet we now have yogaBieb s poses.)

Not gonna lie: I’m a competitive girl. Always have been. I try and reign it in during yoga but every once in a while that shiz comes bubbling out and last week was the perfect example. We spent the whole hour doing a series of progressively deeper hip opening poses, building up to one big doozie. Now, I have two natural God-given athletic gifts (and only two but that’s a post for another time): I’m more flexible than most and I don’t feel pressure as pain. I don’t know if all those years of gymnastics damaged my nerve endings (or brain, whatev) but I can go very deep into most poses and still not feel a dang thing. So of course I bounced right up into the pose — let’s call it Hip Replacement Pose. You know, for funzies.

Oooh! Ahh! SNAP!

I failed to mention that my athletic superpowers come with one mega kryptonite: My muscles, bones and ligaments still work like everyone else’s which just means that I have a greater propensity to stretch too far and hurt myself.

My hip snapped like Oprah interviewing Lindsay Lohan and while I didn’t think too much of it in the moment, the next day – which happened to be day one of our hiking through Arches – my hips just ached. Especially my right one. As a young (read: dumb) gymnast, I used to pop my right hip out in order to hyper-extend my straddle splits. It was a cool party trick but I didn’t realize that that actually isn’t a healthy movement until a physical therapist told me a few years ago. Oops. Turns out that flexibility can actually be a liability in strength maneuvers because your bendiness allows you to go further than your muscles, joints and bone structure would prefer. And I paid for it, hiking all day on a sore hip.

I am not alone in my ability to damage myself. Apparently yoga hip injuries of this sort are so common that they got their own write-up in The New York Times! And women, since we are naturally more flexible than men, are more prone to what is known as “yoga hip”, “dancer’s hip” or “runner’s hip” depending on your preferred sport. Or “aerial acrobat’s hip”, as evidenced by the following e-mail I got from Reader S:

Hi Charlotte,
I have been doing aerial acrobatics for about three years now, and about 6 months ago I started feeling a crackling in my hips whenever I did a straddle. The pain from this has slowly increased, and while it’s not awful, I should probably work on fixing it. I’ve been told that it is Snapping Hip Syndrome, and that it is very common for dancers, gymnasts, and martial artists to get it. I was wondering if you had ever experienced it, and if you had any advice on how to fix it.
Thank you!

First, no pictures Reader S?? You KNOW how I love aerial acrobatics! (My Great Circus Arts Fitness Experiment is still in my top 3 favorites ever and was the #1 most fun workout I’ve ever done.) It’s okay though, I understand how hard it is to hold a camera while dangling from one leg in a silk. We can still be friends.

But to answer your question: What is the deal with all this hip pain going around? Like the Times article points out, this type of hip pain is most common in women who do exercises where the hip is repeatedly extended. Gymnastics, dance, martial arts, acrobatics, yoga and even running are all common culprits from the way they require the joint to move in its socket.

hip-illustration

For anyone who needs a refresher from high school anatomy: Behold, a healthy hip joint!

There seem to be three most common causes of range-of-motion related hip pain:

1. Snapping hip syndrome. According to WebMD , this a condition in which you hear a snapping sound or feel a snapping sensation in your hip when you walk, run, get up from a chair, or swing your leg around. The noise is caused by a ligament – most commonly the illiotibial band – moving over the top of a bony part of your hip. For most of us they say it’s usually little more than an annoyance and the only symptom is the snapping sound or sensation itself. But, they add that for dancers or athletes, snapping hip syndrome symptoms may also include pain and weakness that interfere with performance.

2. Bursitis. We have little fluid-filled sacs called bursa that are found at friction points in the body, like our hips, and when the tendons repeatedly snap over the bursa they can cause it to get inflamed which can be quite painful and become chronic. So this would be like exxtreme! snapping hip syndrome. (Everything is better with more X’s. Don’t you read fitness adverts?) And since your hips are instrumental in walking, it can become a vicious cycle of pain and inflammation, severely limiting your range of motion. 

3. Femoroacetabular Impingement (FAI) syndrome. This happens when you repeatedly jam the neck of your thigh bone into the protruding rim of your hip socket. Sound hard to do? Not so much: Think your standard touch-your-toes forward bend in yoga, your split leap in dancing and your favorite “runner’s lunge” stretch after your 5-miler (or just the running part). Eventually your body builds up extra bone to try and protect itself but ends up hindering the motion of the joint and can be extremely painful.

“Women’s hips showed particular vulnerability. By nature, their pelvic regions support an unusually wide range of joint play that can increase not only their proficiency but, it turned out, their health risks. The investigators found that extreme leg motions could cause the hip bones to repeatedly strike each other, leading over time to damaged cartilage, inflammation, pain and crippling arthritis,” explains the Times piece.

So how do you treat hip pain from overuse in activities that require a large range of motion? 

If your pain is mild or you’re simply bothered by the snap-crackle-pop then Runner’s World has a nifty article on some exercises to do to strengthen your hip joint which will help keep your pesky ligaments in line. My old trainer, who specialized in corrective exercises, was always adamant as well that weak glutes cause a lot of hip pain in women. So you can also try adding some glute-strengthening exercises like band walks, lunges, hip bridge raises and twerking. (What? It might get you some strange looks in the gym but it looks like it would work your buns! Not that I’d know – I can’t do it. Yes, I tried.)

The next recommendation is rest. Yes, you need to stop doing whatever activity or motion is causing the pain in the first place. How long? Here’s my old trainer’s super science-y recommendation: Until it doesn’t hurt anymore. Then once you resume your sport, try not to push so hard into your hips. Yeah it feels cool to be 35 and still able to do all my splits (woot!) but it will feel way cooler when I can walk my grandkids around the park without needing a robot hip. So REST IT. (I’m yelling at myself, not you!)

Splits

 So…stop doing this. At least not every day.

However, if your hip pain is more severe and doesn’t get better with a little rest, ice and ibuprofen then you should see a doctor. They may prescribe more targeted physical therapy or do things to help reduce the inflammation. In some cases, according to WebMD, this pain may indicate torn cartilage in which case you definitely want to see your doctor. But what you don’t want to do is ignore it! Left alone long enough, these injuries can cause your hip joint to degenerate necessitating surgery or even a hip replacement. (And as Sarah pointed out in the comments, the ONLY cure for FAI syndrome is surgery as it necessitates removing the extra bone growth.) Ain’t nobody got time for that! Especially those of us who got it because we love yoga/acrobatics/dancing/running so much!

Dr. Jon Hyman, an orthopedic surgeon, told the Times his typical hip-pain patient was a middle-aged woman who did yoga or something similar, adding that he saw up to 10 a month — or roughly 100 a year. “People need to be aware,” he said. “If they’re doing things like yoga and have pain in the hips, they shouldn’t blow it off.”

Bryan T. Kelly, an orthopedic surgeon at the Hospital for Special Surgery in Manhattan, echoed the warning, saying, “If that’s done without an understanding of the mechanical limitations of the joint, it can mean trouble.”

Aaaand I feel compelled to confess that tonight, as I sit here typing this, my hips are again aching. Because did I learn from my hubris-induced injury last week in yoga? Nope! Did it again in class today. Which I feel especially dumb about because I went into class committed to being gentle and not pushing my hips deeply. But then we were working on Eight Crooked Limbs pose (WHO HAS EIGHT LIMBS?!) and it’s just so fun falling over and rug-burning my cheek that I completely didn’t pay attention to my poor hip sockets!

Anyhow. TL;DR: Just because you can, doesn’t mean you should. Don’t be me.

Any of you had hip pain like this? Have any advice for Reader S? What’s your biggest athletic gift/talent?

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