In my last blog I discussed the shoulder joint. Now, I want to take a closer look at the hip joint, formed by the junction of the pelvis and the femur (thighbone). Like the shoulder, the hip is a ball and socket joint. Unlike the shoulder, the hip joint is a deeper, more stable joint due to its weight bearing role. Moreover, in contrast to the shoulder joint, the hip joint is further stabilized by the resilient muscles and ligaments that surround and cross it.
The hip joint is part of the so-called “pelvic girdle”. Because of this, the flexibility and strength of the muscles and ligaments surrounding and crossing the hip joint affect the pelvis and the entire spinal column. For example, some of the muscles crossing the hip have attachments on the spine so hip movements can have repercussive effects on the spine. Movements of the hip joint include flexion (moving the femur toward the pelvis); extension (moving the femur away from the pelvis); adduction (moving the femur toward the center of the body); abduction (moving the femur away from the center of the body); lateral and medial rotation (turning the femur outward or inward); and c ircumduction (moving the femur in a circular direction).
Common Hip Injuries
Typical hip injuries include trochanteric bursitis, hip adductor strains, osteoarthritis of the hip and hip fractures. An inflammation of the bursa, or fluid sac, of the trochanter bone, trochanteric bursitis presents as a pain in the side of the upper leg. This inflammation can also affect the fascia (fibrous connective tissue) surrounding the hip joint. Trochanteric bursitis is often caused by a leg length discrepancy. A strain of the hip adductor muscles (commonly known as a groin pull) frequently results from quick lateral movements or slipping on wet pavement. Adductor strains can also be caused by imbalances in the body or when there’s not enough lateral movement of the ankle.
Osteoarthritis of the hip can sometimes be caused by repetitive trauma to the hip joint. If severe enough, it may necessitate a total or partial hip replacement. Hip fractures are usually one of two types: a femoral neck fracture one-to-two inches from the joint, or an intertrochanteric fracture three-to four inches from the joint. Most require surgical repair with the use of either a pin or a compression screw and side plate to keep the bone in place while it heals.
Strength and Flexibility
When hip structures are weak and unstable, excess forces are transferred down the leg during impact exercise, leading to injuries of the knee, ankle and foot. The key to preventing hip injuries is to strengthen the muscles supporting the hips with exercises such as squats, leg presses or even stair climbing. For those with osteoarthritis of the hips, water exercise and stationary cycling are ideal. Flexibility of the hips is equally important and can be enhanced with regular yoga and stretching exercises.
“Lisa”, a competitive runner, came to me with chronic left hip pain. I discovered that Lisa had a leg-length discrepancy which was compounded by tight hip flexors and tight and weak hip extensors. I recommended Lisa see a sports podiatrist to correct her leg-length discrepancy with an orthotic. I then prescribed a daily yoga routine for her, emphasizing hip-opening and gluteal strengthening postures. Today Lisa is training for her 5th marathon….pain-free! For more information on athletic training and rehab, please visit www.bewellcoaching.com.
Right now you are sitting on the biggest muscle in your body - your gluteus maximus. Keep it and your other gluteal muscles strong and flexible and your hips will be happy years from now.