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Hip Hurt? Trouble Crossing Your Leg?

Posted Sep 11 2007 12:00am

Lately I have seen a spate of hip injuries. The patient usually comes in complaining of pain the starts on the upper part of the leg but on the side. The pain is usually moderate to severe and the patient can’t sit cross-legged. The pain usually extends from this point down the side of the leg, almost to the knee.
This pain usually does not inhibit the climbing of stairs or getting out of a chair.

In the cases I have seen the patients have been to other healthcare providers and have found no relief. They have taken pain medication and have found no relief.

So what causes this pain and how can I as an acupuncturist and massage therapist help?

The pain usually comes from a tight muscle called Tensor Fascia Lata or TFL. This muscle is situated on the side of one’s torso just above the hip bone (the bulge at the side and top of your leg). The pain radiates down to the knee because of a band of tissue called the Ilio Tibial Band or ITB that is attached to the TFL. When the TFL is tight it pulls towards its center thereby pulling up on the ITB and also pulls on the glute muscles. Usually there is no pain in the proverbial “butt” because those muscles are not used except in certain movements. Don’t do those motions and there is no pain. On the other hand the TFL is a postural muscle and is used all the time to keep you hip & knee in place. Hence it will be the source of the majority of your pain.

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What I can do it use my knowledge of the muscle and the surrounding anatomy to quickly assess which muscles are involved and then design a treatment protocol. I usually will combine heat, with acupuncture, massage and stretching to release the tight muscles and relieve the pain.

The course of treatment for this problem plays out over a good few weeks. Sometimes it could take a couple of months of once a week treatments to fully release all of the muscles that have tightened up. It takes this long or longer because it takes time to release the different layers of tight muscle. It is sort of like shoveling snow – just is with snow one has go at it a layer at a time in order to clear the snow, so too with muscles. In addition the patient is usually in a great deal of pain and discomfort so that working to deep or fast is too much for the patent to tolerate. In addition being overly aggressive with the muscles would be counter productive. So the approach is to gauge what the patent can tolerate as well as what the body/muscles will let the therapist do. A therapist must “listen” to the muscles and proceed apace.

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