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3 Ways to Stop Hip Pain
By Staff Contributor on July 25, 2014
It’s inevitable as we age. The body begins to show signs of wear and tear. More brothers (and even sisters) are asking questions about important non-arthritic causes of hip pain.
Historically hip pain was something people associated with the elderly. The dreaded phrase “I think I broke my hip” has long been synonymous to saying “I am an old man”. It is true that a large proportion of hip pain arises directly from the hip joint and is most commonly due to osteoarthritis, something that can arise quite by the 6th or 7th decade of life.
This change in understanding of who gets hip pain may be partially due to an increasing focus on the health benefits of exercise.
Running is a form of exercise that offers many benefits: it allows individuals to achieve significant aerobic exertion in a relatively short period time, requires relatively little equipment (though the importance of quality footwear should not be overlooked), and provides weight bearing exercise to most major muscle groups of the lower extremity. However, there are risks associated with relying on it as the sole form of exercise, or of starting an intense regimen too quickly. These risks can quickly multiply when running is used as the main way of “getting back in shape”.
Another hip injury that can be related to repetitive trauma that less commonly comes to mind is femoral acetabular impingement (FAI). FAI usually occurs following repetitive micro trauma to the acetabular labrum and cartilage by the femoral head. The labrum can be thought of as a sealant that helps secure your hip joint, though technically it is a fibrous rim of cartilage around the joint. Since part of it has a poor blood supply, repetitive trauma when there is a labral tear can lead to imbalance in the hip joint.
Sports that involve extensive pivoting and hip flexion, like soccer, when combined with FAI, can cause chronic hip pain. It can also occur with activities that push the hip to extremes in range of motion, for example yoga, ballet, and running.
When FAI occurs, the initial treatment is nonsurgical with acetaminophen, anti-inflammatory agents and activity modification. Physical therapy is beneficial for restoring muscular balance to the hip, which can relieve some of the stress on the joint. Other conservative modalities include deep tissue massage and osteopathic manual treatment to address tightness around the hip from long-standing hip impingement, and to optimize body mechanics, respectively.
While effective approaches to treating labrum tears exists, a smarter approach is prevention. Here are three tips on how to prevent labrum tears from occurring.
First, the gluteal muscles are of great importance in supporting the hip and the pelvis during activity. Exercises like side-lying leg lifts and the one legged squat are great ways to ensure these muscles can handle more intense weight bearing demands.
Second, consistently stretching the hip flexors is important. Tight hip flexors will make it more difficult for the gluteus maximus to control extension of the hip and may lead to less control at extremes in hip range of motion.
Third, improving balance utilizing daily one-legged balancing regimen is an important measure in preventing excessive hip extension or excessive sideways movement during running.
It is an excellent sign that so many people are eager to get moving and lead healthier lives. But before starting or intensifying an exercise regimen, it is important to consider the effects that it will have on our joints, and take measures to reduce risks.
Dr. Moshe Lewis MD, MPH, MBA is currently on the Volunteer Clinical Faculty of UCSF. Dr. Lewis specializes in the non-surgical management of musculoskeletal and neurological injuries and diseases. His focus of care is pain relief, regaining flexibility, and building strength with the goal of getting people back to work and enjoying healthy, productive lives.