Why Do My Hips Hurt?

Quick note: I am not a doctor (shocking I know with how well I write and how terrible my signature is). So, if you are experiencing serious pain and doing these movements makes things worse; please go see a medical professional. I hope that is not the case, but better safe than sorry!

‍

Hips can be a real pain in the a$$...

‍

Now that were all having fun, lets get serious.

‍

There are a ton of different reasons why your hips could be hurting, and the only way to know is ASSESS.

‍

Have your trainer or PT assess your hip range of motion, gait, etc… to see what is going on and what the solution is for you specifically.

‍

That being said, not everyone reading this is close enough to Oak Performance to have yours truly run you through some assessments, so lets go over some things you can do on your own.

‍

MOST of the time hip pain is being caused by something non-pathological; meaning there is no damage to the area like a tear or something similar. Typically, it is going to be inflammation based, or hypertonicity of specific muscles/muscle groups.

‍

Also, keep in mind that it is usually the case that it could be something dysfunctional going on at other joints above or below the hip that is causing the pain. My first instinct is to always look at what is going on at the pelvis when someone presents with hip pain.

‍

The reason being is because the muscles that attach onto your hip mostly have an attachment on your pelvis as well. That means if you have something funky going on in your low back/pelvis area, it could lead to pain at your hip.

‍

The assessments and drills I go present below take this into account.

‍

How to assess this on your own

‍

Here are 3 quick assessments you can do to get an idea of what's going on with your hip and what you could try to fix it.

‍

Toe Touch

Just go down and touch your toes. Keep your knees extended and go down as far as you are able.

‍

What you’re looking for is 2 things. First, is there pain when you do this? Where in the movement does the pain begin and does it go away if you go deeper or when you come back up?

‍

Second, is notice if you have any shift of your hips as you go down. Do you shift into your right or left side? Do you notice more pressure/weight on one foot more than the other?

‍

Offset Toe Touch

Whatever hip is bothering you move that side foot back in your stance so its toes are in line with your front foot heel. Have your feet spread about hip width apart and then reach both hands down to your back side leg.

‍

Not observe and notice the same stuff as the Toe Touch. Is there pain? Where in the movement? And do you notice a weight shift?

‍

Single Leg Balance

Just balance on your leg with pain and see how your balance is being affected? Is it as good as pre pain (if you know that answer)? Does it cause the pain to get worse?

‍

Now that we have done all the assessments; lets talk about what they might mean.

‍

Without going too far down the rabbit hole, lets just assume that you did these assessments and came back with these results (mainly because this is how 80%+ people present with their hip pain.)

‍

Minor pain on the toe touch about half way down (less than a 1 out of 10 pain)

‍

More pain on the offset toe touch (2-5/10), but it gets better the deeper into the position you get if you are able to get any deeper.

‍

Balance is significantly worsened and causes the hip muscle activation to be more than it should.

‍

There are so many muscles in such a small area that attach to your hip its not even funny. HOWEVER, that being said there are usually the same culprits when it comes to hip pain.

‍

Glute Med/Min

TFL (Tensor Fasciae Latae)

‍

These are 3 muscles that cause a lot of havoc. They are super important and stuff, but dang it do they cause a lot of problems.

‍

Think of the glute med/min muscles as the suspension in your car. They doesn't necessarily cause a lot of movement, but they stabilize the heck out of it. 

‍

(side note: not a perfect analogy because they do have certain movements that they lead the way in, but bare with me) 

‍

These glute muscles act as the stabilizers of your hip joint as it goes through all its ranges of motion. 

‍

The TFL is a bit different because it doesn't technically attach to your hip, but it does cause anterolateral hip pain. This muscle is like that friend who tries to everything, but isn't good at anything. Sweet guy, but dang he gets in the way.

‍

Lets talk about them glutes first.

‍

These muscles stabilize the hip like I said, but they will also “cause” movement in the hip as it pertains to rotation and abduction/adduction. 

‍

The glute Medius is able to externally and internally rotate the hip as well as ABduct the hip. The glute minimus can internally rotation the hip and help with ABduction.

‍

These muscle are crucial because they are used for every step you take. So, when they aren't working right it usually comes with pain and dysfunction.

‍

What is common to see is a “Hip Drop” which is when your hip will drop when you stand on your other leg. 

‍

The fix: You need to wake those glutes UP!

‍

There are tons of breathing correctives LIKE THIS ONE that can help!

There are also drills you can do, maybe LIKE THIS that can help as well.

‍

The main thing to focus on with these drills is feeling the right things. You should feel the muscles deep in your glutes. 

‍

You also want to do all these movements slowly. Slow movements lead to greater muscle activation, and will allow you to feel the right things and change if you aren't feeling the right things.

‍

2 other things you should work on is holding a split squat hold for more than 3 minutes on each side and being able to stand on 1 leg for more than 30s with ease (and then 20s with your eyes closed.)

‍

Aside from the drills listed above; I would focus on all the other glute exercises we know and love. Bridges, donkey kicks, lunges, etc… As long as you can manage the pain and the movements don’t make it worse, then I suggest do it.

‍

Alright, lets talk TFL.

‍

This muscle is the definition of Jack of all trades, master of none. It does basically all movements at the hip, but isnt good at any of them.

‍

This muscle gets hypertoned (over activated) which will lead to anterior and lateral hip pain or tightness. This is what I struggle with most of the time if I have hip pain.

‍

The answer to calm this muscle down is actually similar to above. Activate your glutes and hamstrings and it usually clears up the issue.

‍

Try these drills in the order and see if it helps:) HERE

‍

Final Note

Stretching is usually not the key to getting out of pain especially when it comes to your glutes. Stretching is something that can be done after you start to activate the proper muscles.

‍

Muscles that are not working properly do not need to find less tone and more length. They need the proper amount of tone (activation).

‍

Once you get a muscle to activate properly during minimal range of motion movements like walking; then you can start to train muscle activation in lengthened positions.

‍

Yours in strength,

Nate

‍