Lets talk about Hip Pain!

Low back and hip pain

Do you notice a nagging pain in one of your hips? By the end of the day, does it become almost unbearable? If you go to your General Practioner, they may tell you you have bursitis or gulteal tendonitis, but how do you know for sure? If you think you've "done nothing". If it just started hurting one day out of nowhere, lets explore the musculoskeletal possibilities! It sometimes could be that your SI joint or pelvis needs re-aligning with your Chiropractor. More times than not, it's a combination of things. A lot of times I will get asked, which muscle is it? It's never just one, its usually a combination of muscles and a disfunction in movement that causes the issue.

Pain that radiates into the hip can be caused by a collection of shortened muscles, trigger points, and weak muscles. First we need to find the trigger points and shortened muscles. How the body positions itself in a relaxed state whether standing or lying on my treatment table can tell a story. You can look in a mirror while standing and see if one shoulder is lower than the other, or if one foot is flaring out to the side. This indicates imbalance and probably shortended muscles. But how do you get a shortened muscle? You can acheive this by repetitive movement or being in a single position for a prolonged period of time; also if the opposing muscle group is stronger or weaker- causing the imbalance, just like a pulley system.

How can massage help? Therapeutic massage with a focus on hip pain, assessing the imbalances, I'd start at the lower back, addressing tightness and trigger points in the Quadratus Lumborum. This is a very large lower back muscle, that can hold trigger points that radiate pain to the SI joint as well as causing a "high hip" on that side. Pain in the gluteal muscles or "butt muscles", can also directly involve the glute muscles, such as the gluteus medius with trigger points high up on the hip bone (Ilium) itself, as well as the deep hip rotator muscles that linger at the hip joint. Opposing muscles, as well as helper muscles must all be addressed to unwind this shortening and distortion of the natural position of the body.

We cannot forget about the ever important deep low back muscles and hip flexors! This is usually the overlooked set of muscles, which if left untreated, the pain will never fully resolve. This includes, the Iliopsoas and Illiacus muscles. I address these muscles while lying on your back, applying pressure through the blanket. The psoas when shortened can cause a low shoulder, which can pull all the way up into the neck, and a

very tight low back and core. The illiacus is a muscle that lines the inside of the ilium. This can pull on the hip (illium) and distort its position, causing pain at the back and side of the hip. Relaxing all of these muscles is crucial. But then comes the next step, addressing function and strength.

Getting on an exercise routine is an absolute must. It does not have to be long or strenuous. Just get the muscles engaged. This will help with the muscle strenghth imbalance, by consciously working each side of the muscle groups. Stretching is also critical to remind your muscles to re-lengthen after being used or contracted. Make sure to warm the muscles before stretching, either with movement, a hot shower, epsom salt bath, or moist heating pad. This will ensure the muscle is soft and ready to be stretched, making your stretches more productive and safer. Include deep slow breathing while stretching, making sure to hold each stretch position for at least 30 seconds to 2 minutes.

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