In terms of diagnosing hip pain, typically a patient will expect when they come in to be asked about their symptoms, and it’s very important to find out when did these symptoms start, how long they have been going on, how frequent they are, if they come on in the morning or the evening, do they come on with any certain activity, and if there is something that makes it better or worse. The intensity of the pain is also important. Does it have any associated radiating symptoms? Is it localized in one spot or does it move? After getting a history and finding out what type of pain the patient is having, which also includes whether the pain is dull, aching, sharp, or intense, then it’s important to do a good physical exam. The physical examination involves testing the muscle strength, testing for sensation, doing provocative maneuvers which might help us rule out one type of injury from another.
A sedentary lifestyle can lead to having weak and tight hip flexors as they are always in the shortened position. Tight hip flexors can lead to a limited range of motion, poor posture, lower back, and hip pain, and even injuries. These muscles need to get a workout when you are standing and doing movements such as raising your leg to climb stairs, run, or ride a bicycle.
The good news is that there are plenty of good hip stretches out there that you can do to relieve discomfort, decrease tightness, and increase mobility in your hips. Since your hips are involved in so many of the movements you make (both inside and outside of the gym) stretching them is a great way to keep them feeling good and ready to work for you. Add some of the 12 hip stretches Atkins demos below to the end of your workout, or spend 10 minutes each day just doing a few of them, to improve mobility in your hips.
Brace your core and bend your knees to lower down into a split squat. Your left knee should ideally form a 90-degree angle so that your thigh is parallel to the ground, and your right knee is hovering above the floor. (Quick position check: your left foot should be stepped out far enough that you can do this without letting your left knee go past your left toes—if you can't, hop your left foot out a bit farther away from the bench.)
So if you’re doing abs exercises and you feel like your hip flexors are putting in more work, refocus and dial in on the muscles you’re trying to target. It might sound trite to just “think” about a muscle working as you’re doing an exercise (for example, thinking about your abs contracting as you do a sit-up), but it might actually prevent you from mindlessly grinding out reps with poor form.
^ Chou R, Loeser JD, Owens DK, Rosenquist RW, Atlas SJ, Baisden J, Carragee EJ, Grabois M, Murphy DR, Resnick DK, Stanos SP, Shaffer WO, Wall EM, American Pain Society Low Back Pain Guideline Panel (2009). "Interventional therapies, surgery, and interdisciplinary rehabilitation for low back pain: An evidence-based clinical practice guideline from the American Pain Society". Spine. 34 (10): 1066–77. doi:10.1097/BRS.0b013e3181a1390d. PMID 19363457.
MRI and x-ray for low back pain are surprisingly unreliable,1 because things like bulging discs usually aren’t a deal,2 most back pain goes away on its own,3 and trigger points (“muscle knots”) are common and can be alarmingly intense but aren’t dangerous.4 Most patients are much better off when they feel confident about these things. The power of justified, rational confidence is a huge factor in back pain.5 Sadly, many healthcare professionals continue to perpetuate the idea of fragile backs,6 which undermines that valuable confidence.
True numbness is not just a dead/heavy feeling (which is common, and caused even by minor muscular dysfunction in the area), but a significant or complete lack of sensitivity to touch. You have true numbness when you have patches of skin where you cannot feel light touch. Such areas might still be sensitive to pressure: you could feel a poke, but as if it was through a layer of rubber. Most people have experienced true numbness at the dentist. BACK TO TEXT
3. Tendinitis and bursitis Many tendons around the hip connect the muscles to the joint. These tendons can easily become inflamed if you overuse them or participate in strenuous activities. One of the most common causes of tendinitis at the hip joint, especially in runners, is iliotibial band syndrome — the iliotibial band is the thick span of tissue that runs from the outer rim of your pelvis to the outside of your knee.
Shingles (herpes zoster) is an acute infection of the nerves that supply sensation to the skin, generally at one or several spinal levels and on one side of the body (right or left). Patients with shingles usually have had chickenpox earlier in life. The herpes virus that causes chickenpox is believed to exist in a dormant state within the spinal nerve roots long after the chickenpox resolves. In people with shingles, this virus reactivates to cause infection along the sensory nerve, leading to nerve pain and usually an outbreak of shingles (tiny blisters on the same side of the body and at the same nerve level). The back pain in patients with shingles of the lumbar area can precede the skin rash by days. Successive crops of tiny blisters can appear for several days and clear with crusty inflammation in one to two weeks. Patients occasionally are left with a more chronic nerve pain (postherpetic neuralgia). Treatment can involve symptomatic relief with lotions, such as calamine, or medications, such as acyclovir (Zovirax), for the infection and pregabalin (Lyrica) or lidocaine (Lidoderm) patches for the pain.
I think you should mention that for some people, stretching is not the solution and that it will deteriorate their posture. Some people need stretching, but most people I know need to strengthen their "overstretched" hip flexors. Many people can't do a single hanging leg raise. Check this site if you want to know more about the importance of hip flexors ********** www.smarterpage.wixsite.com/unlock-
Prior to doing this, warm up to avoid overstretching a cold muscle. Great ways to warm up include jumping jacks, skipping, side-stepping, running in place, or any dynamic movements that mimic whatever sport you do. Given that this targets the lower half of your body, it's best to choose movements that will make the muscles in the groin and inner thigh areas warm and pliable.
Traction involves the use of weights and pulleys to apply constant or intermittent force to gradually “pull” the skeletal structure into better alignment. Some people experience pain relief while in traction, but that relief is usually temporary. Once traction is released the back pain tends to return. There is no evidence that traction provides any longterm benefits for people with low back pain.
The pain of back pain almost always makes it seem worse than it is. The most worrisome causes of back pain rarely cause severe pain, and many common problems (like slipped discs) are usually much less serious than people fear. Only about 1% of back pain is ominous, and even then it’s often still treatable. Most of the 1% are due to cancer, autoimmune disease, or spinal cord damage.
Sit in a chair with good lumbar support and proper position and height for the task. Keep shoulders back. Switch sitting positions often and periodically walk around the office or gently stretch muscles to relieve tension. A pillow or rolled-up towel placed behind the small of the back can provide some lumbar support. During prolonged periods of sitting, elevate feet on a low stool or a stack of books.
Moist heat may help relax your muscles. Put moist heat on the sore area for 10 to 15 minutes at a time before you do warm-up and stretching exercises. Moist heat includes heat patches or moist heating pads that you can buy at most drugstores, a wet washcloth or towel that has been heated in a microwave or the dryer, or a hot shower. Don’t use heat if you have swelling.
Degenerative disc disease. At birth, intervertebral discs are full of water and at their healthiest. As people age over time, discs lose hydration and wear down. As the disc loses hydration, it cannot resist forces as well, and transfers force to the disc wall that may develop tears and cause pain or weakening that can lead to a herniation. The disc can also collapse and contribute to stenosis.
Muscle Imbalances – The front of your hips, your hip flexors, are the muscles that will tighten and shorten while you are sitting for hours each day. While you are sitting, the back of your hips, your glutes and your hip extensors, are being overstretched. But just because they are being tightened and stretched respectively, doesn’t benefit either of them. They are also being weakened because of the lack of use of each muscle group.
Pregnancy commonly leads to low back pain by mechanically stressing the lumbar spine (changing the normal lumbar curvature) and by the positioning of the baby inside of the abdomen. Additionally, the effects of the female hormone estrogen and the ligament-loosening hormone relaxin may contribute to loosening of the ligaments and structures of the back. Pelvic-tilt exercises and stretches are often recommended for relieving this pain. Women are also recommended to maintain physical conditioning during pregnancy according to their doctors' advice. Natural labor can also cause low back pain.
Pain in the front of the joint—where the leg attaches to the trunk—is typically caused by hip joint problems. You may also feel pain associated with a hip injury in the lower part of your glutes and the top of the back of your thigh. Other symptoms include the inability to move the leg at the hip, inability to put weight on one leg due to pain at the hip, or swelling around the joint. As runners, you may also experience pain in the hipo joint only when running due to a hip injury.
Osteoarthritis. This condition results from wear and tear of the disc and facet joints. It causes pain, inflammation, instability, and stenosis to a variable degree, and can occur at a single level or multiple levels of the lower spine. Spinal osteoarthritis is associated with aging and is slowly progressive. It is also referred to as spondylosis or degenerative joint disease.
Start in a runner’s lunge with right leg forward, right knee over right ankle and back leg straight. Walk right foot over toward left hand, then drop right shin and thigh to the floor, making sure to keep right knee in line with right hip. Allow left leg to rest on the floor with top of left foot facing down. Take a moment to square your hips to the front of the room. Hold here, or hinge at hips and lower torso toward floor, allowing head to rest on forearms. Hold for at least 30 seconds, then repeat on opposite side. You want to feel a moderate stretch in the outside of the right thigh, but if this pose hurts your knees or feels too uncomfortable, stick with Thread the Needle.
Place a mini band around your ankles and spread your feet about shoulder-width apart. Keeping your legs relatively straight (you want the motion to come from your hips) and toes pointing forward, walk forward 10 steps, then backward 10 steps. Take a short break and then walk to the right 10 steps, then to the left 10 steps. Again, focus on keeping your legs straight and toes pointing forward.
Lumbar radiculopathy: Lumbar radiculopathy is nerve irritation that is caused by damage to the discs between the vertebrae. Damage to the disc occurs because of degeneration ("wear and tear") of the outer ring of the disc, traumatic injury, or both. As a result, the central softer portion of the disc can rupture (herniate) through the outer ring of the disc and abut the spinal cord or its nerves as they exit the bony spinal column. This rupture is what causes the commonly recognized "sciatica" pain of a herniated disc that shoots from the low back and buttock down the leg. Sciatica can be preceded by a history of localized low-back aching or it can follow a "popping" sensation and be accompanied by numbness and tingling. The pain commonly increases with movements at the waist and can increase with coughing or sneezing. In more severe instances, sciatica can be accompanied by incontinence of the bladder and/or bowels. The sciatica of lumbar radiculopathy typically affects only one side of the body, such as the left side or right side, and not both. Lumbar radiculopathy is suspected based on the above symptoms. Increased radiating pain when the lower extremity is lifted supports the diagnosis. Nerve testing (EMG/electromyogramspina bifida
How to do it: Loop a resistance band around your ankles and lie on your right side, supporting your upper body with your right hand and forearm. Extend both legs out, feet flexed. Brace your abs in tight and lift your top leg up to hip height, rotating your leg to turn your toes down to the floor, keeping tension on the band. Lift your leg slightly higher than hip height, pushing against band, with heel rotated up to the ceiling. Return to hip height. Repeat 20 times quickly and then switch sides.
How to: Get on your hands and knees, in a tabletop position (a). Slowly widen your knees out as far as they can go and bring your feet in line with your knees. Your shins should be parallel with one another (b). Flex your feet and ease yourself forward onto your forearms. (If the stretch is too intense, try putting your arms on a block or firm pillow.) Hold for eight to 12 breaths (c). If holding the stretch for longer, try slowly moving your hips forward and backward to bring the stretch to different parts of your hips.
Simply stand up straight with your feet about shoulder-width apart. Slowly bend your knees and hips, lowering yourself until your knees obscure your toes or you achieve a 90 degree angle. Hold for a count of 5 and then gently resume your original position. This can be a tough one so again, don’t overdo it and hold on to a table if you need a little extra support! Try to repeat between 5-10 times.
Osteoarthritis. This condition results from wear and tear of the disc and facet joints. It causes pain, inflammation, instability, and stenosis to a variable degree, and can occur at a single level or multiple levels of the lower spine. Spinal osteoarthritis is associated with aging and is slowly progressive. It is also referred to as spondylosis or degenerative joint disease.
Workers who experience acute low back pain as a result of a work injury may be asked by their employers to have x-rays.[102] As in other cases, testing is not indicated unless red flags are present.[102] An employer's concern about legal liability is not a medical indication and should not be used to justify medical testing when it is not indicated.[102] There should be no legal reason for encouraging people to have tests which a health care provider determines are not indicated.[102]
Management of low back pain depends on which of the three general categories is the cause: mechanical problems, non-mechanical problems, or referred pain.[52] For acute pain that is causing only mild to moderate problems, the goals are to restore normal function, return the individual to work, and minimize pain. The condition is normally not serious, resolves without much being done, and recovery is helped by attempting to return to normal activities as soon as possible within the limits of pain.[3] Providing individuals with coping skills through reassurance of these facts is useful in speeding recovery.[1] For those with sub-chronic or chronic low back pain, multidisciplinary treatment programs may help.[53] Initial management with non–medication based treatments is recommended, with NSAIDs used if these are not sufficiently effective.[6]
Transcutaneous electrical nerve stimulation (TENS) involves wearing a battery-powered device consisting of electrodes placed on the skin over the painful area that generate electrical impulses designed to block incoming pain signals from the peripheral nerves. The theory is that stimulating the nervous system can modify the perception of pain. Early studies of TENS suggested that it elevated levels of endorphins, the body’s natural pain-numbing chemicals. More recent studies, however, have produced mixed results on its effectiveness for providing relief from low back pain.
Here is how you do the hip rotation stretch: Sit on the floor with your knee out straight. Cross one leg over the other by placing your ankle on top of your knee (as if crossing your legs while sitting). Gently pull your knee across your body, and hold for five seconds. Then gently push the knee of the top leg away from you until a stretch is felt in your hip. Hold this position for five seconds, then slowly release. Repeat 10 times.
Nucleoplasty, also called plasma disc decompression (PDD), is a type of laser surgery that uses radiofrequency energy to treat people with low back pain associated with mildly herniated discs. Under x-ray guidance, a needle is inserted into the disc. A plasma laser device is then inserted into the needle and the tip is heated to 40-70 degrees Celsius, creating a field that vaporizes the tissue in the disc, reducing its size and relieving pressure on the nerves. Several channels may be made depending on how tissue needs to be removed to decompress the disc and nerve root.
Nerve irritation: The nerves of the lumbar spine can be irritated by mechanical pressure (impingement) by bone or other tissues, or from disease, anywhere along their paths -- from their roots at the spinal cord to the skin surface. These conditions include lumbar disc disease (radiculopathy), bony encroachment, and inflammation of the nerves caused by a viral infection (shingles). See descriptions of these conditions below.
Recurring back pain resulting from improper body mechanics is often preventable by avoiding movements that jolt or strain the back, maintaining correct posture, and lifting objects properly. Many work-related injuries are caused or aggravated by stressors such as heavy lifting, contact stress (repeated or constant contact between soft body tissue and a hard or sharp object), vibration, repetitive motion, and awkward posture. Using ergonomically designed furniture and equipment to protect the body from injury at home and in the workplace may reduce the risk of back injury.
People understandably assume that the worst back pain is the scariest. In fact, pain intensity is a poor indicator of back pain ominousness,10 and some of the worst causes are actually the least painful (especially in the early stages). For instance, someone could experience the symptoms of cauda equinae syndrome, and be in real danger of a serious and permanent injury to their spine, but have surprisingly little pain — even none at all in some cases!
The more than 20 muscles that make up your hips are responsible for stabilizing your pelvis, moving your legs from side to side, and shortening to draw your knees toward your chest every time you sit down, run, jump or pedal, explains Kelly Moore, a certified yoga instructor and co-founder of Mindfuel Wellness, which brings health and wellness initiatives to companies throughout Chicago.
Deanna is an ACE® certified personal trainer, Balanced Body® Pilates instructor, and NASM® Fitness Nutrition Specialist. She is passionate about inspiring others to lead a healthier lifestyle through fun workouts and healthy food. When she’s not creating new workouts and recipes for her blog The Live Fit Girls she enjoys running with her two dogs and traveling.