Who Get’s Hip Pain?
Hip pain is a common problem for both ultra active people and sedentary people. It is the extremes of living at both ends of the activity spectrum that gets us into trouble with hip pain.
Chronic pain is a sign that there is irritation or injury at a site. There are a multitude of conditions that can cause hip pain, from trochanteric bursitis to osteoarthritis. The great news is that movement is the solution for many of these conditions.
When I have personal training clients with hip pain I often see that they are overly active/run/ walk/bike 40 miles a week or more, or are living a sedentary lifestyle sitting for many hours at a time. It’s hard not to be sedentary a lot of the time in today’s world. As I sit here and type this newsletter, I am sedentary. My hips are folded and collapsed as I slightly round my lower back and hunch my shoulders forward to type. If I were to stay in this position like many office workers do for extended periods of time, I could expect hip pain, and back pain to eventually creep into my daily life.
I once had hip pain so excruciating that I had given up all activity except light stretching for several weeks and then finally more movement based training as the inflammation subsided.
Though chronic hip pain is frequently improved through movement training, other causes of hip pain can be caused by serious injury. Make sure you see a doctor first if the pain is substantial.
Three Common Causes of Hip Pain
1) Chronic Sitting
The average American sits 13 hours a day. This staggering amount of inactivity causes an imbalance of the hip musculature. The hip flexors remain in a shortened position, while the glutes and deep hip rotators remain elongated. Add to that chronic dehydration and the result is tissue that more closely resembles beef jerky than healthy muscle tissue.
This tissue lacks the necessary flexibility and elasticity to allow for smooth and efficient movement. It tears more easily and becomes overstressed more easily, and the rigidity of the tissue leads to more rubbing against bone and bursae.
2) Strength Imbalance
A strength imbalance is not the same as tightness or in-elasticity. A strength imbalance occurs most often when one’s exercise regimen is consistent and unvaried. Runners are an excellent example of this type of athlete. Whether running 12 miles a week or 45 miles per week, runners often feel like they don’t need more or different exercise. The repetition of the same movement without variation builds strength in some muscles, while neglecting others. This imbalance puts an unnatural amount of strain on those muscles, resulting in overuse injury.
3) Skeletal Imbalance
Skeletal imbalance refers to the uneven stature or movement pattern that many people demonstrate, which can be caused by so many things, including old injuries and leg-length discrepancies. When movements are not even or balanced bilaterally, one side will be the victim of added pressure, tissue friction or workload. These clients often fall victim to conditions such as bursitis or piriformis syndrome.
Fortunately, the fix for many of these hip issues can be found in the right movements.
Fix: Mobility
The best fix for immobility is mobility. Focus on improving range of motion of the hip flexors and hip rotators with gentle dynamic movement. For example, bodyweight squat and lunges.
| You | Bodyweight Squat Variation | Bodyweight Lunge Variation | Bodyweight Deep Hip Opener |
| Healthy and strong | Wide, deep squat | Walking lunges | Walking lunge with contralateral Rotation |
| Healthy intermediate | Wide squat | Walking lunges or split-stance squat | Suspension trainer deep squats |
| New or older exerciser | Suspension trainer and/or box squat | Modified split-stance squat | Body-weight deadlift |
| Injured exerciser | Pain-free: suspension trainer and/or box squat | Pain-free:
split-stance squat |
Pain-free:
Body-weight deadlift |
Fix: Elasticity
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In my personal training business I aim to improve the elasticity of that beef jerky-like tissue by giving my clients stretching homework as well as weight loaded exercises to do daily between sedentary periods of time. Two to three hours of movement each week is not enough to undo 100+ hours of inactivity each week. My homework assignment for clients often looks like this:
| Daily | Static stretch shortened muscle tissue for more than 60 seconds at least once daily. |
| Hourly | Stand up and perform 10 bodyweight squats or chair sits every hour to get the muscles working and moving. |
| Nutrition | Drink water all day. If you are well-hydrated, the hourly movement will pull water into the muscles, turning the jerky back into elastic tissue. |
Fix: Strength
I like to tell my clients not to underestimate the importance of pure strength. Improving the overall strength of various types of lifts and squats can be a great contributor to regaining skeletal balance and achieving strength balance. Getting back to basics is often the best medicine. I believe that strong is good. And I also believe that contrary to some movement professionals that machine weights vs free weight/ body weight exercises can be tremendously helpful in conditioning the muscles to move in various planes safely while increasing the strength of the muscles and joints.
With any injury, use pain as your guide. If a movement hurts, don’t continue. And realize that sometimes small aches and pains do subside as you continue in a movement. If you are ever unsure, just give me a call, email or text and I’d be happy to help you make sense of it.
All My Best,
Kim