Novel Exercises For Hip Pain

To understand hip pain is to understand your hips and what they are doing inside your body. What makes this tricky is that painful hips are often the result of imbalance wherein the symmetry of two “equal” halves that make one whole unit is “off.”  What is hard to discern, even with x-rays, is the nature of the imbalance because hips can be thrown off for multiple reasons in multiple directions. They can be crooked vertically, horizontally and/or rotationally wherein: 

1. One is higher than the other.
2. One is more forward or back than the other.
3. One is rolling inside the socket more internally or externally than the other.

This variability can create significant strengths and weaknesses that depend on where, and how, the hips are out of whack. Remember, pain is commonly the result of weakness or tightness or some combination thereof. This results in muscles overworking (tight) or underworking (weak) which leads to more pain. Left unchecked, this cycle can devolve into one where your muscle or group of muscles are doing nothing while others try to pick up the slack and do everything.

This leads to more pain created by patterns we want to reverse.

So, first, we must get a handle on what is underworking and what is overworking. To do this, using your hands simply touch the muscles in your legs and “test” them. The best position to do this is lying on your back with knees bent and feet flat on the floor. Very often you will find muscles that don’t contract much independently, if at all. This is the starting place. You must get the flaccid muscles innervated again.

Second, once they are back "on," you’re ready to start moving. Simple moves will do, but you still need to touch the muscles to make sure they stay on and active through movement. In this process, as you discover the muscles that have stopped working, you will also notice muscles that are overly engaged, trying to compensate for those that are not participating. 

Most people benefit from PT in these cases, but many don’t because PT assumes that if you are moving, the muscles are working. But, this is not so. Sometimes, depending on your history of injury and surgery or inactivity, when pain doesn’t resolve, you very likely need "pre-PT."

This means you test your muscles around your pelvis and legs to find those that have given up so that you can re-wire them back into the fold before you start moving.

Start with big muscles:

Glutes - You want to feel for contractions on the side of your hip, the top, meaty part of your butt, and at the bottom, right underneath your butt cheeks. Do them separately.

Hamstrings - Palm the large part of the muscle and contract it. Sometimes it helps to put a band against it so you have something to push against. 

Adductors - Wrap your hand around the inner leg/thigh and squeeze the muscle. It is easiest to find this if you cross your leg and make a figure 4.

Quads - Place your hand at the top, near your hip flexor and then in the middle around the fullest part of the quad and push down through your foot to activate the muscles. 

Lower back - Slide your hand under your back and try just to squeeze the muscles above your hip bones and below your bottom ribs... nothing else!

At first, you will most probably feel nothing happening - where your hand is. You will however feel a lot of other areas engage in an effort to try to move the muscle that is snoozing. Stay with it. Eventually, you will feel the slightest awareness wake up the muscle, and then, gradually, you will feel the contractions develop more power each time you try.

After focusing on the big muscles, you can move to smaller muscles around the knees, pelvic floor and hip bones. They can be elusive at first, but as you practice you will find them and figure out how to activate them as they respond to the cues received by the touch of your hand. 

Once you get the muscles back on, then start moving; then start coordinating movement with surrounding muscles; then start loading it with weight to strengthen them.

As you progress, the overworked muscles will start to back off and release, at which point you want to make sure you're stretching them to be sure you're loosening what's tight as you strengthen what's weak.

You may also enjoy reading, Muscles Present A Curious Dichotomy That Can Inform Your Exercise Routine.