Positive Motion Chiropractic provides expert chiropractic adjustments and hip joint manipulation to treat hip pain.
The ball-and-socket joint of the hip is the largest and strongest in the body. It is meant to withstand significant loading throughout a lifetime. However, there are a number of conditions that can lead to hip pain. Some of the hip pain issues we successfully treat at Positive Motion Chiropractic include:
- Tendinitis (aka tendonitis)
- Muscle Strains
- Snapping Hip Syndrome
- Hip Impingement (FAI)
- Hip Flexor Issues
- Sacroiliac Joint (SI Joint) Dysfunction
Causes of Hip Pain
There are many causes of pain in and around the hip joint. Some are degenerative in nature, while others are brought on by injury or overuse. Below we explain more about the most common types of hip pain and dysfunction:
Tendons connect muscles to bones throughout the body. “-itis” is a medical suffix which means “inflammation.” So “tendinitis” simply means “inflammation of a tendon.” When an MD, PT, or chiropractor gives a patient a diagnosis of tendinitis it is imperative that they also determine what caused the tendon to become inflamed. The easy part is saying it is inflamed. And it is never due to an Advil deficiency.
You see, tendons almost never become inflamed randomly. This point is critically important. The two most common causes of tendon inflammation are 1) overuse in an unconditioned tendon and 2) improper biomechanics putting stress on the tendon. We will explore both causes in more detail below.
Cause #1: Overuse of An Unconditioned Tendon
What does unconditioned tendon mean? Most tissues in the body – think bone, muscle, tendon – can adapt to increased use (or load) by increasing in size and strength. A tendon that is not strong enough for the loads imposed upon it is called “unconditioned.”
An example is someone in their fifties who is not a runner, but decides to challenge themselves to do a marathon in 6 months. Having not ran any more than a few hundred feet in the past couple of decades they get some new shoes and set out Saturday morning to do their first three miles.
They don’t follow a walk-run ramp up schedule. And they don’t take rest days. After three days of running they start to notice some nagging pain at their knees and Achilles. By the week mark they can’t run without a limp due to the pain. At day ten they are in the doctors office and are given a diagnosis of tendinitis.
Their patellar and Achilles tendons were perfectly happy with life as usual until this marathon resolution came along. And those tendons can adapt to the increased loads of running (yes, at any age) but not overnight.
Therefore, one cause of tendonitis is ramping up in training too quickly regardless of your fitness level. Indeed, even an Olympic gymnast who takes on a different and intense new workout routine could develop tendinitis.
Cause #2: Improper Biomechanics Stressing Tendon Tissue
Human biomechanics is the study of how we move. The body works to very tight tolerances in its movement. Subtle changes in strength, flexibility, and movement patterns overtime can lead to hip tendinitis.
Lack of strength in muscles is not usually in the ones we suspect. It is rarely in the big muscles we go to the gym to workout (ex: quads, hamstrings, glutes…). The weakness is almost always found in small joint stabilizing muscles.
If these stabilizing muscles are weak they allow faulty movement patterns. Repeated over and over these faulty movement patterns inflame tendons (tendinitis), muscles (muscle strains), and cartilage (arthritis).
People sometimes will stretch daily for months or years and not see much of an improvement in their flexibility. Stretching can feel like a Sisyphean task.
There is another cause of stiffness and inflexibility: myofascial adhesions. Fascia is the covering on top of all your body tissues. The fascia covering your muscles is called myofascia.
Myofascial can develop adhesions (think microscopic scar tissue) from three things:
- Trauma like sports injuries or a motor vehicle accident
- Repetitive motion injuries
- Postural stresses
When muscles around the hip have accumulated myofascial adhesions they promote altered biomechanics which can lead to hip tendinitis. Fortunately, after discovering them, correcting myofascial adhesions is relatively easy and painless.
Our expert sports chiropractors have advanced training and years of experience clearing myofascial adhesions in the hip region. This treatment restores lost flexibility, improves biomechanics, and reduces load on tendons thereby addressing a root cause of tendinitis pain.
Causes of Hip Flexors Issues
People can develop tightness and pain in their hip flexor muscles, namely their psoas and rectus femoris muscles. This can cause pain right at the front of the hip joint. At Positive Motion Chiropractic, to get lasting relief from this hip flexor tightness, we take a different approach.
Most MDs and PTs will tell their patients to foam roll and stretch their hip flexors. We commonly hear athletes who have been told this and after months of increased hip flexor stretching they continue in pain.
We don’t see hip flexor tightness as a fundamental lack of time spent stretching. In fact, throughout most of human history people did not do the type of prolonged static stretches or foam rolling so often recommended today.
That doesn’t mean there is not a place for stretching or foam rolling. But our expert sports chiropractors find that patients are way too frequently given stretching to calm tight muscles.
While stretching a tight muscle may seem to make sense, we look deeper. You see, muscles don’t work in isolation. They work as synergists and antagonists to each other.
For example the hip flexors muscles bring the hip forward into flexion. The antagonist muscles to the hip flexors are namely the gluteus maximus and the hamstrings, muscles that bring the hip backwards into extension.
Most of the athletes our sports chiropractors evaluate with hip flexor and snapping hip issues have inhibition or weakness of their hamstrings and/or gluteus maximus muscles. When the glutes and hamstrings are weak their antagonist muscles, the hip flexors, become overly tight.
Why do the hip flexors get more tight in this situation? Because the body tries to find stability across joints and when there isn’t a balance in strength across a joint then the body will increase the tone of some muscle to “guard” the joint.
We find that with some simple coaching on gluteal muscle activation and targeted strengthening of the glute and hamstrings that most hip flexor issues resolve fairly quickly. Most of the time without any need to stretch or foam roll the hip flexor muscles. When the root cause is address the hip flexor muscles are happy to go back to their normal tone and stop being inflamed.
Snapping Hip Syndrome
Related to the principle described above regarding hip flexor tightness, snapping hip syndrome is most commonly an over tightness of the psoas muscle (a hip flexor). The snapping comes from the psoas muscle/tendon snapping over the superior pubic rami (a bone on the front of the pelvis).
If it is not painful it usually is fine to continue with activity. If it becomes painful then we look to balance out the flexor and extensor muscle tone at the hip joint (as detailed above). Additionally, sacroiliac (SI) joint dysfunction (as described below) can cause asymmetrical loading on the hips and cause hip flexor guarding and so careful evaluation of the SI joints is vital.
Our sports chiropractor specialists are experts at evaluation and treatment of the sacroiliac and hip joint. Chiropractic adjustments and spinal manipulation are powerful tools in helping athletes regain full joint motion and pain-free function.
Causes of Hip Impingement / Femoroacetabular Impingement (FAI)
Hip impingement, or femoroacetabular impingement (FAI), occurs when the head of the femur (ball in the hip socket) rubs against the front (anterosuperior) portion of the hip socket, or acetabulum. When this rubbing occurs it can damage the cartilage at the acetabulum causing pain and inflammation.
There are two different types of FAI:
- One where the acetabulum (hip socket) is abnormally shaped, and another
- Where the head of the femur (ball) is more oval than round in shape.
The shape of the ball and socket contribute to FAI but participation in activities that involve significant and repetitive hip flexion is also causative. Examples of such sports include yoga, dance, and weight lifting.
Pain experience with FAI and hip impingement is sharp pain and stiffness noted in the front of the hip and groin region. It is made worse by bringing the thigh into full flexion, like bringing the knee towards the chest. Motions like riding a bike, tying shoes, and even sitting for prolonged periods of time can exacerbate the pain.
Diagnosis of hip impingement begins with the patients history and a targetted physical exam. Our expert sports chiropractors at Positive Motion Chiropractic have good success with mild and moderate cases of hip impingement and FAI.
If the patient is not responding positively to our chiropractic treatments within a few visits then we order x-rays to further assess the hip joint. Fortunately, most of the time we are able to decrease the patient’s hip pain quickly and there is no need for the cost and ionizing radiation of x-rays.
Trochanteric Bursitis as a Cause of Hip Pain
A bursa is a fluid filled sac which functions to reduce friction in areas of tissue gliding in the body. An example is tendon or muscle tissue gliding over bone. The bursa helps reduce the friction that could cause muscle pain and tendinitis.
When a bursa becomes inflamed, we call that condition bursitis. It is quite painful In the hip region we commonly see two bursa that can become inflamed: the trochanteric bursa and the iliopsoas bursa.
Trochanteric bursitis, also known as greater trochanteric pain syndrome (GTPS), is the most common. It causes pain at the lateral hip near the greater trochanter of the femur. The pain initially might be sharp. Over time the pain becomes more dull, but flares with certain hip movements like going down stairs. A patient can experience the pain when lying on the effected side in bed and when getting up from a chair.
Bursitis, as with tendinitis, comes about most commonly from altered biomechanics which many times come from joint fixations (SI joint mainly) and my-fascial adhesions not allowing proper tissue glide thereby overloading the bursa.
Through chiropractic adjustments to the hip and sacroiliac joints biomechanics normalizes in the pelvis and hip joints. Our sports chiropractic specialists also assess and treat the associated myofascial and muscle tissues with good results.
Treatment Options for Hip Pain
There are many methods for treating hip pain. At Positive Motion Chiropractic we believe that the most elegant solution is always the one that is simple, addresses the root cause, and is the least invasive.
Many people take drugs, get injections, and have surgery to deal with hip pain. These options come with great costs and risks. However, in some cases medications (ex: oral steroids, anti-inflammatories, pain medications), injections, and hip joint surgeries (ex: hip arthroplasty, labral repair, hip joint replacement, trochanteric bursitis surgery…) are the most appropriate treatment.
At Positive Motion Chiropractic we believe in utilizing these options only in emergencies or after trying more conservative alternatives that have failed to produce results.
At Positive Motion Chiropractic our treatment approach is simple and effective:
- Correct the underlying joint and/or muscle imbalances.
- Speed up tissue healing and reduce inflammation to give accelerated pain relief.
- Teach the patient how to reduce the chance of recurrence.
Utilizing this framework we provide rapid pain relief, fundamental joint and muscle changes to correct the root cause, and also help the patient avoid having to keep returning for care.
Here are some of the techniques and tools we use when we treat our professional and Olympic athlete patients. Guess what? They are the same techniques and tools we use with every one of our patients. (follow the links below to learn more about each type of treatment)
There are 210 bones in the human body and in-between them are joints. Just like the hinges on a door can get rusty and stuck, the same thing can happen with your joints (no, they don’t rust). When your joints become fixated and lose proper motion they become stiff, inflamed, and painful.
A chiropractic adjustment helps to restore normal motion back to your joints. There are many different ways to perform a chiropractic adjustment, including by hand and using an instrument called an Activator. Chiropractic adjustments utilizing an instrument don’t involve “cracking sounds” or twisting of the body.
Myofascial therapy, Graston, Fascial Distortion Model (FDM)
Muscle stabilize and move the bones of your body. Fascia, or myofascia, encases your muscles in a thin, yet tough covering. This slippery covering allows muscles, tendons, nerves, and other structures in your body to effortlessly glide over and past each other. But through trauma, repetitive motion injuries, and postural stresses, these fascial layers can become stuck to each other through adhesions (think microscopic scar tissue).
Without addressing these myofascial adhesions the movement restrictions and pain come back shortly after getting a chiropractic adjustment or massage. But by working on and getting rid of these myofascial adhesions we are able to restore normal motion and help create lasting improvement in a patient’s function.
We utilize various myofascial techniques, including Graston technique (an form of instrument assisted soft tissue mobilization or IASTM), FDM (Fascial Distortion Model) and cupping (static or with motion). These soft tissue therapies when directed at the right body tissues combined with specific chiropractic adjustments are core to the results we consistently see at Positive Motion Chiropractic.
Cold Laser Therapy
“My big race is in two weeks and I can’t run if my hip is feeling like this.” “The Nutcracker is opening in three weeks and I have to continue rehearse or I will lose my place.”
When patients need every chance to get back to 100% ASAP we have another tool at our disposal. We utilizes cold laser to help speed up metabolic rate, decrease inflammation, and help control pain levels. Athletes who don’t have any time to waste in getting back to 100% frequently use cold laser therapy in their treatment protocols.
Cold laser treatment is painless, takes around fifteen minutes per session, and is a great adjunct to chiropractic adjustments and soft tissue therapies like Graston.
The feet are the foundation of the body. Sometimes people have imbalances at their feet and arches that can lead to issues higher up in the body. Correcting dropped arches in the feet or asymmetries can have profound impacts on pain in other areas of the body. Utilizing advanced laser technology we look closely at the feet and arches in all patient cases to determine if they could be contributing to pain and limitations.
Targeted Rehab Exercises
A specific single muscle can be weak leading to imbalance and pain. It is rarely a large muscle group that we would think of working out at the gym (ex: quadriceps or biceps). Rather it is usually a stabilizing or balance muscle which is often overlooked. But weakness in a vital muscle can have devastating effects on posture, joint function, and balance.
At Positive Motion Chiropractic we don’t give our patients a page of generalized hip exercises. Who has the time for 30-60 minutes of home exercises per day? Instead, through our detailed and personalized assessment we determine if the patient has a specific muscle weakness and design a customized, targeted rehabilitation program for those individual weaknesses. Translation: tangible decrease in pain and physical limitations with minimal investment of time and effort.
Most people have seen a professional athlete sporting some colorful tape over a body part. Professional and Olympic athletes have been using Kinesio Tape or Rock Tape for years. In the last few years we have seen more recreational and non-athletes using Kinesio Tape.
Kinesio Tape has three main functions:
- Decreases localized inflammation
- Helps reduce pain
- Aids in the correction of motion patterns
We apply the Kinesio Tape on the patient during treatment, but also teach them or a family member how to use the tape so they can use it at home. Teach a person to fish…
If you got this far reading about causes and treatment options for hip pain you deserve to take the next step and get a world-class evaluation by our expert sports chiropractor. Schedule your appointment now using our real-time online schedule.