Hopefully you have all been following my newsletters and you will know my last ones have been on the foot and then the knee – so as the song goes
The knee bone’s connected to the thigh bone,
The thigh bone’s connected to the hip bone…
I will be talking about hips. Let’s be honest it is another joint we take for granted and most people know little about, the fact we can take it for granted comes from the astounding engineering and muscle structure which goes to construct the second largest joint in your body (as you will no doubt remember the knee is the largest).
The hip is a ball and socket joint (there are many different types of joint in your body) that allows a balance between motion and gives you the stability needed to bear body weight. The shoulder is also a ball and socket but sacrifices stability for flexibility, which is why shoulder problems tend to be more common.
The socket area (acetabulum) is inside the pelvis. The ball part of this joint is the top of the thighbone (femur). It joins with the acetabulum to form the hip joint.
Pain in the hip may be caused by injury to muscles, tendons, or the small fluid-filled sacs (bursae) that cushion and lubricate joints.
The hip is one of the most stable joints in the body, but because it bears your body weight, it is more likely to develop wear and tear (osteoarthritis) because of the extra pressure. The joints further up your body have less weight to carry so less likely to get wear and tear. Most of us will know of someone who has had hip problems or a replacement.
Generally the hip is the joint people think about when surgery is used, we find a large number of people who come with hip pain often ask within the first session “do I need surgery?”. There is a lot of options before surgery is required, and although the surgery is a fabulous and routine (for the surgeons!) operation I would still suggest trying all non operative options first, until the surgery is the best option for you. At present Andy Murray is doing an amazing job of advertising the benefits of hip surgery – but sadly most of us are not elite athletes so maybe don’t expect to revive your international sporting career!
If you do have a replacement this is what it looks like:
As humans we walk upright, and spend a lot of time sitting. Our hips have not quite caught up with our 21st century lifestyle, as ideally we would adopt a more gorilla like posture, which when we are in pain we tend towards. But, as that is frowned upon walking down the high street our muscles have to work quite hard so some irritation occasionally is not unusual. There is however a lot you can do to help maintain good hip mobility with some simple exercises and lifestyle changes.
Firstly watch your weight, I know not a nice one but put simply when you walk you put 3 times body weight through your hip, running is 7 times! So if you are carrying extra weight you add extra pressure. This can be a vicious circle as with hip pain, mobility can be difficult but it is worth trying to keep your weight down. Exercise is also a difficult way on its own to lose weight, to put in context if you run a mile its around 100 calories which is the same number of calories as an apple. So try to watch your diet.
Having said that exercise is a great way of maintaining mobility. Hopefully, a life long exercise program will help prevent the damage happening in the first place. But, if you are experiencing hip discomfort there are a number of exercises which will help everyone. These include dangling your leg off a step. Stand on your good leg on the edge of a step, so your affected leg is in mid air – our natural tendency is to hold it up, but try to let it dangle and under its own weight it will stretch out the muscles. A gentle swing would help too, but your are not a ballerina so a gentle swing only
Other exercises which can help can be found on our website
These are general exercises for your back but help your hip too. If however you struggle with the ones kneeling just do the 3 on page 3 with gentle movement of your hip.
Exercise in general can help and later on in the newsletter we have another offer from a Pilates teacher Louise, Pilates or yoga is an excellent way of maintaining strength and fitness.
Another thing that can help your hip is heat, if your hip is aching especially if you have pain on the outside of your leg it is possible your bursa (a little fluid filled sack) is irritated. The bursa loves a bit of warmth as this helps circulation so get a warm hot water bottle and put it over the outside of the hip – it feels lovely.
If your hip is aching at night you may want to try sleeping with a pillow between your knees if you side sleep, or under your knees if you sleep on your back. This takes the pressure off your hip and can ease things so you can sleep which really does help healing.
On occasion we also recommend, if appropriate the use of a stick or walking pole. I know a lot of people are reluctant to use one as they feel a stick makes them look old but I would argue walking badly without one is much more aging than walking well with one. The reasons for using the stick are numerous but simply they can help spread the load off the worn area, and often more importantly they can be a good brain train exercise to remind your body how to walk correctly – with this in mind, the final exercise which can be good is practice marching. So right arm and left leg move together and vice versa, this really does help co ordination and helps balance…Oh and you look younger!
Finally if you have hip pain please don’t suffer in silence or just think it is my age and I need surgery as there are an awful lot of steps which can be done to maximize the hip you have before you have to get a new one. Do not hesitate to contact us as we can help you find out what the problem is and what you can do about it, we can also discuss if we feel you need to be getting x rays and the best way forward.
And to finish off how about a sing song Dem bones Dem bones…