The Hip Joint: A Case for Mobility

Mobility at the hip is incredibly important. I can’t overstate how important mobility at the hip is for a healthy hip joint, as well as the surrounding body regions that it supports. So here it is again:

Mobility at the hip is incredibly important.

If you think of the body as a number of individual components that either “provide a lot of movement” or “provide a lot of support”, you already have the basis for understanding how different body parts work together to create better movement overall. The hip (a joint that provides a lot of movement) is right next to the lower back (above) and the knee (below) — both of these are things that should provide a lot of support.

When this concept holds true, your injury risk is lower because the demands of everyday life and activity are shared between tissues and body regions — there is no need to overload one joint in favour of another. Areas that move well, move well. Areas that provide support, provide support. But when injury and dysfunction is present this relationship often flips. Areas of movement become stiff and tight, and areas of support start moving more to pick up the slack!

For example: some forms of back pain occur while walking because mobility at the hip is limited — your hips are “too tight”, and they no longer swing like usual. In this scenario, in order to keep make up this lost of movement at the hip, you subconsciously arch your spine (lower back) a few extra degrees to lengthen your stride. Unfortunately, while this is an effective strategy in the short term, excessively arching your back repeatedly is a good way to create irritation, pain, and muscle spasm in the lower back. Oops, your lost mobility at the hip created a back issue.

So maybe just one more time, with feeling:

Mobility at the hip is incredibly important.

What is a hip joint

The hip is a ball and socket joint, which gives it the ability to move more freely than many other joints (like the knee). The anatomical components of the hip include the socket (acetabulum) and the head of the femur (your thigh bone). Though the hip joint is similar in design to the shoulder, the hip is built with much more inherent stability — the depth of the socket is much deeper — so dislocations are much less common unless significant trauma is also sustained.

Hip Joint (anterior with ligaments)

The actual joint location is also quite deep from the skin — ie. when you touch the outside of your ‘hip’ at the upper part of your thigh, you really aren’t close to the joint at all.

Is it really the hip joint causing my pain?

Pain in the hip can be significant, and present serious challenges for mobility that are limiting to a person’s day to day activities. This pain can be felt in a number of ways — most commonly as muscle tightness around the thigh and gluteals, stiffness into the back and pelvis, aching sensations into the thigh, and pain referral into the groin. Groin referral is one of the most classically reported sensations of true “hip joint” pain, but buttock pain should also be kept in mind.

Joint issues for older adults are most likely created from long-term use, or “wear and tear” through the years, while for younger individuals there is some evidence that high levels of activity (see competitive sports) through adolescence and early adulthood may contribute to joint changes as well, which can lead to some forms of discomfort.

However, there are a number of soft tissue structures surrounding the hip joint as well that can contribute to a person’s discomfort in the region.

Other things that hurt around a hip

If it’s not the hip joint creating pain and discomfort, a lot of other soft tissue structures around the joint can also contribute to a person’s symptoms. These structures are more common that the actual hip joint as pain generators for most patients.

For example, muscles (hamstrings, quadriceps, hip flexors, gluteals, etc.), tendons, connective tissues (like the IT band), bursae, and other soft tissues (like the numerous ligaments around the hip and pelvis) can all create pain and discomfort in the hip region when they are irritated. Usually these tissues create a more generalized ache or localized discomfort around the hip, but in some cases they are able to mimic joint pain (like the groin referral) as well.

Why do these irritations of other tissues occur? As discussed earlier, overloading of muscles, tendons, and other soft tissues secondary to a poorly functioning hip joint (or other body component) is usually the presumed cause of injury — like the example above about the poorly functioning hip creating lower back pain.

But good news! Most discomfort created by these issues are modifiable. That means working to improve your hip mobility will help to significantly decrease the pain and discomfort caused by most of these issues because there is less opportunity for poor mechanics and development of irritation.

So that’s where we focus next: on getting the hip joints moving. Next time.

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