Hip issues

[tmathis]

My right hip has bothered me for a couple of years now. It only bothers me especially when I run, but also causes some pain if I deadlift or squat heavy.

The pain seems muscular rather than in the joint. When it hurts it is usually in the upper right part of my glute and over on the side as well. I had a PT do some SI manipulation, and he gave me some exercises such as a piriformis stretch but it does not seem to help.

I have a feeling it due to a muscle imbalance but I am not real sure what to do. I also spend a lot of time in my car and I have wondered if all that riding could contribute to the problem.

Any ideas?

[bryanc]

I think more information is probably required here.

[UConnJulie]

Yes, please read the sticky at the top of the sub-forum and answer the questions.

[tmathis]

Sorry for the lack of detail....that was my first post on the forum. I read the sticky after I posted. So here goes:

1. When did the pain begin? about 4 years ago. I noticed after running but I think it may have resulted from a pull in my hip I suffered while contorting to clean out my van. After the pull it felt like my right hip was somewhat elevated for a couple of days. It went away, but it was not long after that that I got pain from running.

I stopped running as a result...but now if I run it comes back. I will sometimes bother me doing squats or deadlifts, but typically only if I get heavy.

3. Where, anatomically, is the pain? the right hip girdle, but it is usually localized in the upper part of my glute and sometimes can travel over to the side (I think that is the gl. medius).

I do notice that after the exercises that aggravate my right hammy will be tight as well.

4. What does the pain feel like? Sharp? Dull? Aching? Stabbing? Shooting? It is usually soreness and aching, but it feels more muscular than joint related.

5. Is the pain constant, or intermittent, or only on certain motions?

constant when it begins but then can be intermittant if I stand for long periods.

7. What, if anything, makes your pain better? rest..and I will try to massage the area...sometimes stretching can help somewhat.

9. What things could you do before, that you cannot do now because of your injury? my ROM in my squats or hip area don't seem limited.

10. What is your main concern regarding the pain and its consequences? it's so chronic and can delay training at times.

12. Is your pain getting worse over time? And if so, how much worse over what time period? it will get worse if I don't provide sufficient rest days between training.

If I were to guess at what is happening based on recent reading...it would not surprise me if I had a muscle imbalance in my hip. I have thought about hitting a four week program where I do unilateral works for my legs. I would not doubt if I have some type of pelvic tilt discrepancy.

[UConnJulie]

It also could be referred from your lower back, that is a common referral pattern that you describe. Might be good to be evaluated by a competent sports medicine doc and/or therapist.

[Leigh P.]

Few questions...

-Do you find it is aggravated by long periods of sitting?
-Are you tight at all in your adductor's?
-do you cross your legs for extended periods of time?

It certainly sounds like you have a muscle imbalance and some postural distortion issues. Do you have a planned stretch program or is it a little of this, little of that?

[tmathis]

-Do you find it is aggravated by long periods of sitting? yes...I drive a lot so I am in my car at least half the day.

-Are you tight at all in your adductor's? I don't think so. If anything my hamstrings can get a little tight at times.

-do you cross your legs for extended periods of time? no

It certainly sounds like you have a muscle imbalance and some postural distortion issues. Do you have a planned stretch program or is it a little of this, little of that? a little of this and a little of that except I do a hip flexor stretch (the lunge) before I workout, and almost always do a prone piriformis stretch at the end.

[Leigh P.]

As always I recommend seeing a specialist, however from this base info...

It seems like you have a ANTERIOR PELVIC TILT Distortion and maybe even a LATERAL PELVIC TILT Distortion. I find also when this occurs it can also mean there are lower postural distortions as well being that it all creates and contributes to balance or lack there of.

The good news is that even though chronic these distortions could be easily managed or even repaired with the right program. The key though is to treat it no different then you would your lifting routine as far as planning and designing your program. Basically make its importance a priority.

I would do the following...

-Really focus on dynamic warm ups and specific warm ups pre-lifting, especially when doing any lower body work. Also I agree with your idea of unilateral work particularly contralateral DB Deadlifts and 1 Legged Squats.

-Design a plan for 5-6 days a week where you have an intensive repair session. Rotate days between SMR work with foam rollers and static stretches. If can include some band work with those static stretches as well.

-Post lifting go right into your stretch program (with re-feed shake/meal in hand of course This is the most crucial time for repair, plus your muscles are nice and warmed and prime for stretch and deep tissue work.

[tmathis]

This is great! Thanks. Because I do sit in my car alot, are there any proper posture for driving.

[Leigh P.]

Try to adjust the seat to best support your spine and neck, fitting right in the curves.

Another good way to "check" yourself is to slouch over the steering, slide yourself back starting with your glutes, now raise up keeping your hand 10 and 2 for support and then extend your feet into need driving postion. If you are to crowded you need to take your seat back a little, if you can't reach the pedals you need to bring your seat forward. Move the seat, not the body. This may feel awkard and weird, you may get irritation and be uncomfortable from seating properly, but it adjusts very quickly.

[tmathis]

Thanks again for all the replies private and public. Here's an update. This might be a bit premature, but I have really worked on the anterior pelvic tilt. I looked in the mirror and realized I had serious anterior tilt. I began just working on adjusting my posture, foam rolling (per the t-nation article "Hips Don't Lie), unilateral leg work, and static stretching. I spend a lot of time in my car, so at my office day yesterday I made a makeshift stand up desk and stood most of the day.

I have a 4 wk program coming up where I plan on doing a lot more unilateral leg work and sumo deadlifts.

So far things have been improving quicker than expected. I even did the "300" workout yesterday and felt no pain in my hip today.

Thanks, and I will try to post another update 4 weeks from now.