Hip Pain. Now what?

Discussion in 'Ask the Docs' started by Jaqa, Mar 14, 2016.

  1. Jaqa

    Jaqa
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    Hi BF's!

    I hope someone can help me here. I have developed a hip pain in the last few weeks and yesterday it flared up quite big.

    It is at the back of the hip joint right on the bone. When I press into it I feel no muscle there, just bone and it is not sore at all pressing very hard into it.

    I went for a 2:45 trail run yesterday, just slow and working on technique. Wearing my brilliant Inov8 TrailRoc 235's. I started off feeling sore in the left hip and was questioning my decision to run. After 20 minuntes my left glute started cramping at the top of the muscle (waist band height). I was really concentrating on my lower core muscles to ease the pressure off my hips. Seemed to work but maybe it was just transference of concentration? Pain then moved into the inside of my left knee and then right calf. Other muscles compensating. After 1:30 , the pains eased and I was pretty pleased to finish the run quite well. But last night walked 5km with my girlfriend and it felt really sore at the beginning.

    Some background- I run barefoot during the week and am now at 1hour/10km no problem and loving it. Also do 1 barefoot track session/week, some weights based on Jason Robillard's books, 2 to 3 barefoot runs, including hill sprints and swim at least 3 times. My stretching is erratic though. Actively NOT stretching really helped me recover from injuries from shod running last year, but I do try to do "salute to the sun" yoga sequence in the morning, followed by scissors, glute activation exercises, some planks and very occasionally those exercises from "The Cool Impossible" . But usually its no stretching and I just warm up running. My cadence is 86-90 barefoot and 80-85 wearing zero drop Trailroc 235.

    So what could it be? I have googled it and the prognosis all looks pretty bad. But it does not feel that bad usually?!

    PS loving barefoot running especially here in Singapore, the best city in the world to barefoot- clean, perfect pavements and year round good weather. If you are ever in town for, give a shout and we can go for a run. Singapore Botanical Gardens are fantastic for barefooting.
     
  2. Dr Emily Splichal

    Dr Emily Splichal
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    Hello and thank you for your question. Seems very odd that you can press into the 'back of your hip joint' as we are all supposed to have muscle there. If you can feel an indent in the back of your hips / glutes then that is a sign of an anterior shift in your femoral head.

    In this case you are going to have a delay in stabilization when contacting the ground.

    What i recommend for patients with this is the following exercises:

    - foam roll / inhibit TFL and anterior hip muscles
    - posterior hip mobilization with a monster band - video is
    - pelvic floor activation with breathing - video is
    - lock it in with short foot - video is

    I would integrate these exercises everyday and be very cognizant of the way your postural alignment is and if you are perhaps "butt gripping".

    Any questions let me know!
     
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  3. Jaqa

    Jaqa
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    Thank you very much for that Doctor Emily!

    I think what you have suggested might help a lot. First video seems a kind of pigeon yoga pose which I already do. Second video is spot on as my bottom ribcage protrudes quite a bit and I do have a sway/hollow back. Third video is very interesting as my arches are feeling slightly tender but I thought that was just because I have upped my milage and ran barefoot last Saturday along an old railway line with lots of that sharp railway gravel. Interesting how things are connected.
    After a fast 12km/1 hour barefoot run yesterday I am definitely feeling stiffness/tenderness in my, what I now call my pelvic basin, (if you think as my hipjoints as the rim and a dish suspended in that cradle!).
    The usual hip flexor excercises do not seem to work those sore muscles at all.
    Just to clarify, when I press on my hip joint from the back, I am coming in from underneath, ie below the Glutes.

    Thank you once again!
     
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  4. Jaqa

    Jaqa
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    Just some feedback on the above-
    I have no pain there anymore, unless I work those muscles (see below)

    What has helped is-
    1.Pigeon pose, 1st video above, after running. I roll my hip around while in the pose until I find the position that "works" the muscle the most. This seems to vary day to day.
    2. Clams and a straight leg variation where I move the top leg out the way, towards my chest, and lift my lower leg up, and hold.
    3. After #2 above seemed easy, I have now progressed to a side plank with top leg on a chair. Lift my bottom leg to underside of chair and hold. Currently doing 3x10 seconds each side after runs. This really works at the spot where the pain was.
    4. I have been "told" 3 times in the last few weeks, including by Dr Emily Splichal above, that I try to straighten my back by arching my back backwards so my chest protrudes more than it should. Really concentrating while I run and walk to tuck my lower chest in and move my pelvis back. Kinda like doing a crunch while running. Also, a mental picture from Barefoot Ken Bob, to hang like a marionette from the top of my head has helped a lot. Added benefit is I bend my knees more and my lower body is looser while I run.
     
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  5. migangelo

    migangelo
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    Jaqa,

    The picture you painted of arching your back to make your chest stick out gives me thoughts of Kim K, Jenn Selter, and other Instagram models. Don't do that.

    Watch Dr. Splichal's video again. She's laying with her back flat on the floor. You can also do this leaning on the wall, you just have to pay more attention to how it's done. If you lay flat on your back with your feet on a chair, you can lift them slightly to engage your core. That should give you what she's talking about in the video.

    If it's still confusing invest in the right professional to give you some help. Things are always lost online and in videos.

    good luck,
     

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  6. Jaqa

    Jaqa
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    Hi migangelo
    I think you have misunderstood me, my bad writing! My problem is that I am sticking out my chest to much. (Trying to lengthen my back from the front, if that makes sense) I am now working on straightening my back from the back. Which, for me, means tucking in my lower chest and pelvis by crunching/engaging my core. Hope that makes sense?
    Years of rowing in High School and University has affected my posture.
     
  7. migangelo

    migangelo
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    isn't it amazing we speak the same language yet interpret different things? I got a picture in my mind of you arching your back like a dolphin! Now what you said makes a bit more sense. I'm about to make a post that shows proper breathing from a different person. They say the same things yet slightly different. I believe it's good to hear from different people because you never know when it will click.
     

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  8. Jaqa

    Jaqa
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    Very true!
    When I write here my brain is in BF running mode which for me, is a lot of mental images and phrases that I use while I run. It make sense to me, and probably only me....
     

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