Conquering Hip Pain Part 2: Getting Relief
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In Part 1 of this article, you learned various conditions that can cause hip pain and how your symptoms can help you to recognize which condition is responsible for your particular hip problem.
In part 2, I will provide you with a simple plan to conquer your hip pain and return to normal activities as quickly as possible.
If you suspect your condition is more severe than a common overuse injury and most likely will not go away with simple home treatments, please seek professional help.
Conditions such as Avascular Necrosis of the hip, severe osteoarthritis, and labral tear most likely need to be addressed by an orthopedic specialist.
Although you can achieve some relief by doing the right things at home, these conditions will not resolve without medical intervention.
On the other hand, hip bursitis/tendinitis, piriformis syndrome, and sacroiliac joint inflammation frequently surrender to timely and appropriate treatment.
If you do everything right but the condition still gives you trouble, consider visiting a qualified physical therapist for guidance and treatment.
Before we delve deep into things to do, let's address the activities and exercises you should avoid to prevent exacerbating your current condition.
Activities and Exercises to Avoid When You Have Hip Pain
Knowing which activities can aggravate your hip pain is the first step in your rehabilitation plan.
Hip Osteoarthritis and Avascular Necrosis
High-impact exercises like
Running
Biking
Jumping
will worsen osteoarthritis and avascular necrosis.
Hip Bursitis and Tendinitis
For bursitis/tendinitis, avoid repetitive hip movements and prolonged standing.
Some exercises or movements can exacerbate the symptoms of hip bursitis.
Here are a few examples:
Running or walking on uneven surfaces. These activities can place extra stress on the hip joint and the surrounding muscles and tendons, leading to increased friction and inflammation of the bursae.
Excessive stair climbing or hill running. Both activities involve a high degree of hip flexion, which can lead to increased friction on the bursae and potentially exacerbate the symptoms of hip bursitis.
Leg lifts (especially lateral leg lifts). This exercise, if done too early in the rehabilitation program, can aggravate hip bursitis by putting strain on the bursae and the surrounding tendons.
Stretching hip abductors. Stretching the hip abductors (such as the gluteus medius and minimus) can aggravate hip bursitis if done too early, improperly, or excessively intensely.
Overstretching these muscles can increase tension on the tendons that attach near the bursa, potentially causing more irritation or inflammation.
Additionally, certain positions in stretching may put pressure on the bursa itself, which could cause discomfort or exacerbate the condition.
Cross-legged sitting or standing. These positions can place undue pressure on the bursae, leading to irritation and pain.
Certain yoga poses or Pilates exercises. Movements requiring extreme hip flexion, extension, or rotation can potentially strain the hip joint and exacerbate hip bursitis.
For example, yoga poses like the Pigeon Pose or the Warrior Poses could aggravate symptoms if performed incorrectly or excessively.
Once your hip is free of pain yoga might be a great addition to your workout program.
Piriformis Syndrome
If you have piriformis syndrome, sitting for extended periods or heavy lifting can cause more discomfort.
Certain activities and exercises can potentially aggravate piriformis syndrome. These typically involve movements that put significant strain on the piriformis muscle.
Here are some examples:
Deep Squats: Deep squatting, especially under heavy load, requires a significant hip rotation and can further strain the piriformis muscle.
Lunges: Similar to squats, lunges, particularly deep lunges or lunges under load, can also stress the piriformis.
Excessive Running or Stair Climbing: Both these activities involve repetitive hip extension and flexion, which can lead to overuse and irritation of the piriformis muscle, especially if done excessively or with poor form.
Prolonged Sitting: Although not an exercise, sitting for prolonged periods can tighten and irritate the piriformis muscle.
Certain Yoga Poses: Some yoga poses, such as pigeon pose or lotus pose, involve significant external rotation and flexion of the hip, which can put pressure on a tight or inflamed piriformis muscle.
Lotus Pose
Labral Tear
The following activities and exercises can exacerbate the symptoms of a labral tear.
High-Impact Activities: Sports or exercises that involve high impact or sudden direction changes can exacerbate a labral tear. These include running, jumping, or activities like soccer, football, and basketball.
Deep Squats or Lunges: These movements involve a high degree of hip flexion, which can increase stress on the labrum and potentially worsen symptoms.
Hip Rotation Movements: Certain exercises that involve extreme hip rotation, especially when weight bearing, can aggravate a labral tear. For example, some dance movements or yoga poses can potentially cause issues.
Heavy Lifting: Lifting heavy objects can put undue stress on the hip joint and, in turn, the labrum.
Please note that for healthy hip joints, muscles, and tendons, all the above activities may be fine.
Remember to start any exercise program slowly, always listening to your body for signs of potential injury.
Home Treatment Program for Hip Pain
Rest is crucial in all these conditions, giving the body time to heal.
It's best to avoid activities that trigger pain.
Heat and cold therapy can be beneficial.
Cold therapy helps reduce inflammation and is especially useful in the early stages of hip bursitis/tendinitis and after activities that aggravate your symptoms.
Heat therapy can help relax the muscles and may be better suited for managing osteoarthritis and piriformis syndrome.
Choosing the correct position to rest or sleep in can also impact your comfort. Sleep on your unaffected side with a pillow between your knees
As for returning to activities, it's crucial to start slow. Remember that you have to do exercises correctly and safely.
If you run into trouble, please seek the help of a physical therapist.
Rest. Continuing to exercise or engage in activities that provoke the symptoms will make the condition worse.
Cold Therapy. Applying cold therapy to the affected area can help reduce pain and inflammation. You can use a cold pack or ice wrapped in a towel, and apply it to the affected area for 15-20 minutes, several times a day.
PRO TIP:
Combination of heat and cold. This works well for pain caused by hip bursitis.
Position yourself on the unaffected side with a pillow between the knees.
Put a cold pack on the painful area and a hot pack on the inside of the affected thigh.
Treatment time 15-20 minutes
Electrical Stimulation. Using E-stim, such as TENS, IFC, or NMES in combination with cold/heat therapy can help relieve your hip pain. (To learn more about TENS and its benefits, click here; for a comprehensive review of other types of Electrical Stimulation, their benefits, and the usage parameters, click here)
When your pain decreases substantially you can start gentle
Range-of-motion Exercises
The next step, if still pain-free, is to start
Progressive Strengthening and Stabilization Exercises
Home Exercises for Hip Pain
You have to get your pain under control before engaging in an exercise program.
If you experience pain while exercising:
You are doing too many repetitions
You are not doing the exercise correctly
a) incorrect position
b) incorrect movement
c) pushing too far into the range of motion
You are not ready for the particular exercise
Incorrect exercise for your specific condition
Please seek help from a rehabilitation professional.
It is a good idea to write down your symptoms, treatments you have done so far, and positive and negative reactions to the activities and exercises
Many of the exercises that are done for hip pain rehab are also done in knee pain rehab protocol, sacroiliac joint rehab protocol, and core stabilization protocol.
The sequence of the exercises below follows the Four Phases of Injury Rehabilitation protocol:
Decrease/Eliminate Pain
Increase Mobility
Increase Strength and Stability
Increase Endurance and Aerobic Conditioning
Isometric hip strengthening is a great way to strengthen the hip if some soreness persists when performing an exercise through the full range of motion. Therefore I provide some isometric versions of exercises in addition to the main exercises.
FOAM ROLL - ILIOTIBIAL BAND - ITB
Courtesy of HEP2GO
To foam roll the ITB, lie on your side with the foam roller under your hip and roll back and forth along the ITB from hip to knee.
HAMSTRING STRETCH
Courtesy of HEP2GO
Lie on your back and place a stretching strap on your foot
Keep your other knee bent to minimize stress on your lower back
Lift your target leg until you feel the stretch in the back of your thigh
Pull on the strap to assist the stretch
Hold for 1-2 seconds
Repeat 10-12 times
Keep your target leg as straight as you can the entire time
If you find it too difficult it is allowed to bend your knee slightly
ILIOTIBIAL BAND (ITB) STRETCH
Courtesy of HEP2GO
Lay on your back.
Loop a belt around your foot.
Keeping the knee straight, bring your leg across the midline for a gentle stretch along your outer thigh.
Make sure that you make the muscles on the inside of your thigh do the work before assisting with the belt.
Hold the stretch for 2 seconds and bring the leg back down. Repeat 10-12 times.
HIP FLEXOR STRETCH
Courtesy of HEP2GO
Kneel on one knee with your other foot flat on the ground in front of you.
Slowly shift your weight forward, keeping your back straight and your front knee directly over your ankle.
Hold for 2 seconds
10-12 repetitions
PIRIFORMIS STRETCH - SUPINE
Courtesy of HEP2GO
Lie on your back with your knees bent and feet flat on the ground.
Cross your right ankle over your other knee, then gently pull your left knee towards your chest.
Hold for 2 seconds
10-12 repetitions
Repeat on the other side
SLR: STRAIGHT LEG RAISE - SLR
Courtesy of HEP2GO
While lying, raise your leg with a
straight knee. Keep the opposite knee bent with
the foot planted on the ground.
Hold 2 Seconds
Repeat 10 Times
HIP ABDUCTION - SIDE LYING
While lying on your side, slowly raise your top leg
Keep your knee straight
Keep the bottom leg bent to stabilize your body
Repeat 10-12 times
PRONE HIP EXTENSION
Courtesy of HEP2GO
While lying on your stomach. slowly raise your straight leg by contracting your buttock muscle and the hamstrings
Hold for 1-2 seconds
Repeat 10-12 times
Alternatively, keep your knee bent with the sole of your foot pointing up to the ceiling. This isolates your gluteal muscles
BRIDGE - BRIDGING
Courtesy of HEP2GO
While lying on your back with knees bent
Tighten your lower abdominal muscles
Squeeze your buttocks
Raise your buttocks off the floor/bed creating a "Bridge" with your body.
Hold 2 seconds and then lower yourself
Repeat 10-12 times
BRIDGING ELASTIC BAND ABDUCTION
Courtesy of HEP2GO
While lying on your back, place a resistance band around your knees and pull your knees apart
Hold this and then tighten your lower abdominal muscles, squeeze your buttocks, and raise your buttocks off the floor/bed as creating a "Bridge" with your body
10-12 repetitions
MEDICINE BALL BRIDGE
Courtesy of HEP2GO
While lying on your back with knees bent,
squeeze a medicine ball between your knees and raise
your buttocks off the floor/bed
You can find a medicine ball here
Perhaps the biggest obstacle to successfully rehabilitating any injury, including hip pain, is trying to rush the process. Therefore, I would like you to take the following to heart.
Healing Takes Time: The Importance of Respecting Pain
In our fast-paced world, many of us adopt a 'push through the pain' mentality. However, when dealing with musculoskeletal injuries or conditions like hip pain, this approach may lead to further damage and a longer recovery time.
Here's why it's crucial to respect the pain and give your body time to heal:
Pain is a Warning Signal:
Our bodies are incredibly intuitive. Pain is a signal from our body telling us that something is not right.
Ignoring the pain and continuing with activities that aggravate it can lead to more severe injury and chronic problems down the line.
Healing Requires Energy:
Healing is a complex process requiring much energy.
When you push through pain, your body has to divide its resources between performing the activity and healing the injured tissues, potentially slowing down the healing process.
Chronic Pain and Overuse Injuries:
Persistent, ignored pain can turn into a chronic problem.
Overuse injuries, common in the hip joint, occur over time when repetitive movements irritate a body part without allowing sufficient time for repair.
Risk of Compensation Injuries:
When we push through pain, we often change our movement patterns to avoid discomfort, leading to abnormal stresses on other body parts. This compensation can lead to additional injuries.
To foster healing, it's essential to listen to your body and rest when needed. It is wise to work closely with your healthcare provider or physical therapist to develop a graded, controlled recovery plan that respects your body's pain signals. The plan should include the gradual reintroduction of activities, ensuring you don't overload the healing tissues. Remember, healing is not a linear process, and setbacks are part of the journey. Be patient with yourself and respect the body's need for recovery.
Dealing with hip pain can be challenging, but with the correct knowledge and approach, it doesn't have to hold you back.
Understanding the source of your pain, practicing prevention, and employing the right home treatments can significantly improve your quality of life.
Remember, everyone's journey with hip pain is unique, and what works for one person may not work for another.
So, be patient with your body and celebrate small victories along the way.
As always, feel free to reach out for personalized advice and support.
Disclaimer
Although we strive to provide the most accurate information possible, please note that all of the content found on ReliefSolutions4you.com, including text, audio, video, and/or other formats are provided for informational purposes only. The content on ReliefSolutions4you.com is not a substitute for professional medical treatment, advice, and/or diagnosis. Always seek out the advice of a physician or other qualified health provider when seeking information for a medical condition or before engaging in physical training. The information on ReliefSolutions4you.com is not to be taken as medical advice. Always consult with your physician when starting a new physical training regimen and/or diet.
