Thursday, April 17, 2014

It's all in the Hips

Part 1 of the Hip
Today's installment is about the hips. We hear a lot about back & knee pain, but many times it's the hips that cause and contribute to pain in those areas.  Here's what the National Institute of Neurological Disorders has to say about back pain; "Americans spend at least $50 billion each year on low back pain, the most common cause of job-related disability and a leading contributor to missed work. Back pain is the second most common neurological ailment in the United States — only headache is more common. Fortunately, most occurrences of low back pain go away within a few days. Others take much longer to resolve or lead to more serious conditions." 
The Hips are the linchpin of the lower half of our bodies, they help us move, dance, perform sporting activities and allow us to do daily living activities like bend over and pick up items. If we view our bodies as a moving chain, you could see how lack of movement in one area is sure to cause a increase in  movement in an area close by. There in lies the conundrum of modern life, for thousands of years our ancestors moved all day, seeking food, preparing shelter and defending those close to them. Fast forward to where we are today; where many of us travel hours for work, then spend the day siting at a work station-- many of those who exercise do so in a seated position on cable driven machines--and to top it off we go home and rest, once again in a seated position.

We Live in a flexion based society
Many of the problems we see in the clinical setting today have a element of muscle imbalance caused or contributed to by the summation of our daily activities. Our bodies are learning machines, they quickly adapt to what ever we expose them to, and in the case of the hip, if we leave it in a flexed position long enough(i.e. sitting) they tend to stay that way. When the hips can't move the compensation typically is the low back moving too much. This quickly overwhelms the low back which is designed for stability.

When Exercise Attacks
Postural imbalances can be worsened with our exercise routines. For those who strength train, there's a tendency to focus developing the muscles we see in the mirror. Those muscles are situated in the front of the body, the same bad influence we get from sitting is accentuated in many of our work out routines.  To add fuel to the fire, running-a constant state of falling forward-contributes to muscle imbalances of the hip. 
Ask me how many runners I treat for knee pain...

What do we do now?
There's a renaissance occurring in rehabilitation, as clinicians we are looking for the weak link as opposed to to simply treating the source of pain. Marvelous movement screens have been developed to detect these postural disturbances.  I use this type of analysis more than orthopedic testing with miraculous results. None of my patients with low back or knee pain leave without corrective exercise strategies to address "the hidden problem".  What I try and get across to them, and hopefully you, is that these problems are a culmination of everything we do.  If lasting relief of an injury or pain is expected, modification of lifestyle AND activity need to be addressed on a semi regular basis. 
Tune in next time for some of my favorite strategies and corrective exercise moves, from the leaders of this renaissance movement. These activities have become a game changer in my personal and professional life.  
^^Now, don't be this guy. ^^
Consider what you can do to make a difference in how you move today-a simple idea such as replacing your office chair with a standing station or kneeling chair, but more of that in our next post. 






 Thanks so much for reading and if you think someone you know can benefit from this post, please share!
Dr. Gene Serafim

Dr. Serafim is a Rehabilitation and a Strength and Conditioning Specialist. He lives and works in the Exton PA area and has devoted himself to furthering his understanding of movement related disorders. He teaches continuing education and operates a private practice. More information can be found at Kinetx.org and feel free to like us at our facebook page.

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