Often misunderstood, the hip joint in one of the most critical joints of the body and one of the most neglected. I regularly get patients in that say my hip hurts so my first question is to point to your hip. This is frequently met with a look of surprise suggesting that I don’t know where the hip is located but it amazes me what area of the body people consider their hip. Everywhere from the sacroiliac joint, crest of the ilium and greater trochanter ( sorry for the big words but I cant just call everything the hip).
The hip, also known as the acetabulum, is a large ball and socket joint connecting the pelvis with the leg. It is a synovial joint, (contains fluid) and is lined with cartilage and held together with thick fibrous ligaments. This articulation is generally strong with a good range of motion and not a common place for injury, unlike all the other “hip” areas. That being said it is not immune to stress and strain over the years and I feel is one of the major contributors to lower back pain.
Most of the movements of the hip are linear, meaning in a line. We walk we sit and some crazies even run for fun, all movements in a straight line. As mentioned previously the hip has good range of motion but after 50, 60 + years of the same linear motion the hip will adapt to what it has been doing over and over. Adding to just preforming linear motion we also have reduced our stride length and extension of our leg when walking. Also we never walk up stairs let alone take 2 stairs at a time.
We need to look at the muscles which cross the hip joint; thighs or quads, ham strings, adductors, abductors, glutes or butt muscles and a variety of other smaller muscles which control fine movement. All of these muscles perform individual movement and when only one linear motion is utilized over and over the other muscles kind of give up, you know the saying use it or lose it. These muscles become flaccid and tend to shorten, the ligaments which check motion will shorten in the direction of less use resulting in a limited range of motion.
With the hips not moving as they should the lower back or lumbar spine will compensate and frequently we over load the lower back with movement we should be getting form the hip joint, primarily rotation. The lower back isn’t the only victim of limited hip mobility, the knees and ankles are directly affected by what the hips do and I feel way too often knee surgery is avoidable by fixing what is going on at the hip.
So what can you do to improve your hip range health? First suggestion is stretch, if you don’t know what stretches just google hip stretching or take a yoga class 2 to 3 times a week. One of my favorite is what I call hip rotators, a simple exercise I HIGHLY recommend for golfers of all skill levels and for everyone else for that matter. Simply stand, weight on one foot, support yourself with the back of a chair, the wall or the top of a golf cart. Take the unsupported leg and swing it in front of you left to right but the key is to always point your toe to the direction of the swing. Swinging to the left turn the toe to the left as far as possible, swing to the right turn the toe to the right, maintain a steady rhythm, short swings at first and work up to larger and larger swings as your hips allow. 10 to 15 in each direction, rest and repeat a few times.
Since the hips are an integral part of your core ( I feel the pelvis is the core and not just the abdominal muscles, see “The Core”) special attention must me made to assure freedom of movement of the joints and all the involved muscles.