This month, I’m focusing on a common problem that we treat here at Preferred Physical Therapy.
HIP PAIN!
Have YOU given up on finding a solution for your hip pain?
When a patient describes their pain as either:
A. “… pain radiating down the front of the leg.”
B. “… pain in front of the hip joint.” May also described as: “… pain along the front underwear line.”
Generally speaking, these complaints indicate problems originating in the patient’s hip.
In the case where the pain tends to radiate down the front of the leg, I insist on doing a thorough exam in order to rule out the possibility of the pain being generated from the back.
Pain felt at the front of the hip joint tends to be very painful when walking, flexing the hip, or getting up from a seated position.
It’s important to have your pain evaluated by your local Physical Therapist sooner rather than later, so you can get back to doing the things that you enjoy every day.
But why do hips hurt at the front of the hip joint? Or as some patients often describe it, “along the underwear line”? You may hear your doctor or Physical Therapist refer to these issues as “Anterior Hip Impingement”.
Today, I’m talking to you about the common musculoskeletal causes of this pain at the front of the hip.
Listen to some common misconceptions about hip pain. Click here.
Common Causes of Pain in the Front of the Hip
1. The Hyperactive Psoas
Now you may be thinking “what the heck does that mean?”.
Well, the psoas muscles (pronounced as so-as-) are the deepest muscles in your core.
The anchor from the front of your lower thoracic vertebrae down to your low back or lumbar vertebrae and then attach to femur or thigh bones. Without this muscle group, you wouldn’t even be able to get out of bed in the morning! They help to lift the leg (essential when climbing stairs) and also allow you to bend forward to bring your chest to the knees. Even more, they help with supporting our standing posture so we don’t flop backward.
When the muscles aren’t working, they should be able to relax. So when it’s in a hyperactive state, they pull the top of the femur forward, making it difficult for the femur to relax and not compress the socket. This is exactly the cause of the front hip pain!
When you begin to walk or do any other movements, the femur begins to migrate forward, impinging on the tissues, creating hip pain. This is where Physical Therapists derived the name “Anterior Hip Impingement”.
So, more often than not, when a patient is describing their pain as coming from the front of the hip joint, it is due to hyperactive psoas muscles. This can be treated with physical therapy.
2. Weak Glutes
The gluteal muscles are located on our backsides. The three main gluteal muscles include the gluteus maximus, gluteus medius, and gluteus minimus.
Together, these muscles help to move the thigh behind the body, move the leg to the side and turn the leg inward. They also support our upright posture when standing so we don’t flop forward.
For those of you who enjoy going on evening walks, weekend golf rounds with friends or even working out, these three muscles are essential to your ability to perform your favorite activities.
Patients that are experiencing pain at the front of the hip tend to have very tight front of thigh muscles, but very weak glutes. Commonly we see this is correlated with jobs that have us sit for long periods of time in the day.
This weakness can eventually lead to altered walking and movement and poor flexibility into hip extension. This is very treatable with a therapy program prescribed by a physical therapist.
3. Poor Posture
Posture plays an important role in preventing spine pain and headaches. Believe it or not, bad posture can lead to front hip pain as well. Many of us, unfortunately, have a tendency to slump forward when we stand, walk, or sit. This tends to put unnecessary strain on the muscles and other tissues that support our hips. Luckily, posture issues are something that is very treatable with physical therapy.
If you think one of these 3 causes explains your hip pain, just follow the link to make a Phone Call or a Discovery Session and let me know which one or ones you are concerned about.
If you want more urgent assistance, call in directly at 623-486-3333 and we will get you scheduled.
Dr, Nick’s greatest passion is seeing his patients recover from injury and return to their activities that bring them joy.
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