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Tuesday, March 7, 2017

Why we roll our eyes when your "hip goes out."

I'll be honest, every time a patient tells me that one hip is higher than the other, or that their hip is "out," I have to force myself not to give the "oh my" eye roll. It usually tells me you have probably see someone for this complaint before and I'm usually cringing on the inside.

Let's be real...if something (hip, back, shoulder) was "out of place" then you probably shouldn't be seeing a chiropractor. For a joint to be out of place, out of it's normal juxtaposition, out of the confines of it's joint capsule, then that would mean that the joint would have been dislocated. This is PAINFUL and there is probably ligament and tendon damage. If this is the case you need to visit the ER or an orthopedic surgeon ASAP!

In most cases (there really are no absolutes), what a patient is experiencing when they feel that their "hip is out" and needs "popped" back in place is a one sided or a diffuse, constant nagging back ache that could possibly have some sciatica associated with it. This pain usually worsens with a prolonged activity (ie. sitting, standing, walking) and with a change in positions (ie, bending, going from sit to stand or stand to sit). So, what's the real issue? It depends! And, I know that is vague. But, everyone is different and everyone has different health histories and different brains that controls how they move!

When a joint becomes "sticky" and lacks in it's normal range of motion it is usually the result of a lack of proper movement mechanics or from your brain creating an abhorrent pattern of movement to avoid pain and instability. Some muscle and/or some movement pattern is not working correctly somewhere. It is therefore, placing abnormal stress upon the joint capsule causing it loose it's normal congruency and feel pinchy, painful or tight.  Does that mean that it needs to be "popped?" Maybe not. Maybe you need to stretch what is tight and strengthen what it weak to get out of the bad movement pattern.

When a patient tells me their "hip is out" usually the first thing I think is: probably not. And, I think that we as chiropractors need to educate our patient's better (gasp) so that you can truly understand what is going on with your body. Who knows...But, if you know to stretch what is tight and strengthen what is weak, and stop doing the activity and is throwing you off balance, you may not need to see anyone to put your hip back!

So, if we look at the key muscles that attach to the pelvis we have to realize they all have to stay in balance.

For all lower back issues we have to maintain a strong core (more on that later) and we have to keep all of the muscles in the lateral subsystem of the lower back in balance (see above). 

For example, if the quadratus lumborum on one side is super tight, it could be because the opposite side hip adductors are not functioning correctly.  Another example is that the quadratus lumborum has to be functioning to keep the pelvis suspended against the TFL and the adductors and the glute medius has to be working to give the TFL a break. 

The intricacies of this system and maintaining function of the pelvis is key to keeping that "out of alignment" feeling away. And this, of course, is not a definite solution. You could have an ankle dorsiflexion issue that could be playing into your pelvis feeling out of alignment

So, it depends!

The take home point: see a professional that will not only have a tool in their belt like chiropractic/manipulation to help with the joint dysfunction but that can also assess your movement patterns so that you can ultimately fix the issue and stop getting your "hip put back IN."

We are not your average back cracker. We want you MOVING BETTER and FEELING BETTER so that you can ENJOY LIFE unconditionally!  

-Dr. Elizabeth

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