While hip replacement is common among the elderly, unfortunately, I see many younger individuals in my practice with hip issues that can potentially end with surgery. Hip pain and hip surgery can easily be avoided if attended to early enough and unfortunately the more common sedentary lifestyle is a heavy contributor. In this blog we will discuss pain in the hips, what hip pain feels like, if hip pain can cause back pain, what hip pain treatment is like without surgery, and how to prevent hip pain, after all at the end of the day, it is easier to prevent a problem than it is to fix it.

Pain in the Hips

To understand your pain and what’s causing it, it helps to know what the hip joint looks like, how it functions and the structures involved that contribute to hip pain.

The hip joint is a ball and socket joint! That means the end of your thigh bone (femur), looks like a ball and that ball sits inside of a socket that is part of the pelvis. This can be seen in the image to the right.

This ball and socket joint are layered with soft tissues such as ligaments, tendons, nerves, and muscles. In a healthy situation, the ball is able to move within the socket in every direction without causing any issues. Any imbalance in the surrounding soft tissue often leads to the jamming of the joint, thus interfering with the movement of the ball inside the socket and causing symptoms. The alignment of the pelvis is also important to a healthy hip joint. If the pelvis is not aligned this directly impacts how the ball will sit inside the socket. 

You have to understand that this shift takes place over time and creates what is referred to as pathological patterns of movement. A movement that happens but not based on the design of the movement (biological pattern) for that area. Imagine if instead of free moving wheels on a cart, one has a glitch and over time, not only the pushing of the cart becomes difficult but that wheel ends up breaking and causing the whole cart to be discarded!

Misalignment and soft tissue imbalance are the two things that essentially result in hip pain and the majority of all chronic issues for that matter. Unless you experienced some direct trauma to this area, you may be wondering what is causing your misalignment and imbalance.

What causes hip pain?

Other than an actual pathology, a disease, causing deterioration of the hip joint, the most common cause of hip disintegration is in fact the misalignment of the ball inside the socket.

In medical/chiropractic schools, they teach us that arthritis is a byproduct of aging and I am here to tell you that I full-heartedly DISAGREE!! It is an absolute end result of improper alignment. If there is a door that is hanging on its frame crooked and is being used regularly, it is fair to say that the parts of it hitting the jam are going to show signs of wear. The same door, if sitting on its frame straight will simply show the aged wood and no signs of wear.

The point here is that arthritis, the inflammation of the joint, the destruction of the bones and cartilage, happens as a result of misalignment and not age. After all, how is it that one hip wears out more than the other?!! They are both the same age, yet you almost always see arthritic changes on just one side or one side significantly more. So what is the reason for this? 

In this society, people are sitting more now than ever before. Our bodies are designed to function in movement following a specific pattern and this movement pattern is disrupted when we deviate from how we are designed to function. Prolonged sitting, especially behind a computer can result in hip pain for the following reasons:

• Postural decline
• Poor Ergonomics
• Muscular Imbalance 
• Decreased Stabilization 

Let’s do a quick assessment and evaluation of sitting for an extended length of time and how that may contribute to the hip malfunction: When sitting, there is an over contraction of the quads, thus shortening of that muscle while weakening of the lower abdominals both of which play a role with the pelvis alignment. Additionally, being behind a computer for so long negatively impacts the part of the brain that signals the body to be upright against gravity and so over time it is easier to slouch than to sustain the upright position. When you slouch you do not breathe properly (because the abdominal diaphragm is being compressed) which means you cannot properly stabilize yourself because your entire stabilizing system is being compressed. If your stabilizing system is not doing its job then something else has to pick up that task. The hip joint is forced to carry a heavier load and so many of what was designed to be the job of the torso becomes the job of the lower extremity with the hip being the big player. Maybe your chair is not set at the correct height so your feet are not touching the floor. This pulls your lower body forward, which will result in an excessive curvature in your lower back, directly impacting the integrity of the hip joint. This can go on and on and is just one simple scenario. You can see how your posture and lifestyle play a huge role in your joint mobility and health.

Hip Pain Treatment Without Surgery

Regardless of what your functional decline looks like, one thing we know for sure is that every baby in the world regardless of race or gender develops movement following specific patterns that we are born with. Developmental Kinesiology is the exact blueprint of these movements which is then applied to the person’s ability to move with proper function. Any deviation from the design is then worked on and addressed and therefore, proper mobility is restored. Dynamic Neuromuscular Stabilization (DNS) is by far the most accurate application of assessing and correcting any deviations from the mobility design of the body. Watch this video to see what it’s all about. 

If all babies go through the same developmental patterns of movement regardless of our differences, then why not re-walk the same paths with a careful set of eyes to detect what is off and do what babies have done over and over, all over the world, to establish movement from the beginning? We don’t need to reinvent the wheel!! There is a reason why all the massages and stretching have only provided temporary relief. Massage is good for relieving tension but does nothing about what caused the tension in the first place, so the pain comes back. Stretching a muscle or joint in isolation feels good for a little while and the pain returns because the problem is not in isolation, it’s in movement. 

The treatment of any musculoskeletal injury cannot be confined to one area, because anything you do requires multiple joints and muscles working together to get the job done. That’s why when assessing someone for hip pain, it’s important to look at the role of the feet, knees, and lumbar spine. Watch the video below to understand what I mean. 

Of course, the first stage in treatment is to get you out of pain so we can have the full attention of the brain during the exercises which is necessary. At my office, this first stage consists of Active Release Technique (ART)  to address any soft tissue imbalances that may be contributing to bring back some mobility to the very joints that will need to be involved in the Developmental Movement exercises. Chiropractic adjustment of the spine and the joints stimulates the nervous system into a more alert state similar to a teacher coming into the class, announcing that she/he has something important to say!

Once the patient is out of pain, we move on to the appropriate DNS exercises that not only address the hip joint but require all the joints and muscles in your body to do their part and work together to move efficiently. This has to happen for the problem to go away and is not over doing it! The video below shows how this exercise that mimics an 11-month-old’s attempt to get up helps with rehabilitating hip joint issues. 

Will Chiropractic Adjustment Help Hip Pain?

Although chiropractic adjustment is necessary and very valuable, it is not the be-all-end-all of treatment. Adjustments help the alignment but keeping the alignment is the key!! THAT is where many chiropractic offices fail to get the patients in a much better place for a LONG period of time, if not forever.

If the desire to become healthy was like asking for a fire to keep ourselves nice and warm, then chiropractic adjustment is a spark; without the spark, there is no flame but just because you have a spark does not mean that you are guaranteed to get the fire. Adjustments stimulate the nervous system. What comes next is crucial and that is where many treatments fail. If it is not the right mixture of procedures customized to the patient’s needs, then the desired result is not gained!!

The reality is very simple: there is no short and simple solution to any complex and long-term problem. I wished I could change that but I cannot. Even once you have gotten yourself to a level of being pain-free and improved function, maintaining what you now have restored is an ongoing process.

As you see, the solution is not difficult but requires investment in time, energy, and clearly, finances. Sometimes we think we cannot afford ‘it’ but what we can’t afford is losing yet another day of our life being unhealthy. All we work for is to be happy and being healthy is a requirement for being happy.

It is all about how you look at it! Remember, you are the Designer and the Director of your own life so design and direct it the way you wish to live it.

Dr. Shakib