Common Dysfunctions at the Hip

Common injuries and ailments to the hip in sports and fitnessFrom the NESTA Functional Training Specialist

The hip is one of the most mobile joints in the entire body due to its structural design as a “ball and socket” joint. The hip has great range in all motions of flexion, extension, abduction, adduction, internal and external rotation. Once again, with great mobility comes instability. Since the hip is so mobile it becomes increasingly likely that injury or dysfunction will occur if hip position is held constant or becomes excessively repetitive. Spending long durations sitting or excessive time spent in one particular movement with flexed hips can create problems for the entire hip complex.

With excessively tight hip flexors from sitting for long periods or much of the day, the pelvis may tilt anteriorly which inhibits function of the gluteus maximus and tightens the erectors of the lumbar spine. This is recognizable by a tendency to perform push-ups with an excessively arched or lordotic curve in the low back. The same position of the hip and spine will be shown while squatting as one fatigues or the load increases. Attempting to perform reverse crunches may exhibit compensation by excessive spinal involvement in extension during the eccentric or downward phase. Unfortunately, it does not just end here. If tight hip flexors and weak gluteus maximus go unchecked, the gluteus medius may also become weak, increasing tension upon the tensor fascia latae, iliotibial band and quadratus lumborum. This situation will be recognized by a tendency to raise the hip while moving laterally, laterally flex the spine for movements that should primarily utilize the hip abductors, and tendency to compensate with an excessive forward lean during squat-ting motions. This may also inhibit proper abdominal activation of the transverse abdominus and internal obliques. Such muscular inhibition decreases stability of not only the hip, but the spine and other core musculature.

The foam roller can be utilized to relieve excessive pressure upon joints due to excessively stiff or overactive and tight muscles. Statically stretching tight areas at the hip may temporarily relieve pain or discomfort. But the gluteus maximus and medius muscle must be actively strengthened along with hip flexor lengthening. Several exercises help accomplish this goal, and refer to your exercise progression segment and video for further discussion. It is not un-common to have low back pain as a result of tight hip flexors which can create a kinetic chain dysfunctional effect down to the knee and up into the spine. Simply taking medication to relieve pain, and allowing time to rest overactive muscles will, once again, only create temporary relief. Some individuals look to chiropractors, massage therapists, and sports medicine specialists for stretching, massage, trigger point activation, and joint position adjustments. All of these remedies can exhibit short term success. However, success cannot continue long term until the source of the problem is alleviated. The debate over the exact source or origin of many injuries and dysfunctions and the complexity of these situations is the reason so many varied specialists exist within the fields of medicine, sports, fitness and wellness. After a sufficient period of rest for muscular pain, overactivity or injury, efforts must be made immediately to strengthen weak musculature. When it comes to the hip, you can bet your (you know what) that this means the glutes.

NESTA Functional Training Specialist