Poor Hip Core

Poor Hip Core

Article by J.Miller, Z.Russell

What’s Your “Hip Core”?

While most people now understand the importance of good core muscle control to fix back pain and improve sporting performance, it has not yet transferred to regions other than your back. This article will focus on the importance of your “hip core” in preventing or resolving hip and groin pain.

You probably won’t find too many articles referring to your hip core as yet. It is known in the medical world as your “deep hip stabilisers” and hasn’t been around long enough to be given a major PR overhaul.

However, your “hip core” exists and is very important for controlling your hip, pelvis and upper leg, especially during one-leg stance, walking, running, jumping and kicking. Which, when you think about it, affects all of us every day!

What Happens?

Just like most people have trouble ‘switching on’ their abdominal core muscles due to previous back pain, pregnancy, post-childbirth or sports injuries, the same applies to the deep hip muscles.

These deeper muscles tend to ‘turn off’ to a degree because of the pain or injury and usually struggle to properly ‘turn back on for a long period of time. This leads to ongoing pain or other problems developing throughout your hip and leg.

As a result, your body compensates by:

  • increasing the workload of the larger hip and buttock muscles, causing muscle fatigue, knots and tightness.
  • causing you to adopt a poor pelvic and lower back joint posture due to weakness.

Ultimately this means that other back and hip muscles tend to tighten up to try and stabilise your wobbly hip. This leads to secondary injuries.

Unfortunately, the long-term results can include a collapsing hip during walking or a run, and an increased likelihood of joint stress and damage predisposing you to premature degenerative arthritis and pain, not only in your hip but in your knee, back or ankle as well!

Problems With Hip Core Retraining

Other than not having a trendy name yet, the hip core can be successfully retrained, but it is more difficult to identify which muscles. It may be helpful to visualise your deep hip core muscles activation pattern utilising real-time ultrasound retraining. Plus, you will have variable hip core ability on your left compared to your right.

Just like with lower back core exercises, it is important not to progress too quickly. If you overload the muscle, it will simply stop working or lose control, leading to increased injury.

What To Do?

If you have suffered hip or groin pain that continues to niggle, it may well be due to a “poor hip core”. Your doctor may have diagnosed you with trochanteric bursitis, a secondary injury caused by hip instability. While an injection may help ease the short-term symptoms, they tend to recur because your “hip core” responds to corrective exercises – not injection!

If this is the case, then please contact us to have your hip core assessed. Your physio can do a full hip and pelvis assessment and start you on remedial treatment straight away.

PhysioWorks has designed a corrective “hip core correction” program to help you overcome hip and groin pain quickly. Plus, we can use an ultrasound scanner to visually help you find your hip core and see them in action for those who have difficulty feeling your correct muscles working.

Hip Pain Treatment

A thorough analysis of WHY you are suffering hip pain from a movement, posture, or a control aspect, is vital to solving your hip pain.

Only an accurate diagnosis of the source of your hip pain can solve the pain, quickly improve your day to day function, prevent a future recurrence,  or improve your athletic performance.

The first choice of short-term therapy has been symptomatic hip treatment. This approach could include local chemical modalities such as cortisone injections or painkillers. Ice or heat could also assist along with some gentle stretching or exercise.

However, persisting hip problems will require additional investigations to assess your joint integrity or range of motion, muscle length, strength, endurance, power, contraction timing and dynamic stability control.

You should consult a healthcare practitioner who has a particular interest in hip pain and injury management to thoroughly assess your hip, groin, pelvis, lower limb and spine. Due to the kinetic chain, they all impact, especially at the high athletic performance end. A quality practitioner will educate you on your condition and combine it with exercise and manual therapy as per the Clinical Practice Guidelines. (Cibulka et al., 2017) Hip pain education should also include teaching you specific activity modification, individualised exercises, weight-loss advice (if required), and methods to unload any arthritic joints.

Recent research evidence-backed approaches have modernised physiotherapy treatment approaches to effectively managing hip pain. Together with a thorough hip assessment, your hip treatment can progress quickly to restore you to a pain-free hip and perform your regular sport or daily activities in the shortest time possible.

For specific rehabilitation advice regarding your hip pain, seek the professional advice of high quality and up-to-date physiotherapists experienced in the assessment, treatment, prevention and optimisation of hip pain and related conditions. After assessing you, they will individually prescribe therapeutic activities based on your specific needs for daily living, values, and functional activities or point you in the direction of the most suitable healthcare practitioner for you and your hip condition.

Hip Pain Treatment Options

Your hip physiotherapist may consider an extensive range of treatment options, including manual joint therapy to improve your joint mobility, muscle stretches or supportive taping. Your physiotherapist is also likely to add strengthening and hip joint control exercises as they deem appropriate for your specific functional and sporting needs. Please consult with them for advice.

Acute Injury Signs

Acute Injury Management.

Here are some warning signs that you have an injury. While some injuries are immediately evident, others can creep up slowly and progressively get worse. If you don't pay attention to both types of injuries, chronic problems can develop.

For detailed information on specific injuries, check out the injury by body part section.

Don't Ignore these Injury Warning Signs

Joint Pain

Joint pain, particularly in the knee, ankle, elbow, and wrist joints, should never be ignored. Because these joints are not covered by muscle, pain here is rarely of muscular origin. Joint pain that lasts more than 48 hours requires a professional diagnosis.

Tenderness

If you can elicit pain at a specific point in a bone, muscle, or joint, you may have a significant injury by pressing your finger into it. If the same spot on the other side of the body does not produce the same pain, you should probably see your health professional.  

Swelling

Nearly all sports or musculoskeletal injuries cause swelling. Swelling is usually quite obvious and can be seen, but occasionally you may feel as though something is swollen or "full" even though it looks normal. Swelling usually goes along with pain, redness and heat.

Reduced Range of Motion

If the swelling isn't obvious, you can usually find it by checking for a reduced range of motion in a joint. If there is significant swelling within a joint, you will lose range of motion. Compare one side of the body with the other to identify major differences. If there are any, you probably have an injury that needs attention.

Weakness

Compare sides for weakness by performing the same task. One way to tell is to lift the same weight with the right and left sides and look at the result. Or try to place body weight on one leg and then the other. A difference in your ability to support your weight is another suggestion of an injury that requires attention.

Immediate Injury Treatment: Step-by-Step Guidelines

  • Stop the activity immediately.
  • Wrap the injured part in a compression bandage.
  • Apply ice to the injured part (use a bag of crushed ice or a bag of frozen vegetables).
  • Elevate the injured part to reduce swelling.
  • Consult your health practitioner for a proper diagnosis of any serious injury.
  • Rehabilitate your injury under professional guidance.
  • Seek a second opinion if you are not improving.