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 the prevention or resolution of 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” does exist 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 they are. 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 chance of 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 as having trochanteric bursitis, which is 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, for those who have difficulty feeling your correct muscles working, we can use an ultrasound scanner to visually help you find your hip core and see them in action.

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 have an impact, especially at the high athletic performance end. A quality practitioner will specifically educate you regarding your condition and combine 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 physiotherapist 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 joint control exercises as they deem appropriate for your specific functional and sporting needs.Please click the links below for more information about some of the conventional hip treatments that your physiotherapist may recommend or utilise for your hip pain.
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