One of the most common ailments we see at Atlantic Coast Physical Medicine is misalignment of the hip joint and associated joint pain. The hip is a very unique and complex joint. The depth of the socket, the strength of the muscles and ligaments surrounding it, and the way it functions in weight bearing activities is unlike any other joint in the body. The focus of this article is on the relationship between the hip and the rest of the body and why treatment should focus on all of involved elements if we are to really restore long term function.
The hip joint is a synovial joint, meaning it moves freely lubricated by fluid. It is a ball-and-socket joint that is made up of the femoral head (the “ball”) and the acetabulum (the “socket”). The ball is largely contained within the cup or socket, though there are genetic and cultural differences with regards to the depth and shape of the hip joint in any one individual.
The relationship between the hip and the surrounding joints is intimate in that each joint affects the next. The hip and joints of the leg and lower back support your body’s weight and must work in close coordination to provide the mobility most people take for granted, until injury, arthritis, or other problems interfere.
For instance, ankle pronation—or the inward rolling of the foot and ankle—results in a knocked knee, which can then shift the hip outwards. The pelvis then drops down on that side, the tailbone or sacrum becomes unleveled or sloped, and the lower spine curves to compensate with the ultimate goal of keeping your eyes level. Hence, when your hip hurts, our Chiropractor will examine and treat the ENTIRE lower kinetic chain—the foot, ankle, knee, hip, pelvis, and spine—as ALL are so closely related to each other. When it comes to managing you and your hip pain, be prepared for management of any of the following:
- Ankle pronation: This is the inward rolling of the ankle often associated with a flat foot. When viewing someone with ankle pronation from behind, the angle from the Achilles tendon to the ground will lean inward when it normally should be perpendicular. A valgus correction in a “rear foot post”—a heel wedge thicker on the inside—of a foot orthotic (customized arch support) is needed to correct this.
- Knocked-knees: Ankle pronation can result in “knocked-knees” (genu valgus) which overloads or jams the outer knee joint, over-stretching the inner knee joint and ligaments. The knee cap (patella) then rides excessively hard on the outer surface of the femoral groove in which it glides as one bends and straightens their knee, causing knee cap pain.
- Hip inward angulation (or coxa vera): As the knee shifts inward or knocks, the head of the femur moves outward, leaving the joint less stable. Leg length deficiency (LLD)—or a short leg—occurs when the pelvis drops on that side further destabilizing the lower kinetic chain.
Once ankle pronation is properly corrected with a rear foot post and the hind foot is repositioned back to neutral a heel lift can be placed under the foot orthotic to correct this imbalance. Only then will the pelvis become level and stable so it can properly serve as a strong foundation for the spine the rest of the body to rest on!
Problems of the hip joint can lead to muscle imbalance, weak hip extensor muscles, or overly tight hip flexors and adductor muscles, and most commonly, pain in several locations and joints. When an initial problem, like ankle pronation, goes untreated, your body naturally attempts to cope, but can also cause a cascade of other related issues and lead to long term instability, muscle weakness, and incorrect postures. Often, when seeking treatment for joint pain, patients are given narcotics and told to rest. The real underlying issue may not even be addressed. Pain can be masked but the damage being done persists. This is not an approach that you will find within our comprehensive integrated practice.
We offer collaborative, preventive, and holistic care. Our team of board-certified nurse practitioners, physical rehab technicians, massage therapists, and chiropractors offer patients comprehensive types of treatment, all under one roof. Often, when visiting a doctor for joint pain, patients are given narcotics and told to rest. The real underlying issue may not even be addressed. Pain can be masked but the damage being done persists. This is not an approach that you will find within our comprehensive integrated practice.
During your initial consultation, exam, and creation of a care plan, we put together a regimen that may include treatments such as assisted stretching, muscle building exercises, assistive devices, massage, chiropractic adjustments, pain reliving and anti-inflammatory non-steroidal joint injection, decompression treatments and a home exercise plan. We utilize the skill and knowledge of many types of medical practitioners to come up with individualized treatments specific to each patient’s conditions. Our purpose and passion is to get to the root of a problem and implement corrective action so that our clients can resume active and fulfilling lives without pain.
Our primary focus of care at Atlantic Coast Physical Medicine is individualized. We restore the normal alignment of joints throughout the body while strengthening the muscles around these joints to help stabilize and heal the instability within these areas. This form of treatment proves to be highly effective in resolving pain and regaining function to your everyday life activities.
Sources: Chiro Trust