I had a question recently on face book asking about anterior hip pain . It came at a good time as I have been a bit slack on my blog posting lately and needed some ideas .
The hip is a pretty interesting joint as it rivals the shoulder joint in range of motion and muscle attachments . I have mentioned this in a previouse post but to maintain healthy hips you need to be weight bearing for 9 hours a day and very few people are . Hips need to be flexible , stable and very strong .
Most of our clients will be very quad dominant , so tight and strong in the front and weak at the back . If we delve a bit deeper into the mechanics of the hip ( thanks to the brilliant work of doctor shirley saharman ) it becomes apparent that if the muscles in the front are too strong and the muscles at the back are too weak the hip joint will loose joint centration .
The head of the femur will be pulled into the acetabulum with no counter pull from the posterior chain leading to pain in the front of the hip .
There are a couple of tests I will carry out on any client complaining of anterior hip pain .
- 1. Firstly without causing too much pain we need to put the hip in a position that will reproduce the pain and confirm our suspicions .
- 2. Test the firing pattern of the glutes and make sure synergistic dominance of the hamstrings are not present .
- 3. Test for flexibility any way you want just make sure you cover the entire hip . Hip flexors , extensors , internal rotation , external rotation , adduction and abduction .
- 4. Test for stability in single leg stance , with eyes open and closed . A good rule of thumb is 10 seconds with eyes closed for an athletic population and 5 seconds for normal folk .
- 5. Test for strength using a bridge watching for the opposite hip dropping .
Manual mobilisations to drive the head of the femur posterior into the acetabulum .
The mobilisation is only a principal . Use your imagination and find a position that is comfortable to perform this mobilisation . As long as you are on the hip joint and pushing the femur backwards then you are doing just fine .
The only reason I have a new location and model for the hip joint mobilisations is because I ran out of memory space at the swimming pool and so had to wait until I got back to chiang mai to make more space and find a new model . As you can see I had not changed my t shirt yet .