Your hip - strong and flexible
Your hip is a ball and socket joint which connects the largest leg bone the femur to the pelvis. The hip is normally very stable because it is surrounded by many strong muscles and ligaments which support it. When your hip is put under stress, such as when walking or running, the articular cartilage within the joint will be distributed over a wider area. This allows your hip to mould into the joint space. When running or jumping, the load on your hip can be up to 3 ½ times your body weight. Your hip has less mobility than your shoulder which is also a ball and socket joint, but its movement is enhanced by coordinated movements in the pelvis and lower spine.
In perfect balance (or not)
When standing on two legs the hips could be compared with a balance with the pelvis acting as the crossbar. Body weight is transmitted equally to each leg which act as a supporting column. Muscles above and below should work in unison without much effort. When balancing on one leg, as you do every time you take a step, all the weight is transferred to that leg and the strong muscles must pull in the opposite direction to keep the pelvis and you from falling over. If there is any joint above or below that is misaligned, the hip joint will start to compensate and change the way it was designed to work. Going away from our natural blueprint the body starts to wear out sooner than it needs to.
Referred hip pain
There are many muscle groups that attach from above and below your hip that help to create its great stability and flexibility. If any of the muscle groups are not working as they were designed to it sets up mechanical derangement somewhere along the chain. With some conditions, if your hip is the problem, pain can be referred to the legs, back or groin but not the hip. Or areas above or below your hip can refer pain into the hip area, so I might start working on your hip pain, but work away from that area as your body relaxes and tight deeper muscles start to show up.
Quadratus lumborum and psoas
The two muscles that I see that are a common cause of hip pain are quadratus lumborum and psoas. These two muscles are important in that psoas flexes the hip (tilts your pelvis to so that your lower back has a larger curve –lordosis) and quadratus lumborum which connects your lower ribs to your pelvis and stabilizes your lower spine. Both of these muscles or any area they effect, can refer pain to your hip. Pain causes your body to compensate by moving in a different way to stop the pain, which might feel better for a while, but is putting more wear and tear on other areas like your knee, ankle, lower back or even neck.
How I would treat you if you came to see me with hip pain
I listen to your story about your hip. It doesn’t matter if you have already had a hip replacement or are waiting for one, pain source release can take the tension out of the soft tissue around your hip. Nothing is forced and I always ask you to tell me to stop if ever you feel uncomfortable. I will balance your pelvis by gently placing my hand on your sacrum and resting my arms on your thighs. From there, I will go wherever you feel tight or restricted. I could end up working on the ankle and hip, or the opposite shoulder and hip. Everyone is different and I follow your tightness. If just one muscle or area can soften and relax at a deeper level your whole body will react and that is what I follow.