Hey guys, it’s Dr. Anderson at Life Centers Chiropractic in Missouri City. And today I’m gonna talk to you about how to determine the cause of all different types of hip pain.
Understanding the Different Types of Hip Pain
So the hip joint, and what people refer to as hip pain, can present in all sorts of different ways.
Some people feel it around the back of the hip, the glutes, or SI joint. Some people feel it on the side, and it’s achy down through the side of their hip. Or even though they might refer to it as their IT band, they might feel like they might be getting IT band pain, which can even be here or run down.
Some people get pain in their hip flexor group, which is like a muscle and connective tissue tightness and stiffness. But also, that can feel very similar to pain in your hip socket, where you might have issues where the hip socket has become impinged or even torn or degenerated.
So there’s a lot going on in the hip, and I do just want to kind of shed some light on how to tell the difference. And regardless of which one it is, we get awesome results helping with all of them.
Understanding the Hip Anatomy and SI Joint
So if you look at the anatomy of the model, these two bones are here. When we walk, our hips naturally just walk, they go back and forth. So the natural motion of the spine is rotating back and forth, back and forth.
There are these two hip bones, which are called your ilium, and there’s this big triangular bone called your sacrum. And where they meet, they make a joint, and that’s your SI joint.
So if you’ve ever heard of your SI joint, that’s what it means. It’s the joint where those two things come together, right?
So with this rotation, the spine can actually get stuck in that rotated position, or the sacrum can tilt many different directions. And that can create an impingement in the SI joint and create spasms and knots in your glutes and piriformis, and even cause issues with the front where the femur goes in and inserts. That’s actually the socket where your leg bone goes in and connects to the pelvis.
So if this bone’s rocked or misaligned, it may cause pain here, or it may cause pain in the socket, or it may cause [unclear], or it could be all three, right?
Evaluating Hip Alignment and SI Joint Motion
So one major thing that we always like to do is evaluate, through X-ray and posture evaluation and orthopedic testing, the alignment and symmetry and motion of the ilium and the SI joints.
So I’m gonna demonstrate that on a patient here.
She’s gonna go and lay face down. And she’s already had a full exam and spinal imaging, and she’s been around care for a long time.
So I know that currently, where she’s at is her left hip, or ilium, is in rotation this way, the right one is going this way, and her sacrum is also tilted.
Checking Leg Lengths and Sacrum Rotation
So how we correct that, there’s a couple of indicators that we can check.
I’m gonna have her slide down just a little bit.
And first, we’re gonna check the leg lengths, and we’ll be able to see that when that hip is rotated, that leg will shift and become longer than the other.
Another thing with the sacrum is when we bend the knees here, the heels towards the hips, one leg will go a lot further than the other, and that indicates the side where the sacrum might be rotated as well.
Correcting Pelvic Alignment With a Pelvic Drop Piece
So today, how we’re gonna adjust that, there’s two different ways that we’re gonna adjust it.
One is called a pelvic drop piece. It’s loud and it makes noise, but it’s actually very gentle, and it just simply uses gravity to just sort of align the spine or the pelvis with itself.
And this is one where there’s not any popping or cracking noises or releases like that. It’s just repetitions of gravity falling and gently leveling the pelvis.
So there’s a pedal that props up the piece. We contact the two different hip bones, and we drop them a few times.
And then on the sacrum, we’re also gonna drop that.
Now we can reevaluate, and we can see that the legs are back in line, which is great.
And we’ll check the symmetry of the SI, the heel to pelvis. And that’s looking much better too.
So that’s one way.
Side Posture Manual Adjustment for the Pelvis
So another way that we might adjust the pelvis is we’ll have her turn to her side facing me.
And we do what’s called a side posture manual adjustment on the pelvis.
So we’re here, and again, we’re just gonna very gently contact that joint. And I’m just gonna gently align it.
And that will create a nice release of pressure. Actually, it feels really good to just set the alignment.
So that’s the most helpful thing for the SI joint, the back of the pelvis, the ilium. And we want to level that.
Addressing Lateral Hip Pain and IT Band Tightness
Now she’s gonna lay on her back.
Another thing that she has, and that’s very common, is that there might be pain or irritation of the lateral part of the hip, and sometimes it even radiates to the side.
Many times you might have a stiff IT band, but if you stretch it and you stretch it and you stretch it and you [unclear] it, but it always seems to come back, that’s many times due to some rotation that occurs inside where the femur goes into the pelvis in that socket.
And that’s also a pretty simple thing. It’s very, very, very effective for people that have had that chronic pain there.
So we’re simply just going to raise the leg, and we’re just gonna drop it a few times and derotate where that insertion point is.
So this is very effective for the lateral hip pain.
And we’re just simply gonna drop. Drop.
And that’s a really effective adjustment for lateral hip pain.
Relieving Hip Socket Impingement and Irritation
Now, another one that we see very commonly is impingement or irritation where the femur goes into the socket itself.
So this is where we’re going to just simply contact here. We’re just gonna gently distract and just create a little separation and gap in the center, that femur with itself as well.
So we’re just gonna very gently pull, decompress, and distract, and take pressure off that joint.
Very good.
So those are some really common ways to actually help the pelvis. And anybody with hip or pelvic pain, typically we get almost a 90-plus percent success rate at helping.
Identifying Tight Hip Flexors With an Orthopedic Test
There’s one more issue that might come if there’s an issue with the actual hip flexors and tight hip flexors.
So here I’m gonna have her take one knee up. A simple orthopedic test where she can just cradle this knee.
Now, what you want to see is this connection point. If it’s normal length and tension, the leg should very comfortably just fall to the ground and relax.
Now, you can see that her femur is not touching. There’s this huge space where that’s not touching the ground.
And what that says is that this is actually shortened.
Stretching and Lengthening the Hip Flexors
So in this scenario, there’s some specific stretches we’ll do, which we’ll demonstrate in another video, where we actually lengthen the connective tissue.
And over time, you’ll be able to see, now, as if it was stretched, you would see that.
Now, if it was normal length, you would see her femur actually come down very naturally and gently and touch the table.
So we’ll show you how that works in another video, and those are some things you can work on at home.
So I hope that helps.
