Hip Pain

Do you experience pain on the front of the hip?  Are you stretching or using other methods to loosen it up on a regular basis?  Does it help?

News Flash: Pain on the front of the hip (anterior hip pain) is rarely caused by tightness in the muscles in the front of the hip.

This pain is often a symptom of another part of the body not moving correctly.  This is why you continually stretch the area to loosen it I up, but it doesn’t actually help the problem.

Common drivers of this problem include:

• Weakness in the muscles along the spine
• Stiffness in the hip joint
• Postures/habits we maintain

Weakness in the muscles along the spine

Your psoas runs from the front of your spine down to the front of your hip.  The primary function of this muscle is to raise your thigh up (hip flexion) or to bend your torso forward.  It also assists in rotating your leg outward.

What can happen, though, because of its attachments on the spine, if the spinal muscles are weak or become fatigued, the body will tighten up the psoas in order to attempt to stabilize your spine.  This tightness is frequently displayed as pain in the front of the hip along the path of the muscle.

You can attempt to loosen up the psoas all you want, but if you don’t change course and work on improving the stability and strength in the muscles that actually stabilize your spine, the psoas will just continue to tighten up.

Stiffness in the hip joint

This can be a twofold problem.

First off, when a joint gets stiff, muscles must work harder to move that joint.  The larger the muscle, the more the body will use that muscle to do a task.  This may cause a muscle to get overworked.  As a muscle gets overworked and fatigued, it tightens up in order to then guard and protect the body and the joint.  For the hip, this tends to reflect to the front of the hip, specifically the psoas or iliacus, the two larger hip flexor muscles.

Secondly, when a joint gets stiff, it can also tighten up the joint capsule.  Without getting to scientific with you, basically it causes the joint to not move like it needs to for normal function.  This tightness of the joint and the capsule can cause pain in the hip when going through normal movements.  I see this causing anterior hip pain frequently with squatting motions.

Postures/habits

People sit a lot…commuting to work and from work, sitting at their jobs, carpooling the kids around to events, sitting at events the kids are in, eating, relaxing in the evening…you name it, our society sits. 

Even if you exercise for health/fitness or are training for competition, that time does not constitute the majority of your day and does not counteract the amount of sitting that you do.  This constant and frequent sitting is why the majority of people have very tight and stiff hips.

Sitting is a reason that the discomfort on the front of the hip can actually be caused by tightness in the hip flexors.  When you sit, the hip flexors are in a shortened position.  Sitting long periods for a day or two, such as a long road trip or sitting at a conference, won’t necessarily cause it to tighten up.  Sit for 8+ hours a day on a regular basis, as many people do, and it can cause the hip flexors to tighten up if you don’t do anything to counteract it.

The other issue with sitting goes back to the first topic of discussion, weakness along the spine.  When we sit, especially if we sit with our backs against the back of a chair, the muscles in the spine are not required to fire, they are essentially at rest.  This can cause those deep spinal stabilizers to forget how to work when they are actually required to work, thus causing the psoas and the larger spinal muscles to support the spine.

In summary, yes, pain in the front of your hips can be caused by tightness in the hip flexors.  But, if you are working on loosening them up every day and it is not working, it is time to look elsewhere for the true driver of the problem.

Is this something you are dealing with?  Have questions?  Email me at brianne@getyourfixpt.com.