Here is an old blog post, recycled and updated with free videos. It has stood the test of time.
Strengthening hip muscles doesn't always relieve hip joint pain.
In this post about hip pain and labral tears I questioned the commonly held belief that strengthening the muscles of the hip will somehow relieve general hip joint pain when you've had an injury (like a labral tear). Here's a recap:
Labral tears are generally the result of athletic injury or wear and tear over the years due to accidents. Labral tears cause instability in the hip.
Instability in a joint causes muscles to contract to try and create stability.
This kind of reflexive contraction to save yourself from further pain or injury or to compensate because because of an injury changes the way in which you would normally move.
The muscles involved in this "Trauma Reflex" pattern must be trained to relax first before beginning any course of strengthening or exercise. Otherwise you will more deeply entrench a pattern of muscular dysfunction.
I recently read a blog written by a young woman who has struggled with hip pain (and also has a labral hip tear) for 4 years. One extensive post had to do with her experience of dealing with hip pain. She strongly advocated hip exercises, and included links to videos of yoga stretches and repetitive Jane Fonda-esque exercises, all under the heading, "Hip Exercises Will Hurt."
Maybe they will.
And if you have a hip injury that hasn't been addressed, hip exercises will hurt your chances of ever feeling really good again.
To her credit, the writer admitted that she still has hip pain despite the exercises and noticed that one leg seems "shorter" than the other - yet her own doctor's advice was to strengthen her hip muscles and to "not expect much more mobility than she already had." Despite her good intentions and obvious search for pain relief, from a Somatic Education perspective there is better advice out there than what her doctors gave her or what she is giving her readers.
Try these Somatic Exercises for hip pain relief.
When hip joints are tight, it's because the muscles that attach into the joints have learned to stay tight. They need to be retrained, slowly and intelligently - not forcefully - to release, lengthen and move freely again.
Here are a few easy movements you can do at home to begin to release hip muscles that, when habitually contracted, contribute to chronic pain. Then I'd like to caution you against certain commonly prescribed exercises that can sometimes make hip pain worse.
Instead of stretching the muscles as you go through these movements, you will pandiculate them - contracting the muscle first, then slowly lengthening it to a full relaxation (as if you were imitating a cat or dog getting up from rest). Pandiculation is the key to resetting muscle length and sensory awareness and motor control without forceful pr painful stretching.
Arch and flatten: This movement relaxes the back muscles. Tight back muscles contribute to tight hip joints.
Arch and curl: This movement helps to relax the abdominal muscles, while the washrag allows for easier full body twisting. It relaxes the back, waist, belly and hips.
Side Bend: This movement directly addresses the "Trauma Reflex" muscles of trunk rotation that, when habitually contracted, are probably the biggest contributor to hip pain. This movement will teach you to relax, release and lengthen the waist muscles so that both sides of your waist are the same length and have the same ability to bend from side to side.
Lay on your right side, as shown in the photo below. Have the knees folded on top of each other at right angles to the body. Rest your left arm on the floor so that your head can rest on it. Get comfortable.
Let's first explore the lower part of this exercise: put your top hand at your waist and, keeping the knees together, slowly lift the top foot as shown at right. Notice how the hip slides up toward the ribs as you lift the foot. Allow the hip to move as the foot lifts. The waist muscles are drawing the hip up as the foot lifts. Repeat that movement 3 times slowly. Completely release the hip and foot back to neutral.
Now let's explore the upper part of the exercise: reach the left hand over top of the head and grab your right ear. Inhale and on the exhale, very slowly lift the head into the air. Let the waist muscles and ribs contract to bring your head up. Sense the contraction in the waist as your ribs squeeze down toward your hip. Slowly release down to neutral. Repeat this 3 time slowly.
Now, let's put both movements together for a full pandiculation of the waist muscles. Inhale, expanding the ribs, and on the exhale lift the head, and the top foot at the same time. The ribs squeeze down as the hip slides up toward the ribs. You're making an accordion with the waist muscles!Let the movement of the waist and hip raise the foot. Notice the contraction in the groin as well. Only go as far as is comfortable and don't force any movement! You are retraining the muscles, and reminding them that they can move.
On the inhale, slowly lower the foot and the head down at the same time. You're lengthening and relaxing the waist muscles as the hip rolls down to neutral and the ribs relax. up the right hip to touch the right armpit. Lengthen the entire side of your body as you come down to neutral and completely relax as shown in the photo on the lower right. You're beginning to gain length in the waist muscles! Repeat this movement 6 times slowly.
Roll onto your back and take a minute to notice the difference in sensation between your left side and your right side. Let your brain soak up the sensory feedback. Now roll onto the other side and repeat the side bend 6 times slowly.
Finish this series of movements with theWashrag.
Remeber to do all of these movements SLOWLY, GENTLY, and WITH AWARENESS.
Take a moment after doing these movements to notice the sensations of your body. Lie quietly on your back. This allows your brain time to absorb the sensory feedback you have given it. This new sensory awareness results in improved motor skill and flexibility.
In my next post, I'll discuss my own answers to the following questions about labral tears:
Should they be repaired?
How do you deal with the discomfort of a tear if your doctor says, "let's just wait and see."
Are you setting yourself up to create serious structural damage to the hip joint by not repairing the structural weakness?
I welcome all feedback about the advice given in this blogpost. Do the above movements for a couple of days and let me know how it goes. If you need help, advice or guidance, please contact me!
To learn these movements at home for rapid, long-term muscle pain relief, you can purchase my new, easy-to-follow instructional DVD.