Movements That Don't Feel Good For My Hip

As promised, in my last post I shared my daily Somatics routine. In this post I'll discuss the movements that don't feel good for my body and hip, as well as movements I enjoy that help me feel strong without stressing my hip and causing pain. To start, here's what I've learned about my labral tears:

Because I can't fix the structural problem I need to listen to my body, move in a way that feels good and stay away from movements that cause pain. I had to get past my self-competitive nature and embrace acceptance of what I can't change and know that I can be strong, healthy and happy without pushing my body into places that don't serve it. It's calling letting go of your ego. Not always easy.

Movements that aren't pleasant for me:

Running. Though I like to run a block, walk, run another block, then walk, I can only do this a few times. Not having equal structural stability in my right hip simply causes my brain and muscles to come down just a bit harder on the right side. I wind up quite sore for a day if I do this and it puts unnecessary stress on my hip joint. It's not worth it.

"Core strengthening:" Sit ups, certain Pilates mat exercises. Why? Because the more I tighten my "core" the more it hurts my right hip. Sounds odd, right? Not really. Many people with a labral tear also have a cyst on their hip. Their hip joint structure isn't symmetrical. This can create some sensitivity that those without tears don't have.

Look at an anatomy chart and you'll see where the abdominal muscles insert into the pubic bone, the pelvis and you'll get a better idea of how excessive strengthening exercises can create pressure and tightness into the hip joint.

The best abdominal/core strengthening for me is functional body weight movement like vigorous hiking. I also love the movements of Exuberant Animal. They're fun, functional, creative and strengthening.

Fast twisting movements: Zumba doesn't work for me. It's simply too fast and one is never able to get to the full range of the muscle, nor have enough time to learn to do the movement properly. Slow hip movements are great, but super fast? It serves no purpose that I can see.

Stretching: Stretching only makes muscles tighter and, when done statically, invokes the stretch reflex. I pandiculate - a lot. And it means that I move in a comfort range that is right for me and optimum for my muscles.

I have had to become extremely aware of my tendency to revert to the original pattern that likely caused the tears in the first place: the Trauma Reflex. When stress hits most people revert to their most deeply familiar habit. For me it's the Trauma Reflex. Don’t worry. The beauty of the human brain is that we have the capacity to be internally aware of and in control of these habits. This leads to the ability to be self-correcting, self-actualizing and self-healing. We can start all over again every minute of the day.

Becoming aware of how you emotionally respond to stress is a critical part of the process. Do you cringe into that hip? Do you tighten your back, hunch your shoulders? Does that hip begin to ache when you’re stressed? Has it never occurred to you that your emotional or psychological state is connected to how your muscles move and how you feel in your body?

The lesson is to learn to listen to yourself, sense the information your brain is giving you about your body and move in ways that create pleasure, learning, growth and strength. It's a life long process that makes us smarter and more resilient.

My Daily Somatics Hip Pain Relief Routine

In my last labral tear update I wrote that an habituated Trauma Reflex is always a part of the posture of someone with a labral tear. Whether you get surgery for your tear or not it is critically important to regain full muscle function of the muscles of the somatic center if you're ever going to move efficiently again.

My daily pain relief tips for hip pain

Pandiculation - first thing in the morning! I never get out of bed without pandiculating. I wake IMG_3791up and take a few minutes to yawn out my arms and legs - my own natural version of the Human X - "hike" my hips up and down, and twist the center of my body, letting my head and neck move with the movement (like the Washrag).

A daily Somatics routine of between 10 - 15 minutes, morning and evening.

  • Arch and Flatten - sometimes moving into the Flower (especially if I've done a lot of computer work that day).
  • Cross Lateral Arch and Curl
  • Back Lift
  • Arch and Curl with psoas release
  • Side Bend - I prefer the "arm sweep variation"
  • Washrag (or Steeple Twist)
  • Walking Exercises

A varied routine, with movements such as:

  • Hip Lift and Reach
  • Propeller
  • Arch and Curl with Psoas Release (find it here on Laura Gates' DVD)
  • Arch and Flatten with Cactus Arms
  • Side lying shoulder and hip circles (relaxed shoulders help release the hips)
  • Seated Somatics
  • Standing Somatics (from my book)

Pandiculate often during the day! I make movements up: rolling my hips, shoulders, squatting, Screen shot 2013-09-23 at 4.14.33 PMreaching my arms up, twisting our my center, swinging my arms, bending to the side.

Stand up frequently if you're doing desk work. I stand up frequently and do "Reach to the Top Shelf," sometimes 15 times a day!

Sun Salutation - done very slowly and somatically. I take all the time I need to sense the flow of the movement without stretching or holding stretches. I do about 3 rounds 3-4 times a week.

Walking, walking and walking.  Walking integrates my movement and allows me to coordinate the whole body. Walking is, after all, the most important movement any human being needs to be able to do easily and efficiently.

Stair climbing or hill walking. Incorporating stairs or a hill allows me to strengthen and coordinate my hips, back, legs and waist within a functional movement. I can really tell what's out of balance when I go up and down stairs. It gives me a chance to go back, notice what's not moving as freely and see how I can tweak it.

In my next post I'll share with you movements that don't feel good for me considering that I have a labral tear. They might feel good to those with no structural hip issues, but not for me! So I honor what my body has to tell me and stay away from them. There are so many movement choices, why stick with something that doesn't feel good?

How Hanna Somatics Helps Me Move Well Despite Labral Hip Tears

It’s time for an update. Several years ago I wrote several blog posts about hip pain, labral tear surgery, and how to help alleviate hip pain - not as a quick fix, but for the long term. Since then I’ve had countless emails from readers asking advice about hip pain and labral tears: which exercises are best for it, can Hanna  Somatics really help and advice on whether to have labral tear surgery or not.hips

So where do I stand now that I’ve had labral tears for several years, a very active schedule and haven’t had surgery?

I’m moving really well. I feel strong, I am still quite flexible and I know how to honor my limits to keep myself out of pain. You see, I am a poor candidate for surgery (I also have osteoarthritis in my hips from years of dance training and injuries), so there has only ever been only one clear choice for me: to incorporate the exercises, concepts and principles of Hanna Somatics into my daily life. This includes awareness of my emotional responses to stress, my postural habits, and my daily movement habits.

That means that I have had to walk the talk and be the example of what Hanna Somatics has to offer those in pain: the ability to become self-aware, self-monitoring, and self-correcting in their movement and muscular control. I know which activities help me and which ones don't and I know that if I "push on through" because I want to be competitive, and I ignore how my body is feeling, I will be sore for a few days afterwards.

I was diagnosed with labral tears after recovering from a skiing accident, which resulted in an ACL tear. As a Somatic Educator, I knew that my tears were the cumulative result of years of Sensory Motor Amnesia as well as minor, but very important, imbalances in the center of my body. For some people labral tears occur suddenly due to an accident or over time due to overuse; baseball players, martial artists and dancers are athletes who frequently suffer from labral tears, all due to repetitive movements.

The Trauma Reflex contributes to labral hip tears

If you have a labral hip tear, you've probably had an accident, injury, surgery, or performed repetitive IMG_3857actions - all of which evokes a sudden and powerful reflex called the Trauma Reflex. The brain, the command center of the muscles, loses its ability to contract and lengthen the muscles of the waist and trunk voluntarily and equally. You find yourself slightly tilted to one side, the pelvis twisted and leg length  a bit  uneven. Your gait changes and smooth walking or running becomes a thing of the past.

Here is what I have advised my readers:

If you have a labral tear and decide to have surgery, the surgery won't fix the muscular imbalance that you undoubtedly have in the center of your body. Only you and your brain can do that through sensory motor retraining. Then, once the tear is fixed, it's important to restore full muscle function, balance and coordination through Clinical Somatics sessions and daily Hanna Somatic Exercises. If you don't, you just may experience continued tightness in that hip, or aches and pains in other areas of the body due to compensation.

If your goal is to avoid a hip replacement (or put it off indefinitely) then the smartest thing you could do is to get the muscles which attach into and move the hip socket to release and relax. This is what I have done. Reduce excess muscle tension and free up your movement. This will take the pressure off the injured area and help you regain freedom of movement.

No matter what you decide, improved somatic awareness and control is what will change the course of your recovery from one of pain and limited movement to one of greater movement and self-control.

So what does my daily practice look like? There are so many Somatic Exercises to learn and choose from, yet some are what I call the “non-negotiables.” All this in my next blog post...

How To Reverse Hip Pain

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:

  1. 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.

  2. Instability in a joint causes muscles to contract to try and create stability.

  3. 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.

  4. 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.

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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.

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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.

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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.

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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.

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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:

  1. Should they be repaired?

  2. How do you deal with the discomfort of a tear if your doctor says, "let's just wait and see."

  3. 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.

Labral Tears - Surgery or Not?

Releasing painful muscles is the first step in hip pain relief.

In my last post I wrote about chronic hip pain, what is counterproductive for it, and what works from my perspective as a Hanna Somatic Educator,

  • Strengthening painful hip muscles can cause further pain or injury.
  • Learning to relax the muscles of the hip joint and the compensatory full body pattern of contraction in which the muscles are stuck can provide long lasting pain relief, relaxed hip joints, and balanced movement.
  • Understanding Sensory Motor Amnesia and the Trauma Reflex, the root cause of chronic hip pain, will help you understand how to intelligently regain pain-free movement of the hip.

Exercises such as the "clam shell" or "butterfly," and lateral leg lifts only serve to tighten the hip muscles even more, making it more difficult to move the hip. Often they create more pain, not less. Sitting with the soles of the feet together and pushing the knees out to stretch out the inner thighs can cause tight adductors to contract back against the force of the stretch. Even psoas stretches performed in isolation, can induce the stretch reflex, causing muscles to tighten back against the stretch. This further reduces the amount of control your brain has over your muscles.

Muscles that the brain cannot fully contract nor fully release are muscles that cause pain.

  • Address the pattern of contraction, not the individual muscles.
  • Pandiculation is the most effective way of regaining muscle function, improving movement and resetting muscle length. When you contract a muscle first, then lengthen and relax it you address muscle function at the level of the nervous system.

I hope some of you tried a few of the Hanna Somatic Exercises I included in my last post. Here is a wonderful variation of one of my favorite Somatic exercises: the Steeple Twist. This variation, made by Charlie Murdach (a Hanna Somatic Educator and Feldenkrais practitioner) shows how differentiating movements with the hips creates improved overall movement. Remember to go slowly and only as far as is comfortable. "Micro-movements" are perfectly fine!

[youtube=http://www.youtube.com/watch?v=lGuBU-1M0xM&feature=relmfu]

All these movements are a good beginning to learning to relax the muscles involved in the "trauma reflex."

Improved body awareness and muscle control is crucial when you have structural damage.

If you know that you are injured, but your doctor tells you it's nothing to worry about, then it's critically important to focus your attention on how your brain and muscles are compensating to deal with the injury (Sensory Motor Amnesia), and how that is changing the way in which you move. Unconscious and habituated functional problems left unchecked can, over the years, result in structural damage.

Do you have to be A-Rod to get a good doctor?

About a year ago I finally convinced my doctor to give me an X-ray on my hip. I had intermittent hip pain that I knew intuitively wasn't merely a functional issue.  The X-ray showed a tumor on my hip and an MRI confirmed a tumor, the result of two labral tears. My surgeon, a well known sports medicine doctor here in New Jersey, took time to show me my results: labral tears, osteoarthritis, and a tumor. He told me that, "there's just not enough science out there about labral tears to go ahead and do the surgery."

Unrepaired labral tears could create the need for a hip replacement in years to come.

Before my appointment was over, I asked my doctor if he thought that not repairing the tear in my hip soon would set me up for a full hip replacement in the future, due to compensation over time. His reply: "Yes, that just might be the case."

As I said in my first post about hip pain, it didn't take Alex Rodriguez's doctors long to figure out that if the Yankees were going to get their star player back on the field, earning his millions and hitting home runs, labral tear surgery was a must. ASAP. Why was there no absence of scientific data there?

So where does this leave the rest of us?

Recovery from labral tear surgery is no walk in the park, especially if you have no addressed the Trauma Reflex that got you there in the first place; it can't be solved by surgery. Surgery helps to repair the structural damage (which is wonderful), but it doesn't address the Sensory Motor Amnesia that alters movement in the first place.

The winning combination: Surgery + skilled physical therapy + Hanna Somatic Education = focus on regaining full functioning of the body as an integrated whole

While the jury's not out about what route I will have the option to take, improving my own sensory motor system and paying attention to my daily movement habits is critical to create long-lasting pain relief.

 

Hip Exercises for an Injury? You Might Be Strengthening Your Pain.

Here's something I haven't told many of my clients: I have two labral tears in my right hip as a result of years of compensation from injuries. Labral tears are more common than many of us realize and, as my orthopedist admitted to me, there's not a lot of science about what to do about them. There is also a hesitancy about surgery when it comes to labral tears. I'm curious about that, because the doctors caring for Alex Rodriguez of the New York Yankees seemed pretty clear that his torn labrum was getting in the way of smooth, pain-free running and batting. They whisked him off pretty quickly for surgery to repair the labral tear in his hip, and he was back on the ball field two months later, his form as smooth as ever.

What happens when you have an injury?

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Accidents and injuries, like spraining an ankle, slipping on ice, or a sudden fall, can cause muscles to involuntarily contract to avoid pain and protect from further injury. This is called the Trauma Reflex. The photo on the right is a typical Trauma Reflex.  This kind of posture is responsible for such conditions as sciatica, piriformis syndrome, leg length discrepancy, scoliosis and plantar fasciitis. The client in this photo broke her left ankle and had to compensate for months using the right side of her body to protect the left side. Notice how the waist muscles on the left side of her body are tighter than the right, causing the left hip to be slightly higher up than the right. This causes a slight tilt to her right.

Compensating muscles = tight, painful joints.

Muscles attach to bones. Muscles pull on bones. Chronically contracted muscles compress joints, making them painful and tight. Chronically and habitually tight muscles around joints can cause a lack of joint mobility. Over time, too much compression on joints due to habitually contracted muscles can cause serious structural damage, such as labral tears or worn out hip sockets. Even sitting too much at a computer or in a car can create this kind of muscle tension.

From my clinical (and unfortunate personal) experience, I have found this to be a cause of many cases of chronic hip pain.  But here's the thing:

Release the underlying pattern of tight muscles, and muscle pain "magically" disappears.

Many medical professionals advocate strengthening to reverse hip pain. This approach doesn't make sense, and here's why:

If you have a muscular pattern of compensation and you strengthen the muscles of that compensatory pattern, you're merely making that dysfunctional pattern even stronger. You will literally "strengthen your pain." If muscles are contracted and causing pain, they need to be relaxed and released, symmetry has to be restored, and then strength training to maintain that muscular balance will be beneficial.

So what about labral tears and what to do about hip injuries? More in my next post... but in the meantime, if you have hip pain, do this: stand facing a full length mirror. Close your eyes and sense how you're standing. Do what comes naturally. Now open your eyes and notice:

  1. Are you standing with your weight centered over both feet, or are you tilting slightly to one side?

  2. Are your shoulders level, or is one shoulder slightly lower than the other?

  3. Put your hands at your waist, on top of your hip bones and see whether or not one hip is sitting higher up than the other (look back at the client photo in this post).

  4. Now feel the waist muscles on both sides. Is one side of your waist tighter than the other? If so, is it the same side as your sore hip?

If you are "out of kilter," then the core muscles that attach into your hips are working harder on one side than the other. This can cause hip pain. The good news is that it can be reversed....

Begin to learn the methods and movements of Clinical Somatics in order to relieve hip pain, increase mobility, balance and coordination! Check out my instructional DVDs at the Essential Somatics® store.