Releasing painful muscles, not strengthening them, is the first step in hip pain relief.
In my last post I wrote about my perspective as a Hanna Somatic Educator regarding chronic hip pain and what is counterproductive, and what works.
- Strengthening painful hip muscles can cause further pain or injury.
- Learning to relax the muscles and the pattern of contraction the muscles are stuck in can provide long lasting pain relief, relaxed hip joints, and balanced movement.
Exercises such as the “clam shell,” and lateral leg lifts tighten the hip muscles, making it more difficult to move the hip. They can, in fact, create more pain. 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.
- Address the pattern of contraction, not the individual muscles.
- PANDICULATION is the most effective way of regaining muscle function, improving movement and re-setting muscle length. When you contract a muscle first, then lengthen and relax it you address muscle function at the level of the nervous system. You provide needed sensory feedback to the brain and “wake up” the cortex to take back control of the muscular system.
I hope some of you tried the small sample of simple Somatic Movements I included in my last post. Here’s a wonderful variation of one of my favorite somatic exercises, called the “steeple twist.” This variation, made by Charlie Murdoch (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!
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, like a labral tear.
If you know you’re injured, and your doctor tells you to “wait and see,” or “it’s not a big deal,” then it’s critically important 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. Improving somatic awareness applies to all of us – elite athletes, teenagers, and Baby Boomers hitting their 60’s. 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, 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 he walked out the door I asked, “do you think that if you don’t fix the tear in my hip now, and I walk around compensating for slightly the next 5 years due to intermittent pain, that I might be causing worse structural damage, thus setting me me up for a full hip replacement?” He replied, “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. No absence of scientific data there.
So where does that leave the rest of us?
In googling, “labral tear surgery” recently, I came upon a forum on both Men’s Health and Runner’s World. The desperate pleas for help regarding recovery from labral tear surgery were horrifying. Terrifying. Depressing. From the feedback I read, never in my life would I consider this kind of surgery. The one saving grace was this: I’d be willing to bet that few to none of these people realized that their original functional problem – the trauma reflex that got them into the problem in the first place – wouldn’t be solved by the surgery. The surgery helped to repair the structural damage, which is wonderful. It didn’t address the sensory motor amnesia that altered their movement in the first place.
Surgery combined with Somatic Education focused on regaining full functioning of the body as an integrated whole and skilled physical therapy would be a winning combination.
I’d be willing to bet that what A-Rod got was a winning combination: excellent surgeons, excellent functional trainers, and PTs who knew what to look for (gait symmetry, ribcage symmetry, evenly swinging hips, even leg length that comes from relaxed obliques, lats and abdominals). I would add to anyone’s rehabilitation program Hanna Somatic Education.
So while the jury’s not out about what route I will decide to take – or have the option to take. Improving my own sensory motor system and paying attention to my daily movement habits (which are fodder for yet another blog post) is critically important and profoundly helpful in creating long lasting pain relief….which is what we’re all looking for, right?
I teach a variety of workshops on how to release tight hip joints, hamstrings, backs, necks and shoulders. There are lots of movement patterns, and each one gives more and different sensory feedback to your brain, in order for your brain to intelligently and safely increase flexibility, proprioception and muscle control. If you’d like to bring me to your area for workshops, weekend seminars or private, clinical sessions, please contact me. There are lots of options for learning more: online video consultation, phone consultation or private sessions.