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1414 Views 3 Replies Latest reply: Apr 10, 2012 4:33 AM by damien pressley
deanscox Pro 107 posts since
Jan 3, 2012
Currently Being Moderated

Apr 4, 2012 1:20 PM

Hip joint pain

I have been running for 12 weeks after 35 years of not doing anything.  I finished the C25K program and one organized 5K and am doing a new stepped up prgram to cut my time down for a 5K on 4/21.


I have begun experiencing a pain in my hip when I am NOT running.  It hurts when I walk around during the day.  It is tender when I first start running but pretty much disappears when I am warmed up and returns when I am cooled down.


  It is in the joint, not the muscles and is experience in the front of the hip on about 180 degrees side to side.  I suspect it is a little inflamation due to stepping up the training and due to the shock of taking myself from sedentery to active.   I am 6' 3" and approx 180-185 lbs, so it is not a wight issue.  I have a chonically tight and sore lower back and am adding some back and stomach strengthening exercises to my routine.


Any thought or suggestions are appreciated.

  • JamesJohnsonLMT Legend 1,291 posts since
    Aug 23, 2009
    Currently Being Moderated
    1. Apr 4, 2012 4:21 PM (in response to deanscox)
    Re: Hip joint pain

    12 weeks out, after changing your lifestyle from inactive for 35 years, to actively stepping up your program for a faster 5k, you can expect these aches and pains. It took me years to shake off the side-effects of growth, and it's the same for most people who post here. Anyone who says they took up running without these pains is either lying or exceptionally gifted, and should be considered the odd-ball, not you.


    When you say the pain is coming from your joint, not the muscles, how do you know this? If your brain had a mechanism for knowing exactly where a pain was coming from, that would be an anomaly. The brain depends on input from nerves several inches or feet away, and cannot reliably distinguish between potential sources along that nerve. To paraphrase one of the texts on the subject, problems in xyz muscle feel like they are coming from within the affected joint, which is sometimes nearby, and sometimes remote. It's medical fact.


    The soft tissue of muscle is richer in nerve endings than the bones, joints, tendons and ligaments that give them leverage, and they routinely refer pain to the joints they act upon. You've got a lot more mass in that soft tissue than in bone, etc., with a lot more nerve endings at stake, and it doesn't like being ignored. The biggest clue is that the pain retreats as your muscles warm up during workouts, and returns at rest. Joints and bones, on the other hand, are stressed more by activity and less by rest. Muscles can become more painful at rest as they attempt to repair with inflammation, and starve for the circulation movement brings. They become stiff.


    You said your lower back is chronically tight and sore. An inflexible core will translate into more work for the lower muscles supporting it, including those of the hip. Hip rotators, flexors and adductors are notorious for producing hip pain that feels, for all the world, like it is within the hip joint itself. The brain has no clue other than what messages are sent back from the area, which almost always map to a general area that is uninvolved. People rub or stretch and expect the pain to go away, but it often doesn't, because the source has not been directly identified and addressed.


    Sometimes a scan will show internal inflammation as a cause, when that inflammation is in turn being produced by relentless pressure, from overworked muscles that can no longer relax at rest. A life of relative leisure lowers the bar for what constitutes "overwork."


    People without chronic pain have been voluntarily scanned to find considerable internal "damage" usually blamed for chronic pain, yet with no effects. Similarly, chronic pain has been shown to exist in people with clean scans. The correlation is indirect enough to be determined coincidental. Your muscles are the canary in the mine, that begin to complain before actual joint damage is imminent. As stated earlier in this paragraph, even actual joint degradation has been shown to be as invisible and painless as early arthritis.


    To be more specific, pain from hip adductor muscles has sent people to the hospital for hip surgery, only to find the pain continues even after a hip is needlessly replaced. Since most of the adductors double as hip flexors, a more aggressive workout regime can bring frightening new pains to the non-seasoned runner. I'll repeat: the pain feels like it is coming from inside the joint itself.


    An even more specific example is the the hip flexor/abductor TFL (Tensor Fasciae Latae) that rides the outside of your hip joint, yet generates a pain image anywhere from local, to inside and behind the hip socket (it is also responsible for ITB pain as far down as the outer knee, but you'll probably get that much later).

    (image: Wikipedia)


    Other candidates are all of the gluteal muscles, hip flexors (shown above top), other adductors (above center), and intrapelvic muscles such as the Piriformis (above right). All can produce hip symptoms, and all must compensate for an inflexible upper core (back, abs, obliques). Unfortunately, ab exercises are one of the primary sources of lower back pain, because the abs pull on the other side of the lumbar spine in opposition to the back muscles, via their attachment to the ribcage.


    Flexibility is more important than strength when your core is stiff. "Exercises" should be oriented toward improving range of motion through gentle, non-load bearing movements. Crunches, situps, etc. will make the situation worse.


    So, you called it right when you mentioned the shock of sedentary to active, but don't jump from the frying pan to the fire. A race goal is a worthy pursuit until it forces you to sacrifice your physical health. A race limped, has less glory than one properly run and prepared for. You want to race again, I'm sure, so you owe it to your remarkable comeback from "not doing anything," to growing your changing body with grace and restraint. There will be plenty of time later for the passion of youth, as you gradually become fitter and physically younger.


    Find a tennis ball or equivalent, a stretch of carpet, and begin rolling it into the nooks and crannies of your lower back and pelvic muscles, using gravity alone for pressure. A smaller ball may be necessary for the TFL. Explore the area around the hip to replicate symptoms. Attempt to curve the lower spine from side to side, and move the hips through their range of motion, unloaded, to see where things catch, and what parts of you do not want to move.


    An inability to stand or walk comfortably erect, is a clear sign of dysfunction in gluteal and pelvic muscles. Aim for the area between the hip socket and upper pelvic crest to look for painful reflexes to the pressure. Observe as the application and release of pressure in those areas causes the muscles to warm and relax long-held tension. Professionals use manual therapy to find and treat these injuries, with greater knowledge, true, but without the benefit of directly feeling what you feel. Advantage: You. Trust me, in the next 12 years of running, you'll have plenty of time to get the knowledge part.

  • damien pressley Rookie 1 posts since
    Jan 15, 2008
    Currently Being Moderated
    3. Apr 10, 2012 4:33 AM (in response to deanscox)
    Hip joint pain


    I have had hip/ back pain for approximately 3 years and have finally found success with my chiropractor.  I initially got the injury after a 10 km run in Townsville, Australia.  Anyway after having constant physio, back strengthening sessions and absolutely no exercise to do I am now on the mend.  I will have to start slow.y but am starting to see some light at the end of the tunnel.  I have found chirps to be so much more helpful than physics.

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