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If you have problems in your hips or pelvis, the usual treatment is:
Anti –inflammatory medication and rest
The result is predictable:
Temporary reduction in symptoms and then symptom flare-up .
Getting “Hip” to It
“I have no power in my leg!” “My hips ache.” “My back hurts.” “I think I pulled my groin.” “My pelvis is out.” “It just hurt,s Doctor!”
Of the different complaints heard from cyclists, the hip area is one of the most commonly involved. Cyclists (as well as all athletes) require strength and stability from the hip and pelvis. Without it they can’t transfer the power from the core muscles into the legs.
If you have problems in your hips or pelvis there is much to consider. Too often athletes are given a simplistic diagnosis without thorough consideration of all that could be involved. The diagnoses often given are: Bursitis, a pulled muscle or a pinched nerve. Oddly enough the treatment always seems the same: Anti –inflammatory medication and rest. The result of this type of “care” is predictable: Temporary reduction in symptoms and then symptom flare-up with return to sport.Problems in the hip are often multi factorial. This essentially means there are several issues involved and all must be discovered and addressed for the best results. A proper evaluation must include:
It may sound like a daunting task to get an evaluation that thorough, but the greatest challenge is really in finding a doctor or therapist who understands the mechanics of the hip and pelvis AND the demands of your sport. When you properly diagnose and evaluate a hip problem, you can then fully treat the condition.
With “cookie cutter” treatment you are destined to have chronic, recurrent hip problems that hurt your performance -- or prevent you from participating in your sport! As an athlete you don’t have time to waste when you are injured You need to get back to training and competing. To do that you must work with a professional who understands your sport and your athletic mindset.
The common denominator for these issues is they lead to imbalance in strength and movement in the pelvic and hip joints. This causes compensation patterns which lead to pain, inflammation and overuse injury. When the doctor looks only at the area of pain and does not fully evaluate the entire “kinetic chain” from the foot up to the spine these other factors are not accounted for and thus not treated. Treating only the painful area may provide temporary symptom relief with the symptoms returning or never fully resolving. The longer this goes on the more the athlete develops compensatory patterns of movement leading to deeper problems.
Prior to this he raced a full season on the road without significant hip problems. When asked to point to the pain he touches a point on the upper right buttock. He feels the pain especially when remounting the bike but also when rising up from sitting or when climbing steps. He feels like he can pedal hard, but there is pain during these hard efforts.
Evaluation showed his pelvis to be low on the right side and rotated posterior. He had full right hip range of motion in all planes but there was pain in hip extension and hip external rotation. Low back range of motion was limited modestly in extension and there was pain in low back extension, rotation and flexion. Tenderness and tightness was noted in the right low back and the right hip flexor. Tenderness was noted in the right sacroiliac joint. Both hamstrings were short and tight. The hip flexors were tight and tender especially the right side. The gluteal muscles bilaterally and the right hip flexors muscles were weak. His gait was normal. Sit to stand was normal but reported as painful. Squat test caused both feet to collapse into pronation (with the right side more significant) and his lumbar spine went into flexion (he could not maintain a straight back). Intersegmental joint motion revealed restrictions in the sacroiliac joint on the right, the right lower two vertebrae and the lower thoracic vertebrae.
Diagnosis: Acute right sacroiliac joint pain and dysfunction
Underlying problems leading to the acute sacroiliac pain were:
Therapy to address each of these problems brought balance to his hips and pelvis. He followed my therapy recommendations:
By performing these exercises he gained the benefits that were top priority for him:
In your athletic life, and other daily life, you deserve the same kind of evaluation and care for your injuries and pains. Your health and happiness are important!
Work with a professional who understands you and the demands on your body of any sports you love. You'll want a complete evaluation to find not just the acute problem but also the underlying factors which led to the problem.
By taking this more thorough approach to your evaluation and your treatment, you will have better results and less chance of chronic issues that slow you down. Getting the finest care, with a chiropractor who truly partners with you, can change the quality of your life.
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