Fitness Column: Hips absorb the energy

Since we all have them, let's talk about a common area of the body - the hips.

Lots of back and forth motion - for some of us more than others - lots of impact compression and always a "taken for granted" full movement pattern. Unless you have suffered a blow to the hip area, or a degeneration of the hip joint itself, you seldom think of any area less likely to be injured.

Generally this is true, at least with non-contact sports. However, as you age, and if you are maintaining a specific form of fitness continuously, you may find tenderness of the hip gradually becomes more noticeable.

Hip bursitis or hip tendinitis can be the result of long-term continuous movement patterns. It can be brought on by sudden blows or a sudden different movement and then escalated with repetitive exercise. Essentially, hip bursitis is an overuse injury. The hip bursa is located between the Iliotibial band of muscle on the outside of the thigh (it runs down the outside of the leg to the knee) and the top of the femur leg bone called the greater tropchanter.

There it sits as a cushion to maintain smooth movement over the hip joint. The hip bursa also provides synovial fluid to lubricate the joint and tendons of the hip. When inflamed, it produces more fluid and expands, resulting in a self-perpetuating pressure on the bursa sac.

Another cause of hip bursitis, and one that I see most often, is the result of unequal leg lengths or other structural imbalances. One arch may be flatter than the other, one hip higher, one leg longer, or there may be a slight curvature of the spine. These all create an imbalance of the body during running or other impact moves. Whether landing or taking off in any impact movement, extra stress is then placed on one side of the body. This imbalanced region of the greater tracochanter produces extra exertion for the take-off or landing and the bursa sac may then become irritated.

Several different muscle and ligament areas also interact with the hip structure; those of the gluteus minimus and medius. They lift the femur away from the torso and help stabilize the pelvis when you run. So, when you hurt in the general area of the hip joint, the factors involved for cause and prevention are many.

First, suspect a structural problem if your irritation is only one hip. Maybe a simple solution of an orthotic shoe insert will help; maybe cutting down your running time or impact moves for a few weeks will relieve the symptoms. Maybe a pre-workout session of stretches will loosen the hip movement and relieve the pressure on the bursa. In any case, the most important step is to realize you have a problem before it becomes so severe that you lose your sport entirely.

A good rule of thumb - try not to increase your pace and length of run at the same time. It is usually too much for some part of your body!

Jerry Vance is certified by the American Council on Exercise and teaches fitness at the Carson City Community Center and for the American Lung Association.


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