Tuesday, July 10, 2012

Hip Pain While Running in Boston

As the summer flies by here in Boston we're seeing more and more people come into our Copley Square Chiropractic office with a common running injury which can only be described as hip pain.  The hip is a hard area to define for most of us because it combines many different parts of our anatomy.  Most of us think of the outside part of our hip or butt area when we think of the hip, but others think of the internal structure, where our leg connects with our pelvis.  It all depends upon who you talk to.  The main point of this post is how to deal with pain felt more externally, on the outside of the hip area, or the "jamming" internal feeling that is primarily caused by a tight and tender Tensor Fasciae Latae muscle.

Picture Source: http://www.bcnlp.ac.th/Anatomy/page/apichat/muscular/page/Tensor-fascia-latae.html

Your TFL runs essentially from the top of your hip bone (iliac crest) to the outside of your femur.  It's not very long, only a few inches in most people, but is essential for proper walking and running.  Along with your gluteus medius muscle it helps to stabilize the leg and hip area during one legged movements, such as the push off phase of running, or standing on one leg.  It's an area that tightens with sitting, but to this point we don't have a great stretch to ease the tightness.  Eventually the TFL "turns into" your iliotibial tract (or IT Band) which connects to the outside of the knee, as seen in the picture above, and may cause knee pain.

Common symptoms of TFL issues are low back pain, outer hip pain, pain going from sitting to standing, outer knee pain, a "jamming" feeling inside the hip joint, and pain during or after running.  Tightness in the TFL often leaves the athlete feeling as if the hips are "twisted" or that they need someone just to pull their leg away from their hip.  It's an annoying problem that can last for months and in some cases years.

Luckily for runners of all ages there is a way to treat this problem.  The first step is to work on the TFL muscle yourself.  This can only be done with self trigger point work, which means you get some sort of a ball (tennis ball, golf ball, softball) and lie directly on your TFL.  It will look as if you're on your side, with the ball jamming into your TFL.  It's always recommended that you find exactly where the TFL is located before performing this movement, because if you end up lying on your hip bone or femur you're going to be in more pain than when you started.  Once you find the TFL you can lie on the ball for 2-5 minutes.  This should decrease some of the pain, and after a week should take the pain away completely.

If you're an avid runner or athlete who has tried this approach and aren't getting the results you're looking for it probably means you need some outside help.  Here in the office we see many people, and not necessarily runners, who just can't seem to get relief on their own, so they need our  help.  What we do is deep muscle work on the TFL itself and also we can adjust the femur so that it's not so tight in the hip joint.  This takes away the "jamming" feeling and enables the TFL to relax.

Doctors Note:  Hip or outer glut pain is often caused by a tight TFL.  TFL tightness is caused by sitting or squatting too much.  Stretching hardly ever helps... and this is NOT something that just goes away on its own.  Try self trigger point therapy for a few days to see if you get relief.  If not, call either your chiropractor, physical therapist, or massage therapist (whoever knows how to do deep tissue work) to have them work the muscles on a deeper level.

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