There are many reasons as to why you may be suffering with hip pain. Whether an acute or chronic injury this can often be severely painful. Lying on the side may illicit symptoms or a long period of inactivity can lead to pain. The many different causes of hip pain can be accurately diagnosed by a professional, and whilst you can try to help to yourself; best practice would be to get a professional to accurately diagnose your problem. Then a treatment action plan will truly benefit you in the long run.
What causes general hip pain?
General hip pain can come in all sizes and shapes. The type of hip problem that you are suffering with is dependent on a variety of factors. Your age is a key factor in the development of hip pain. The older you get the more at risk of arthritis you are, whilst, other structures become less able to react to potential forces placed on them. Tendon injuries and joint capsule injuries become more common and frequent with poor management following the initial injury.
Tendinopathies
Bursitis – Inflamed bursa
Muscle weakness
Muscle Strain
What can cause hip pain during a run?
Ultimately, you should seek professional assessment and advice to fully determine the root cause of your pain. This can then bring about the best corrective exercises to get you back running pain free again.
Hip pain from running can present in many ways but two of the most common injuries that affect runners are muscle strains through a sharp increase in the acute workload/overuse of a muscle or hip impingement. Hip impingement is commonly referred to as femeroacetabular impingement (FAI), and is caused through the interaction of the femoral head on the acetabulum.
What are the most common hip injuries in a sports person?
Acute adductor strains
Adductor tendinopathy
Osteitis pubis
Sportsman hernia
FAI
These are the 5 most common pathologies that can illicit hip pain. Some of these will cause groin pain too, but the professional will be able to determine the root cause through accurate assessment. Hip injuries are most common in sports that involve high speed change of direction movements and kicking, such as; football and hockey. The best thing to do when you suspect and injury is to rest it, elevate and ice it. Check out a previous post of the immediate management following an acute injury here.
Exercises to prevent hip pain
My hip pain also gives me knee pain; what can I do to help this?
The muscle that sits on the mid-portion of your quadriceps is called the rectus femoris muscle. This sits across two joints, so if and when it gets tight it is going to affect the hip and also the knee. In several cases the pain sits at the front of the knee or just below the patella. This is simple to diagnose and fix, often, a deep tissue massage will get rid of your pain quickly. The video above shows exercises that are perfect to get rid of hip pain, with these certainly able to help get rid of this type of hip pain.
Through your daily activities, fluid is lost through sweating but also through the water vapour that is lost through your breathe. This will all lead to an increased state of dehydration which can then cause a general loss of performance and you will find that you fatigue far quicker.
Being dehydrated will lead to a reduction in blood volume, placing a greater strain on the heart, lungs and circulatory system. It has been reported that a 2% loss of body weight, through fluid loss, leads to a reduction in aerobic capacity by 10-20% during exercise lasting 90 minutes or more.
The more dehydrated you become the less able you are to sweat, this is due to the body prioritising blood flow to the muscles rather than the skin, therefore, the body is unable to manage body temperature as effectively.
How much fluid should I consume before exercise?
The main priority before exercise should be your hydration. As previously mentioned, if you are dehydrated and are looking to perform at the highest level that you possibly can, then you are physically unable to do this. A study involving long distance runners reported a 2% drop in body weight through fluid loss, caused a substantial drop (6-7%) in the speeds they were capable of reaching.
In an ideal world prevention of dehydration is better than curing it. This should be thought about more so when exercising in hot and humid conditions, as you will dehydrate quicker. To monitor your hydration status you should observe the volume and colour of your urine. There are many charts available to compare the fluid colour with, whilst your urine should ideally be pale yellow in colour and not completely clear.
It is recommended that an athlete should consume 5-7ml of fluid per kg of body weight slowly over a 4-hour period. Therefore if the athlete weighs 70kg they should consume 350-490ml of fluid pre-exercise. Always carry a water bottle with you, this allows you to manage your own hydration rather than depending on a coach.
What should I be consuming during exercise?
Fluid consumption throughout the period of exercise will vary from athlete to athlete. The American College of Sports Medicine reports that there are no specific recommendations on fluid intake during exercise due to the differing sweat rates and composition of the sweat. The aim of maintaining hydration throughout exercise is to limit the total loss of performance.
Exercise will vary in difficulty, this depend on the environment or intensity of a session. Therefore, the best strategy is to observe the fluid loss that takes place through sweating before and after a standard session. This is done by taking the weight of the athlete before and after exercise; with the aim to limit the dehydration in future sessions to less than 2% of body weight. Alterations then can be made on how much should be consumed dependent on the environment.
How will fluid help my recovery?
Following exercise the body needs to have the fluid balance returned to normal; this involves the restoration of water and electrolytes that were lost through sweating. Researchers have recommended that you should look to consume 1.2-1.5 times the weight lost following exercise. Working on the assumption that 1kg of body weight is the equivalent to 1L of sweat, you should look to replace the fluid loss with 1.2-1.5L of fluid. This should not be drunk in one go, however, drunk steadily over a longer period of time.
A key reason to maintain good hydration following exercise is for the recovery of the athletes muscles. This is a process known as protein synthesis; it plays a role in the rebuilding of muscle, and requires the muscles to be hydrated to work. Therefore, poor hydration will lengthen the time at which the muscle recovers following exercise.
Water versus Sports Drinks?
When performing moderate-high intensity exercise you may feel nauseous when consuming water, this can be due to dehydration or the intensity which you work at. A sports drink will aid you during exercise at the high intensity when it is performed for longer than an hour. A sports drink containing 40-80g of carbohydrate per litre can promote hydration and normalise blood sugar level. If the exercise is longer than 2 hours in length or you are sweating heavily you should opt for a sports drink that contains sodium.
There are three main types of drinks available to us in daily life; hypotonic, isotonic and hypertonic.
Hypotonic drink – This drink contains less than 4g of carbohydrate per 100ml. This has a low osmolality (concentration of particles in comparison to that of the body); due to it being more dilute than the body this is absorbed faster than plain water.
Isotonic drink – This is the typical sports drink and has a similar osmolality to the body. This drink offers the ideal compromise between rehydrating and refuelling. This is absorbed as fast or faster than water.
Hypertonic drink – This can be categorised as a ready to drink soft drink, this has a higher osmolality than the body with a higher concentration of electrolytes, this is absorbed more slowly than water.
How to make your own Sports Drink from home?
What are the sports drinks available to me?
There are two designated types of sports drinks that are available to us. You have the choice of either a fluid replacement drink or a carbohydrate drink.
Fluid replacement drink – This has dilute concentrations of electrolytes and sugars (carbohydrates). Sugars that you will often see in these drinks are glucose, fructose and sucrose. The aim of this type of drink is to replace fluid faster than plain water, whilst the added sugar in the drink will maintain blood sugar level.
Carbohydrate drink – These will provide a greater amount of carbohydrate per 100ml than fluid replacement drinks. This is typically made up of maltodextrins. You would typically use this drink following exercise by way of recovery rather than rehydration.
Both of these types of drinks can be either hypotonic or isotonic.
We are always told that warming-up before a game can benefit us, but how often do you find yourself wondering, why do I have to spend so much of my time on it? Well the idea of the warm-up is to get the body fully prepared for the activity that lays ahead. When the warm-up is of a certain quality and length, it will produce physiological and psychological effects on the body. Whilst it has also been shown that a warm-up can reduce the risk of injury through stretching of the muscle-tendon unit; this in-turn allows for an increased stretch with less tension when exposed to an external load.
What are the two main types of warm-up?
General Warm-up: This incorporates more general movements rather than specific movements. This type of warm-up will tend to use generic body movements and activities that are unrelated to the specific neuromuscular actions that are used in their particular activity or sport. An example of an activity that takes place in this stage is dynamic and static stretching.
Sport Specific Warm-up: This is the application of big muscle group actions with rhythmic movements that provide a rehearsal of skill for the activity ahead. This is the performance of actions that directly relate to your sport examples are; throwing a ball to prepare for cricket or baseball, hitting a ball with your racquet for tennis and shooting a ball into a net for basketball or netball.
What happens physiologically during a warm-up?
Physiological effects can be defined as the effects that take place within the body.
A warm-up will produce a higher muscle temperature, an increase in local muscle oxygen availability, increase in the uptake of oxygen within the muscles and lower the blood lactate level. There will be an increase in blood flow around the body and muscles with an increase in oxygenated blood being delivered to the working muscles. This is due to the increase in heart rate, increase in stroke volume and an increase in breathing rate. This increased breathing rate helps to oxygenate the blood whilst also removing the waste products from the blood.
Faster contraction/relaxation in the muscles
There is a greater economy of movement in the muscles through the decreased viscous resistance
Due to the higher temperatures, oxygen is released more readily by the haemoglobin
Facilitated nerve transmission and muscle metabolism
Increase in the blood flow through active tissues due to vasodilation
What effect does a warm-up have psychologically?
This is the effect the warm-up has on the mental aspect of physical activity.
Whether this helps to motivate the athlete or bringing a level of focus to their game. It has been reported that the specific skill based warm-ups consisting of movements or techniques involved in the chosen physical activity can improve accuracy and co-ordination. Further to this, there is a notion that preparation before completing the activity can sufficiently prepare the athlete to compete at their highest level without fear of injury.
Ultimately, it does come down to the athletes personal beliefs and feelings; if they believe that a warm-up is beneficial prior to their activity then their performance levels are likely benefit directly from a warm-up. However, if their belief is that a warm-up provides no true benefit to their performance; a warm-up may provide little to no effect, however, the risk of injury will be increased.
Structure of a warm-up
Exercise
For How Long
Rationale for Use
Run or team based game
5-10 minutes
Elevates heart rate which increases the blood flow around the body.
Variety of dynamic stretches: squats, lunges, sidesteps, skips, bounds (naming a few exercises there are a wide variety available)
5-10 minutes
This prepares the joints and muscles for activity. Placing the muscle-tendon junction on stretch to prepare it for the external load. All of these exercises should be dynamic in nature with limited use of static stretching. The main aim is to maintain the temperature in the tissues so they are ready for the activity.
Sport-specific: These should have exercises that steadily progress through in intensity. For example, if the sport involves throwing and catching you would aim to start off doing small underarm throws and catches. This would then progress onto overhead throwing over a greater distance, with the view to then incorporate the running aspect to familiarise the body with the levels of co-ordination needed
5-15 minutes
This will fully prepare the athlete for the particular movements involved in their sport. This further helps to prevent injury whilst further incorporating the psychological effects previously mentioned.
The gluteal muscles are the biggest muscle group in the body. These muscles often become weak and inactive due to the majority of the population sitting at a desk for work. When sat down the glutes are in a lengthened position, whilst the hip flexors are shortened; if you get pain when you stand up after a long period of sitting this could be your cause.
What are the glutes?
You have three muscles in the gluteal group. One of these everyone knows of and that is the gluteus maximus. The role of this muscle is to extend the hip whilst also operating in the external rotation of the hip. The other two gluteal muscles are the gluteus minimus and gluteus medius. The role of these two is to assist with abduction of the leg, internal rotation of the hip and for stability when standing.
Why should we exercise our bum muscles?
Ultimately having weak glutes will mean that other muscles will have to pick up the strain. When there is a weakness in the glutes this can often be seen in people with lower back pain; whilst it can often cause pain in the hip when running. When walking or running, your glutes off stabilisation to the pelvis and hips. By having these muscles active and strong, you will be able to walk and run more pain free. A simple test to see if there is a weakness present is to stand on one leg and observe how the pelvis reacts to this. Exercising the glutes will help to reduce the risk of lower back pain, whilst increasing the stability in your hips.
Exercises to improve your glutes function
How can I make my glute exercises harder?
There are many ways to increase the difficulty of an exercise. Firstly, if the exercise is starting on two legs then you can move to a one leg exercise; for example, a two leg squat can progress initially from holding a wall into two leg with no support into 1 leg.
Other than changing the number of limbs in contact with the ground, you can slow down the rate at which you perform the repetition. So, instead of working at a 1-1 ratio you can change to 3 seconds up 3 seconds down. Then you have the resistance you are working with.
Ultimately, most exercises start with body weight exercises and you may not have any weights available to you. Grab yourself a bag or rucksack and fill it will heavy books, food items from the cupboard or pots and pans. This will increase resistance with items you already have!
How often should I do my glute exercises?
This all depends on what you are looking to achieve. If you are looking to work for muscular endurance, then you would look to perform a slower action for around 12-15 reps with the use of a fairly light weight. Muscular strength you would speed up the action for around 8-12 reps working at 70-80% of your 1 rep max. Power work is a short sharp movement, working at a fairly high weight of around 80-90% of your 1 rep max. You would aim to complete 4-6 reps for this. As training for power is exhaustive on your muscles you need to make sure that you allow a decent rest period in-between sessions.
Want to find out what you need to do to get yourself fixed or pain free again? Click the image below or follow this link to book in.
The plantar fascia is situated in the sole of the foot and is a leading cause in sole pain in the majority of people. This fascia plays a vital role in normal foot biomechanics, supporting the arch in the foot and acts as a shock absorber.
What can cause my sole pain?
Poor footwear
Excessive pronation of the foot
Loss of ankle dorsiflexion
Weight-bearing activities such as running
An increase in body mass
Tightness in the muscles in the lower portion of the leg e.g. calf
What is plantar fasciitis?
This is an overuse injury that is caused by micro-tears in the fascia but can also be caused by a traumatic episode. It is often referred to as inflammation of the plantar fascia, however, there is a significant absence of inflammatory cells. You will often feel a stabbing pain near the heel when you wake up in the morning. This pain should decrease when you get up and moving, but, could come back again after a period of standing or getting up after being sat down. This is easy to diagnose through questioning from the therapist, book in now to get the ball rolling on your recovery from plantar fasciitis.
Why am I affected by plantar fasciitis?
This is the most common cause of foot pain whilst it typically affects around 10% of runners. The pain can last for 6 months or more, with women more affected than males. Plantar fasciitis also affects around 10% of the general population with 90% of all cases being resolved with conservative treatment. Your age will also be a risk factor for developing this pathology, if you are between the age of 40-60 you are at a heightened risk of suffering from plantar fasciitis.
How I can relieve my pain immediately?
The first things you should do is to ice and rest the affected area. The rest will give the fascia time to heel whilst the ice will act as pain relief. A useful tip is to freeze a small water bottle, from here work it from the heel towards the toes. This will have a pain relief effect will also helping to relax the affected area. Following this, you should always stretch you calves, these will have an impact on the amount of movement you have through your ankle. More importantly, the calf plays a key role in the amount of ankle dorsiflexion that is available. We have already outlined that a reduced range of ankle dorsiflexion is a risk factor for plantar fasciitis.
Is it possible to prevent plantar fasciitis?
Yes and no. By putting in place stretching routines and actively managing your loading through the tissues you can help to reduce the risk of developing plantar fasciitis. However, you can’t prevent all traumatic episodes from occurring and you may subsequently suffer from plantar fasciitis. If you do suffer from plantar fasciitis then the best thing you can do is manage your pain as best you can whilst getting the tissues mobilised.
Sciatica is a debilitating disorder that can often leave you with pain, numbness or tingling down the back of the leg. A common mistake is lower back pain and other pathologies being wrongly diagnosed as sciatica. In most cases of sciatica, this is due to irritation of the nerve. For some of the population the piriformis is the cause of the sciatic related symptoms, however, this is called piriformis syndrome and not sciatica.
The sciatic nerve originates from the the lumbar spine and is easily the largest nerve in the body. The pain is often worsened when bending over, twisting and coughing. In most cases there will be an inflammation of the nerve due to the something irritating the nerve, such as a bulge in the vertebral disc. I do stress, if you have any numbness in the saddle region or have some bladder dysfunction related to what you think is sciatica, then go to the hospital for once over. As this could be something more serious.
Lower back pain the cause of your sciatica?
What causes Sciatica?
Due to the origin of the sciatic nerve, a bulging or herniated lumbar disc can cause sciatica
In an older patient, spinal stenonis can cause symptoms
Spondylolisthesis, slipped disc, can also cause the nerve pain
A tumour can lead to compression of the nerve
A traumatic episode
Muscle spasm can lead to the impingement of the nerve leading to production of symptoms
Who does sciatica commonly affect?
No specific gender is affected
There is a peak incidence for sciatica in populations entering their 40’s
Rarely occurs in the population before the age of 20, unless there is a traumatic episode
Jobs that subject the person to get into awkward positions have predisposed people to sciatica
How can I alleviate my sciatic pain?
There are many ways you can help yourself when you have sciatica. Firstly, the accurate diagnosis of the cause of the sciatica needs to be identified. If it is suspected that you have a spinal pathology causing your symptoms, then you should have a scan that can determine the true cause. From here then a treatment action plan can be put in place to help you out.
Deep tissue massage to relieve muscle tension
If your pain is muscular related, a deep tissue massage will be of great benefit to you. But when you aren’t able to see someone for treatment what can you do to give you comfort and reduce the pain you are feeling. Heres a few tips that you can do to relieve the symptoms when they arise.
Use hot or cold packs to relieve pain and reduce inflammation
Gentle stretches of hamstrings and muscles in the lumbar region
Correct lifting techniques
Try to avoid prolonged sitting
Core activation exercises can be beneficial too
Lifting technique key?
Exercises that can get rid of my sciatica?
Surgery for my Sciatica?
Surgery is the absolute last case scenario for sciatica and should only be thought about when all possible conservative treatments have been exhausted. This would be to treat the cause of the disorder. If you have a disc herniation then the surgery would remove this to reduce the compression on the nerve. There are many others that can be completed but this relates to the alternative pathology that causes the sciatica. Ultimately, not all surgery works, with many patients still complaining of pain and discomfort many months following surgery. Conservative treatment, when correctly directed can produce the better outcomes in a short time frame.
Do you suffer with sciatica type symptoms, book in so we can get you back to your lives pain free.
