Ask a PT: What’s the Root of My Hip Pain?

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Question 1:

When I drive my left hip joint hurts after about an hour. I move around and can’t seem to find release. It doesn’t seem to matter what, if any, training I’ve done that morning.

Help a hip out.

–Chad

To submit your own questions, email us at AskAPT.Competitor@gmail.com.

Answer: Dr. Marc Robinson

Hi Chad,

Thank you for your question. To get an accurate physical therapy diagnosis, we’d need to do a detailed assessment of your signs and symptoms, the activities or positions that aggravate and alleviate the pain, and how your range of motion and symptoms respond to tests. I’ll discuss a few possible diagnoses, my intent is to help you sort through the information and help you make better decisions, but I am not providing a diagnosis because I do not have enough information to make one.

The first thing that comes to mind when reading your comment is to rule out the lower back as a referral source. It is common for issues in the lower back—even without back pain—to manifest itself in the hip. I have this opinion because your hip pain increases while sitting which is pattern we see in the clinic when the lower back refers to this hip.

A way to investigate this further is to use a lower back support like a rolled up towel to see if that helps to reduce the hip pain. The low back support will change the position of the lower back and you can assess your response to the change. The lower back and hip are closely related, and the position of one can influence the other.

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The hip joint can also be a source of your pain. In sitting, the hip is positioned in flexion. Sitting for one hour places the hip in prolonged flexion which, at times, can aggravate the joint. In this case, moving the hip in a stretching position such as doing a hip flexor stretch may be another way to investigate whether prolonged sitting is playing a role in the hip pain.

Ask yourself, “Why is my hip hurting?” Try to find the underlying movements or positions that aggravate or alleviate the pain rather than try to guess what structures are hurting. Generally, exercises to strengthen the hip (if there is weakness) and improve mobility (if there are restrictions) are beneficial to maintain an active lifestyle. In addition, progressing your training properly will be key to getting restoring the quality of life you want. It sounds like you are taking action to resolve the hip pain which is the first step to achieving pain-free function.

Stay active,

Dr. Marc

***

Dr. Marc Robinson is a Physical Therapist in San Diego, CA who provides online physical therapy and virtual consultations for those who need on-demand help with injuries. His company, Evercore offers online injury prevention courses and fitness products to promote a pain-free, active life. They specialize in low back pain and helping their clients achieve health goals beyond what the traditional medical system can offer.

Question 2:

Can physical therapy help someone with idiopathic peripheral neuropathy that has balance problems?

–Kathy

To submit your own questions, email us at AskAPT.Competitor@gmail.com.

Answer: Dr. Marc Robinson

Hi Kathy,

Thank you for your question. Yes, physical therapy can help with idiopathic peripheral neuropathy. As you may have experienced, peripheral neuropathy can influence balance due to the disruption in the motor and sensory nerves in the feet. I want to encourage you that balance training and coordination exercises can stimulate those nerves and help your body to develop compensatory adaptations. Depending on the extent of the nerve disruption, the nerves may not fully regenerate, but your overall balance, mobility and quality of life can improve.

The balance systems in the body consists of the visual, vestibular and proprioceptive systems. With peripheral neuropathy, the proprioceptive system is impaired; however, you can still improve by increasing the proficiency of the visual and vestibular systems through specific exercises. A vestibular physical therapist or a physical therapist with a board-certified clinical specialty such as a Neurological Care Specialist (NCS) will have the most experience in designing an exercise program for someone with peripheral neuropathy.

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I have seen a fair number of people with neurological issues like peripheral neuropathy and their ability to improve depends on several factors such as the extent of their nerve disruption (as I mentioned before), motivation, strength and activity level. In addition, lifestyle habits play a role such as diet and nutrition.

In summary, consistency with an exercise program designed by a rehab professional can help you improve your balance. There is a lot of information to cover and contacting a physical therapist is a great way to find the strategies to help you accomplish your goals. Staying physically active and making healthy lifestyle choices will put you on the path to success and better balance.

Stay active,

Dr. Marc

***

Dr. Marc Robinson is a Physical Therapist in San Diego, CA who provides online physical therapy and virtual consultations for those who need on-demand help with injuries. His company, Evercore offers online injury prevention courses and fitness products to promote a pain-free, active life. They specialize in low back pain and helping their clients achieve health goals beyond what the traditional medical system can offer.

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