Self Care for Hip, Groin, and Back Pain

Self Care Steps:

This blog is for those of you who have hip pain, groin pain, hip impingement, sciatica, SI joint pain, or low back pain. And if you don't have any of these, then you are lucky and prevention is the best medicine!
Hip mobility is paramount for a healthy body and spine. During an evaluation I like to observe a static standing assessment, a functional movement assessment, and then perform a passive mobility assessment.  
People with back/hip/groin pain often have a postural position of "butt gripping" (read a great article about it here Diane Lee).  In this position, the pelvis is thrust forward and the deep hip rotators are contracted. When these muscles are overactive, they push the head of the femur into the front part (anterior) of the hip capsule which can interfere with hip motion: hip flexion (bringing the knee toward the chest) and internal rotation (turning the thigh inward).

On the functional exam I will see an inability to go into a deep squat, or the hips will shift to the opposite side during the squat.  On the passive motion test there will be a limitation in hip flexion, and they may express pain with a combination of movements: hip flexion, adduction and internal rotation.
Standing in alignment and learning how to let go of the grip in the rotator muscles is essential for healing, as well as reprograming the normal glide of the head of the femur.  In normal motion, as the knee moves toward the chest, the head of the femur should glide back and down.  Due to the tightness of the rotators, the back (posterior) hip capsule can be restricted.  Restoring the tissues and the hip motion can be achieved through simple self mobilizations.

1. Standing Alignment: vertical leg, torso stacked over the legs.  Think about a plumbline going through the midpoints of the shoulder, hip, knee and front of the ankle bone.

---

2. Release Deep Hip Rotators:  Lie down on your back with your knees bent.  Place a tennis ball under your left butt cheek just to the side of your sacral bone.  Rock your knees to the side and return to start position 3 times.  Find a new spot and repeat.  Complete in 3-5 different areas and then switch sides.

3.  Hip Release and Hip Glides:  this is a video demonstrating how to do the self mobilizations to regain normal motion.

Susan McLaughlin is a physical therapist who specializes in the management of pelvic floor and orthopedic dysfunctions. She is the owner of ALIGN integration|movement in Salt Lake City, UT.  Helpful tips and other self care strategies can be found at www.alignintegrationandmovement.com.