An Expert Opinion

Readers, this right hip pain has been a real drag for me. This week, I finally threw in the towel and arranged to see a (very reputable) physiotherapist to get a proper assessment. The results were not what I had anticipated.

Not that I had a very clear picture of what was going on in the first place. After all, if I had I might have been able to solve the problem myself. Instead what I had was a list of potentially involved tissues without a clear idea of what I was doing to make them so angry. A lot of uncertainty and frustration.

With the swiftness and laser precision of years of clinical experience, she examined my spine, and found a segment of my lower back that moves excessively when my core is disengaged. Particularly on my right side, where I get all my pain. She also found that my hips lack a great deal of rotation, and the right hip is a bit stiffer than the left.

This is an example of something called a “stress riser”. In the context of the body, this refers to the vulnerability created when you have a stiff joint or tissue adjacent to one that moves a lot. When movement goes through the system, the stiff joint is not able to contribute properly, and its movable neighbour is forced to compensate. This often ends with the loose joint becoming looser and inflamed over time. So, in my case, certain movements that require a lot of hip range of motion are just translating the stress into my lower back.

The more disturbing finding, however, was her impression that my hips don’t have a whole lot of potential to gain range of motion in certain directions! There are variations in the structure of the socket of the hip and the head of the femur which can limit or bias movement in particular directions, and it looks like I drew the “can’t internally rotate more than five degrees” card.

On one hand, this was a bummer. It implied to me that my hips lack the potential to develop a high level of mobility in certain directions. Certain activities will have to be modified to respect my anatomy. On the other hand, it was kind of liberating. I have struggled for a long time to find a technique that would actually improve my internal rotation. I poured a ton of work into it, and got almost nothing in return. Knowing that my skeletal structure simply doesn’t allow that range gives me closure on the issue. For years I felt like I was failing to take it seriously, or that the stretches I found were just poor techniques, but now I know I was just running up against a brick wall!

I do think, however, that my hips have a particular endowment to balance that restriction. They seem to move very generously into abduction. Side split type movements have always come easy for me since my Tae Kwon Do days, and that flexibility has never diminished much in spite of very little maintenance work. So it doesn’t seem to be a total loss. I’ll just never make a good hockey goalie.

Now, with a clear diagnosis and the support of a skilled clinician I can move forward and hopefully solve this long-lived problem. I feel a peace around the injury that I haven’t felt very often in the past year, and I learned something very valuable about my anatomy that will inform all of my training. And yeah, maybe I have some limitations in certain ways, but there is no changing that, and armed with this knowledge I can take proper advantage of my unique build.

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