A common complaint I get from new clients is anterior hip pain (most of the time on the left side). Let’s take a moment to talk one of the common causes of hip and how to fix it. Note: if you are experiencing severe pain that last for over 2 weeks, consult a licensed healthcare practitioner to rule out any structural damage.
The most common cause of anterior hip pain that I see (that wasn’t caused by a traumatic injury ie. motor vehicle accident or fall) is from asymmetry gone awry. Our bodies are naturally asymmetrical. We have a heart biased to one side, a liver on the other, and our diaphragm is segmented into the left and right. The left diaphragm, due to its flatter structure and the heart that rests atop, is prone to being in a more inhaled position. Whereas the right diaphragm, with a more domed shape and supported by the liver, has an easier time exhaled position. Problems arise when we are unable to fully exhale on the left ribcage and get fully inhaled on the right ribcage. Because the pelvis follows the influence of the ribcage, we see that when the left ribcage is hyperinflated and tipped back, the left hip will tip forward to compensate (we can go into the intricacies of exactly why that is in a future post). The tipping forward of the pelvis cause the acetabulum (the cup of the pelvic) to face down and to the side while the femur is shifted forward instead of sitting back into the hip. Once the pelvis is out of position, the femur during hip flexion (leg moving toward the head) runs into a problem when we enter ranges around 90 degrees. There is no more room in the hip, so the femur must drive against the acetabulum (cup) and divert in or out (moving out in most of the clients I see). If you perform any movements with hip flexion repetitively, this will aggravate the soft tissues that surround the hip capsule (labrum, psoas, TFL, etc.). A common sign of this hip impingement is when you pull the knee toward your chest, you get a pinching sensation. Now before you panic and think you need surgery, I have found great success with clients working on simple breathing and position exercise to address the underlying problems:
Asymmetrical Breathing Patterns Gone Too Far
Posterior Structures Of The Hip No Longer Yielding
Now that we know why our hip is hurting, it’s time to address how to fix it. In this case, I will talk about left anterior hip pain. The goal of any exercises address the hip pain will need to activate left abs, left adductor, and left glute max while turning off left posterior capsule, left glute med, and right adductor. This is just a fancy way of saying, “You need to be able to stand over your left leg.” Now I know this sounds simple, but it is actually really challenging. Let’s do a test. Stand in front of a mirror so you can see your entire body. Now, shift your weight to the left and support yourself with your left leg (both feet are still on the ground). Take a look at the angle your spine creates from side to side. Is that angle pointed more toward the left or the right? How about the zipper of your shorts/pants? Is that over the left or right leg? If you answer right to either of these questions, you are actually on your left leg, but trying to get back to your right. Your left side has not yielded, and is instead stuck in driving back to the right mode. It’s the same reason you will see runners stuck in a leaning position as you see them go by. They have a wheel out of alignment and there is no stopping it!
Luckily for you, I have a simple exercise that will help you feel both left abs and let go of that left posterior capsule: 90/90 Hip Lift with Left hip shift and Right Hand Reach:
Watch here as I explain exactly how this is done. Give it a try for 2 sets of 5 breaths and then retest the standing over the left leg.
Need some more help with hip pain? Feel free to reach out! I work both remotely and in person.