Dooley Noted: 9/21/2015
The hip joint is s ball-and-socket, triaxial joint with enormous movement potential. As the femur (thigh bone) makes the joint with the acetabulum (pelvic landmark), the hip moves into flexion, extension, abduction, adduction, internal and external rotation.
In a healthy, properly mobilizing system, the hip naturally compresses and decompresses as it moves through space.
As the lower extremity swings through gait, the hip naturally compresses. It decompresses slightly on heel strike to move into full compression on suspension. This phase involves flexion, internal rotation and adduction, or full compression.
This action is carried out by many muscles, but 2/3 of the action comes from gluteus medius in the healthy hip.
As we move from suspension into propulsion, our hips must decompress to go into extension, external rotation and abduction.
Herein lies the problem. People struggle enormously with that transition for a number of reasons. Here are just a few common ones:
1. Lack of right side abdominal stability
2. Lack of calcaneal eversion in pronation, limiting propulsion transitioning
3. Lack of hip propulsive muscle activation, such as gluteus maximus
4. Falls or car accidents that jam the femur into a medially rotated, adducted position
These reasons are linked from everything to assymetrical right diaphragm/liver positioning to right hand dominance to sitting all day.
This can result in faulty movement patterning at the hip, keeping the joint in a compressed position.
Failing to fully decompress the hip starves the joint of its mobility. It also can starve it of its nutrition and lubrication.
For some people, it results in pain in a “C” shape, that wraps from groin to the lateral hip and into the buttock. That “C” they draw always made me think: compression.
The pain can be exacerbated by walking, since the hip cannot fully decompress to propel the person forward.
The pain may also be exacerbated by excessive sitting or squatting, where the hip moves into a modest amount of flexion with a planted foot.
The person will beg anyone around them to simply pull their lower extremity outwards to unjam the hip.
Please don’t.
Unless the person has experienced a fall or traumatic injury, hip compression is the result of faulty movement patterning that won’t improve should you yank their lower limb from the pelvis.
Most often, the hip is compressing to attempt to create stability for a tension-leaking abdomen. By not addressing this energy leak and yanking on the hip, one creates potential for the hip to jam more once you stop yanking.
Gray Cook calls this “bringing mobility to a stability problem.”
The tension-leaking abdomen encourages muscle recruitment like pectineus, a femoral and pelvic-attaching adductor that encourages the compressed position.
This internally rotated, adducted hip will then lock the deep obturator muscles in an eccentric (long) position, creating a pathological compression that down-regulates superficial gluteal functioning.
After all, the obturators are much closer to the joint, giving the system the position sensing to tell the outer glutes, “Hey, we are doing the compression here. No need for you to do healthy compression (gluteus medius) nor decompression (gluteus maximus).”
Thus, healthy hip compression and decompression by outer gluteal function is traded for unhealthy compression by smaller, overeager stabilizing muscles that are closer to the joint surface.
Please – stop asking your friends and family to yank your hip away from you. You are creating long-standing instability that can result in more compression. And more compression can lead to osteoarthritic changes.
On my YouTube, you’ll see videos on half kneeling, deadlifting, kettlebell swinging, triplanar hip stability, propulsion (hip decompression), and abdominal and gluteal activation drills.
You may not know which is right for you. If you’re in pain, you need analysis and possibly treatment.
If you are experiencing this issue, get yourself to a movement specialist that can address the abdominal leaks and hip compressive components – in exactly that order.
As always, it’s your call.
– Dr. Kathy Dooley