Because of its central location in the body, multiple planes of motion, and the myriad of deep, criss-crossing muscles that connect it to the abdomen and legs, the pelvic area is often a source of mysterious pain.
However, compared to the knees, the hips are a very stable mechanical structure, surrounded by large muscles and protected by a ball-and-socket joint with multiple capsules that increase the depth and strength of the joint.
Therefore, unless you have osteoarthritis or have experienced a traumatic injury, joint pain in the hips is often caused by muscles, ligaments, tendons, or nerves—not by the hip joint itself.
Here are some common hip pains caused by tight, weak, or strained muscles, often experienced by active people:
Hip Flexor Pain
The hip flexors are a powerful group of muscles situated at the front of the thigh, responsible for lifting the knees in common motions such as walking, running, biking, and climbing stairs. The hip flexors can easily become strained through overuse in one plane of motion.
If you are a runner or a cyclist, for example, most of your exercise movements are oriented around the forward action (contraction) of the hip flexors. If you do not counteract this tendency with strength training in every plane of motion, as well as with stretches that lengthen the hip flexors, you may begin to feel tightness or pain when you exercise.
This mysterious pain, like hip flexor pain, often strikes recreational runners who are not appropriately strength training to counteract the pounding stress of high-impact exercise. The piriformis is a small muscle running sideways through the gluteal muscles, responsible for the outward rotation of the hips and legs.
It may begin as a twinge during exercise, but piriformis pain can quickly become a near-debilitating mimic of sciatica that limits fitness activities and causes pain when sitting. This pain occurs in the gluteal sitting muscles, but radiates down one or both legs as well.
The “referral pain” that can be experienced in the knee, leg, or even foot is due to the impingement of the sciatic nerve, around which the piriformis muscle is wrapped for many people.
When the muscle is tight, it effectively “grabs” the sciatic nerve and tightly exerts pressure, sending pain signals throughout the leg that is affected. Piriformis pain can be alleviated through rest, specific strength-training moves, stretches, and self-myofascial release (foam-rolling).
Bursitis, which is a catch-all term for any time a fluid-filled sac at a joint is inflamed, affects the outer sides of the thighs, running from hip to knee, and may cause tenderness on the outer hips.
Bursitis can make everyday movements, such as bending or walking, extremely painful, and can mimic the severity of arthritis. Bursitis can be treated not only by rest and by using ice, but also by strengthening the inner and outer thighs (the adductors and abductors).
Here are some easy, simple strengthening moves that balance out the muscles surrounding the hips, to reduce pain, increase mobility, and enhance athletic performance:
Lie on your back with your knees bent and your feet flat on the floor. Place your arms at your sides with your palms pressed against the floor.
Contract your abdominal muscles, and lift your hips so that your body is in a straight line from your knees to your chest. Be sure not to exert pressure on your neck, but instead focus on contracting the muscles around your hips, lower back, and abdomen. Hold for five breaths, then relax back to the ground. Repeat five times.
Shift onto your hands and knees, and carefully lift your right knee to your chest.
Then, maintaining a 90-degree angle at your knee, slowly lift your heel toward the ceiling.
Return your knee to your chest.
That’s one repetition. Perform 20 repetitions on each side. Be sure to keep your abdominal muscles contracted the entire time.
Shift to lying on your left side, resting your hand on your arm or hand. Bend your knees so that your feet are close to your hips and your right leg is directly on top of your left leg.
Keeping your feet together, lift your right knee, then lower it. That’s one repetition. Perform 20 repetitions on each side.
Start on your left side once more, and straighten out your legs so that your legs are stacked on top of each other. Then, carefully shift your top (right) leg so that the right toes are just behind the left heel.
Maintain this angle, and then slowly lift the right leg about 24 inches in the air, keeping the leg straight. Then gently lower it. That’s one repetition. Perform 20 repetitions on each side.
Rachel Trotta, certified personal trainer (NASM), is the author of “Injury-Proof: 28 Days to Better Movement, Smarter Training, and an Invincible Core,” and the owner of Zenith Personal Training. Her unique modality provides effective cross-training for runners, dancers, and other high-impact athletes, but also appeals to new exercisers who want to reach their fitness potential. To read more, visit PersonalTrainingUWS.com