really, you think i need surgery?
These ‘stiff hips’ don’t really bother me in every day life, or even when playing a movement-challenging sport (I play tennis to quite a high level).
It’s just when I try to stretch, I notice I’m not flexible, and despite trying to increase my flexibility, nothing happens.
Gees, all this talk of FAI etc, OP flexibility is a relative thing. Who can determine if a particular part of your body is flexible or not. You could be stiff all over your body, which means that relatively speaking your hips are “normal”. I hate when health professionals start diagnosing problems at a whim without all the subjective assessment etc and scare people into thinking something is wrong.
No ones body let alone flexibility/ROM etc is perfect/normal just keep on stretching, like other people have said flexibility is easily lost but hard to gain. If it starts troubling you, go see a PT.
Nelioh09 stop your scaremongering, there is no substantiation for it.
[quote]alternate wrote:
I have both short hip flexors and hamstrings, so I have limited range of motion both flexing the hip and extending it. Abduction is even more limited and painful at the end ranges.
I’ve also noticed that I have very tight internal AND external hip rotators. I though that if you had tight internal rotators it might follow that you’d have loose external rotators to compensate, but both are definitely tight which means I have very limited hip external and internal rotation. On internal rotation and flexing of the thigh there is also a clunk but I’ve had this since an early age. External rotation and abduction (like you would when doing an exaggerated sumo deadlift) is very painful at the end ranges.
[/quote]
No, I definitely do not think you need surgery. Particularly for the reason you just mentioned - your hips do not inhibit you during activities of daily living. It’s mainly affecting your exercise routine.
Now, this is just my opinion and it’s based off personal experience (which started of very much like your’s) and also other people who I have known who have had the condition – I think it would be WISE at this point to have a simple consult. I would not go to any orthopedic; I would first do some research in terms of who is experienced with hips. I can PM you a reference link just as an example.
No, I don’t think this consult SHOULD or WILL end with surgery. A surgeon’s job is not specifically to cut open everyone who walks into his/her office. The point would be to get a better understanding if there is a mechanical issue within your hip joint (i.e. bony impingement or significant cartilage degeneration). The point of knowing this is because it will give you a REALLY good idea of what you should and should NOT be doing in terms of treatment. If you are able to find an orthopedic who works with a lot of good athletes, he will most likely be able to give you some great advice/contacts for PT/etc. The reason I had surgery was because my impingement was extremely bad. I had two forms of it (it runs in my family). I had the condition since I was young but it never stopped me from doing athletics/sports until I was 25 years old and within a 6 month period I literally had trouble sitting in class, walking more than a couple blocks, driving for over 10 minutes, I couldn’t bike or swim or run…And keep in mind less than a year before that I ran a marathon in under 3 hours with my only issue being my hips felt abnormally tight and had poor range of motion all around.
The surgery I had was arthroscopy. So essentially what he did was cleaned up the inside of the joint, reshaped my bones a bit, fixed my labrums, and saved me from developing arthritis at an extremely early age and needing a hip replacement before 60.
But no, to answer your question I don’t think you need it. I just think making sure that the integrity of your joint is healthy is important because you can’t really go back once you compromise that. But you can PREVENT further damage for quite awhile if you know what you are dealing with. Sorry if I confused you before.
Hi Neliah
It’s wonderful to have such great firsthand knowledge of a subject after going through serious hip trouble yourself. While it would have been disheartening to have to go through all that treatment, stress not knowing what’s going on and surgery. However a one person case study on yourself really doesn’t constitute scientific evidence. Considering it is on yourself you will be emotionally involved and any conclusion you gain will be severely biased!
You say you are calling me out, however you clearly already had pathological damage to your hip joints before you started those mobility exercises, probably the reason why they didn’t work for you in the first place or made them worse as you alluded to.
I agree people really shouldn’t be messing around with exercises they don’t know about and I’ll curse the day I walk into a gymnasium and see a trainer attaching a large rubber band to a machine to help someone gain hip mobility. However people will do whatever they feel like and the OP did suggest he didn’t want to shell out money anyways. His call really, but from what I’ve seen from many health providers I actually don’t blame him.
Yes the OP has been doing a lot of exercises, however what constitutes a lot and has he been doing everything he can?
It’s funny how initially you claim that this guy is an idiot and then 2 posts later you say he’s awesome, like you just found his website or something??
Hi Mr. Stern,
You make a great point about taking more than one approach and learning from multiple experiences and resources. I by no means can argue with that. Hence why I have never stated “Don’t ever try this.”
My main point throughout this thread (which I feel I am having to repeat like a broken record player) is that the hip joint is a very complex part of the body and should be treated with respect. It is better to maintain a cautious approach and be conservative. If there is one thing I have learned about the hip (that can be applied not just to myself but almost every single joint patient I have worked with whether it be in-patient rehabilitation, out-patient rehabilitation, or on the playing field) is that a long term history of poor ROM and a moderately painful end-feel (doesn’t have to be severe) is often a red flag that goes unnoticed.
It doesn’t mean the person specifically has impingement or a labral tear, but it IS a classic sign that is easy to ignore because it’s not debilitating at the time. There is a big difference between paying for one or two consults (through insurance coverage) to get an opinion along with some thorough imaging than simply ignoring something and possibly setting yourself up for a real long term and EXPENSIVE problem. I’m not just basing this off of me – I’m basing it off of the history of just about anyone with a joint problem that I’ve had the privilege to work with (knees, hips, and shoulders) and also case studies I’ve read.
I never once said Starrett was an idiot. I said that video made me cringe a bit. It still makes me cringe. Do I think it’s unsafe for everyone? Of course not? Would I recommend it to a patient without first recommending imaging based upon chronic joint stiffness and painful end-feels? Absolutely not. And neither would a responsible DPT, such as Starrett. Stretching through stiffness or a soft-end feel is OK.
Stretching moving into an ROM with a sharp/painful or hard or springy end-feel is a BAD idea. And the only reason I am familiar with Starrett is because I had a coach in college who was big on his mobility stuff for our hurdlers. I know it helped a good handful of them greatly. That is why I said I thought he was pretty awesome in general.
[quote]Dil Pickle wrote:
Gees, all this talk of FAI etc, OP flexibility is a relative thing. Who can determine if a particular part of your body is flexible or not. You could be stiff all over your body, which means that relatively speaking your hips are “normal”. I hate when health professionals start diagnosing problems at a whim without all the subjective assessment etc and scare people into thinking something is wrong.
No ones body let alone flexibility/ROM etc is perfect/normal just keep on stretching, like other people have said flexibility is easily lost but hard to gain. If it starts troubling you, go see a PT.
Nelioh09 stop your scaremongering, there is no substantiation for it.[/quote]
#1. I suggest until you have helped to rehabilitate over a couple thousand cases of major joint disorders (ages ranging from 18-85) and including anything from arthroscopy to total joint replacement, do some research before you attempt to argue with no valid input or ideas.
#2. No one in here is claiming to be a health care professional (least of all me). I simply stated what experience I had regarding joint knowledge, injuries, and training in general. None of it makes me an expert on any level.
#3. No one is “scaremongering.” Quite frankly it’s a fairly common issue dealt with in any type of PT clinic or orthopedic office and it’s something people should be better educated on and aware of. No one is going to be upset if you chose to remain blissfully ignorant.
[quote]neliah09 wrote:
[quote]Dil Pickle wrote:
Gees, all this talk of FAI etc, OP flexibility is a relative thing. Who can determine if a particular part of your body is flexible or not. You could be stiff all over your body, which means that relatively speaking your hips are “normal”. I hate when health professionals start diagnosing problems at a whim without all the subjective assessment etc and scare people into thinking something is wrong.
No ones body let alone flexibility/ROM etc is perfect/normal just keep on stretching, like other people have said flexibility is easily lost but hard to gain. If it starts troubling you, go see a PT.
Nelioh09 stop your scaremongering, there is no substantiation for it.[/quote]
Haha your are very arrogant for a student.
How do you know I have not seen 10,000’s of patients.
Please try harder.
You have categorically stated in another post that you are a exercise physiologist and a PT student. So correction no one else but YOU.
By the way qualifying your poor clinical reasoning and lack of experience by listing your degree and partially finished degree is both LAME and childish. On an internet forum you could be talking to the PT for the North Korean olympic lifting team or in your case not…
You just told me not to join in the argument until I had seen many patients, supposedly like yourself which, in a not so round about way, YOU are a self proclaimed expert.
Please try harder.
[quote]#3. No one is “scaremongering.” Quite frankly it’s a fairly common issue dealt with in any type of PT clinic or orthopedic office and it’s something people should be better educated on and aware of. No one is going to be upset if you chose to remain blissfully ignorant.
[/quote]
The OP stated he just had hip stiffness. He also answered under your post and incredulously asked “do I need surgery?”, he sounded pretty worried or some might say(sorry OP) scared.
I have shoulder stiffness. Should I undergo a deluge of tests and a surgical examination?? Maybe all of us with minor issues should all go to a surgeon. Maybe a group discount led by you nelioh? You could all hold our hands.
Maybe once you finish your degree and join the rest of us in the real world we can talk.
So once again please try harder.
[quote]alternate wrote:
How long should you stick with something before you acknowledge it is not working?
For example, I have held two sets of 2min planks and weighted iso glute bridges, done static hip flexor and hamstring stretches for two sets of 2 minutes (for each leg), foam rolled psoas, quads and hamstrings and completed a lateral lunge complex every day without fail for close to 2 years now, and there is no improvement in hip flexion or hip extension - both are still just as limited as before I started.
Do I just keep at it, and maybe on the 10th year I will notice some improvement?
Or if not, how would you change my routine?[/quote]
Throughout this process of attempting to increase flexibility have you altered your excercise routine (outside of mobility work) or daily activities to accomadate rest in the area? The first thing we do with an athlete when dysfunction is discovered is shut them down from activity. This is because the rehabilitation protocals will not take if he keeps repeating the patterns that exacerbated the imbalance or outright caused it. In theory you should have seen some results from even a poorly constructed flexibilty program by now. That is to say unless something else you are doing is obstructing the progress. If you haven’t tried these mobility routines while abstaining from lower body and heavy concentric abdominal activty, then try taking a month off and only focusing on mobility. You won’t completely reverse the issue in that time, but you should begin to increase range of motion if it is something that can be treated conservitively. If you don’t see any results then look to more extreme measures. Think about if you expierienced elbow tightness while playing tennis and attempted to correct it while still playing. Just a thought, but many times what you stop doing is more important than what you start doing when correcting an imbalance. Hope things turn around for you.
i’ll tell you about my own case and maybe you can take something that helps you.
when i first started training at the age of 30 after major injury prior i had a lot of work to do on improving my mobility / flexibility / activation.
my right hip clicked with abduction, in particular. i didn’t have the flexibility to get into a squat. and so on. things that helped me:
bodybalance / centergy (whatever fitness center yoga class). they can be better or worse depending on the instructor but doing this 3x a week really helped me a great deal.
foam rolling. also a tennis ball (to roll around the hip joint for improved mobility / instant flexibility)
activation. as the hip flexors stretched out / relaxed i developed anterior femoral glide where i could feel the head of the femur jamming in the front of the acetabulum. know what fixed it? activating the glutes - in particular the little lateral rotators and medial glutes.
the lateral rotators have been called the rotator cuff of the hip. they help the head of the femur not jam against the pelvis. saving you from pain and clicking crunching grinding sounds… saving you from needing a hip replacement. saving you from ripping the cartiledge etc.
improving the ROM (in a way that doesn’t jam the joint) is the best thing to heal the joint. get the synovial fluid moving around properly inside the joint capsule.
gently does it.
it can take years to undo years of disuse / misuse.
luck.
A clunking hip indicates some sort of imbalance. The only time I personally had a clunking/popping hip on flexion was when my psoas was terribly WEAK. This also caused a reciprocal weakness in my glutes. It only involved my left side, though. This was very confusing to me for a long time. I wrongly assumed the glute weakness came first, but it was the other way around. Got much worse before it got better…
You may not be as flexible in the hips as you like, but, it may just be ‘the way you’re built’. As an example, some people can do full splits to the side and others can’t even come close, but, it has nothing to do with inflexibility in the hips. It is because of the shape of the femur neck at the hip socket. The femur actually strikes the ilium, if forced.