Deep Hip pain?
Do you every experience nagging hip pain? Maybe it feels achy along the outside of your hip and maybe even moves toward your tailbone, or into your low back? This can sometimes be related to pelvic floor muscles, believe it or not!
The pelvic floor is made of a sling of muscles that travels from the pubic bone to the tailbone. They work to help support pelvic organs, and play a role in things like continence, sexual function, and stability. Some of these deep pelvic floor muscles act on the hip to help rotate it in and out; think of the motion you might do when performing a fire hydrant exercise or kicking a hacky sack (do kids still play with those?).
Because of the relationship with the pelvic floor, hip pain that we believe to be related to the hip joint, may in fact be related to these pelvic floor muscles that double as hip rotators.
If you’ve been following along in this blog or on social media, you’ve heard me describe some of the tension or guarding that can be seen in the pelvic floor muscles. This can sometimes contribute to pain and dysfunction, and it may manifest as hip pain with or without the symptoms we typically relate to pelvic floor dysfunction.
So, how can we address this?
Just like any other muscle, the muscles of the pelvic floor need to be exercised through their available range and placed under the appropriate stress to meet the demands of life and activities. These hip rotators that we’re highlighting today are not always trained into this rotation movement, so may not have the opportunity to move through this range as often as we’d like. They play a huge role in singe leg stability, pelvic control, and low back support! Therefore, giving them a little TLC can help not only improve function of the pelvic floor, but in turn, support the hips, pelvis, and low back more effectively!
Here are some of my go-to movements for improving mobility here and progressing toward strength!
Give these a go, see how they treat you, and reach out with questions!
Elle Carlson, PT, DPT
P.S. This will be the last blog for a few weeks as we jet of to Croatia this weekend! See you soon!
To stretch or not to stretch?
When we feel tightness, stiffness, or pain in a certain area, we often think we need to just stretch it away! Stretching can feel great and can provide relief to pain; but it’s important to note that this is short lived.
At Mobility Innovated, we see strength training as the best long-term approach to this sensation of tightness. It may be that the tightness you’re experiencing is in fact telling you those muscles need some strength! Here are some common myths about stretching to discuss this week.
#1: Stretching should be part of a warm-up routine
Static stretching – which involves holding a stretch for a period – has been used as part of warmups for decades. Recent research has suggested that warmups may not be the best time to incorporate this static stretching. Of course, this depends on the type of workout you’re doing.
We believe that a warmup should support you as you head into a workout for both performance and safety. Current research points toward static stretching potentially doing more harm than good when it comes to strength and performance during the chosen activity.
Perhaps instead of static stretching as part of a warmup, the warmup should consist of a gradual progression of intensity that mimics the coming workout and elevates the body temperature. Static stretching does neither of these things as it does not mimic the workout movements, and typically does not increase body temperature due to the static nature.
Dynamic stretching can be a great alternative that increases the body temperature and increases blood flow to the muscles that you are about to use. Some of our favorites include squats, lunges, skips, inchworms, or anything that elevates the heart rate and targets the muscle groups about to be used.
#2: Stretching improves sport performance:
As we alluded to above, studies have shown that static stretching can decrease performance, especially when it comes to power, strength, and speed. It’s unclear what exactly contributes to this decreased production of power and strength.
This is not to say that stretching cannot be helpful at other times during the day, but it may be best to find time other than right before a workout or activity in which performance is important to you.
#3: Stretching makes muscles longer:
This is a tricky one to debunk because it seems to engrain in our brains – to get longer muscles we need to stretch more! As we learn more and more about the human body and how it functions, it appears that although there is an increase in range of motion with stretching, it is not due to an actual change in the muscle length! Rather, we see changes due to a neurological adaptation and improved tolerance to the tissues being placed on stretch. Simply put, our brain becomes more willing to move through a range of motion because it is less sensitive to that stretch; the muscle itself has not changed.
So, what to do instead of stretch?
At Mobility Innovated, we’re big fans of strength training! It’s a lot easier to create changes through tissues via resistance training than static stretches. Of course – just like anything of benefit – strength training requires time and consistency; however, the payoff is far greater than stretching, plus you get stronger while doing it! The effects of resistance training have been researched extensively, and its effectiveness proven. Stretching lacks this evidence to back it up.
An example of an exercise that works on both strength and length is the RDL, or Romanian Deadlift. If you’re unfamiliar, this exercise involves a hinge at the hips while keeping knees as straight as possible. This movement takes the hamstrings through their full range for a lot of folks, moving through an ‘eccentrically’ controlled range of motion. This movement simulates a passive stretch of the hamstrings as if you were touching your toes, while at the same time requiring the muscle fibers to adapt to the added load of strength training.
All this to say, it’s not BAD to stretch:
If stretching feels good to you, go for it! We’re all about making sure you feel great and enjoy what you’re doing when it comes to exercise and movement. With static stretching, you may see a slight increase in joint range of motion, but it’s important to recognize that this will be transient; and that perceived tightness of a muscle is likely just weakness of the muscle. “Most stiffness is a sensation, a symptom, a kind of mild pain with movement rather than an actual limitation of movement” (Ingraham 2020).
You know your body better than anyone else, so if stretching makes you feel like you can move better, or relieves some soreness, do it! Stretching and modalities like myofascial release, foam rolling, etc. can still have their place in warmups, cooldowns, and for recovery.
Elle Carlson, PT, DPT
Elle Morgan, PT, DPT