Stability and mobility — are they joined at the hip? According to an old song, the hip bone comes after the thigh bone and before the back bone — or reverse in verse two. The song isn’t wrong, but that particular anatomy lesson should suffice for the average, bendy third-grader only. Hip functionality can get a bit more complicated as one ages, making it important to understand more about what’s really going on in there. Physical Therapist Josh Smith, PT, DPT, MDT, shares a more in-depth look at what the hips are made of, the causes and symptoms of dysfunction, and ways to restore hip health. As one of the largest and most dynamic joints in the body, the hip is designed to both stabilize and mobilize the lower extremity — a challenging set of expectations because, generally, stable things aren’t very mobile, and mobile things aren’t very stable. COMPOSITION OF THE HIPS The hips, like many of the other joints in the body, are made up of three basic structures — bones, muscles and nerves — each of which plays a role in stability and mobility. Beginning with the bones, the thigh bone, or femur, runs from the knee to the pelvis. The north end of the femur is the femoral
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head — the “ball” component of the ball-and-socket hip joint. The acetabulum, a part of the pelvis, is the socket. The skeletal chain of the hips continues with the sacrum, which is the bone that supports the lower, or lumbar, spine. The bones are the foundation of the entire hip operation. The muscles of the hips are attached to and woven around the bones. Each muscle has a different responsibility in the continuum of stability and mobility. Some are primarily stabilizers, some are primarily mobilizers and some are expected to do both. The nerves, which extend from the lumbar spine and connect to the muscles, are like the electrical wiring of the hips. Their job is to transfer signals from the brain that tell the muscles to stabilize and/or mobilize the bones. Two additional structures that play vital roles in overall hip function are ligaments and cartilage. They work behind the scenes to cushion and support every movement, much like shock absorbers on a vehicle. DYSFUNCTION IN THE HIPS When the structures of the hips are in optimal condition, it’s safe to assume that the balance between
stability and mobility is near perfect. But this is rarely true. Structural damage and imbalance in the hips can have many causes, but the most common causes are lifestyle and habits. Too much movement throughout the day can be just as damaging to the hips as too much idleness, Smith explains. Someone who is on their feet all day puts loads of pressure on their joints, which can cause inflammation and degeneration, whereas someone who sits more often is likely to suffer from weakness and damaging compression. Similarly, habits like slouching or carrying a heavy load can also damage the structures of the hips. No matter the cause, when the hips — and therefore the balance between mobility and stability — are compromised, adverse symptoms usually follow. Aches, pains and tightness in the hips and groin are some of the more obvious symptoms. However, hip impairment is also known to manifest in places like the knees, lower back and even the feet. Additionally, more serious and painful conditions, like arthritis, bursitis and tendonitis, can develop over time if the hips are not addressed.
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