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 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.

VISIT BAYHEALTH.ORG/OUTPATIENT-THERAPY TO LEARN ABOUT THE OUTPATIENT REHABILITATION SERVICES THAT BAYHEALTH OFFERS.

IMPROVING HIP HEALTH Given the complexity and connectivity of the hips, knowing what’s impaired and what to treat can be tricky. Sometimes the symptoms are a direct indicator of the problem, but other times pain in one joint can be caused by impairment in another.

For this reason, it’s important to consult a physician or physical therapist at the onset of symptoms in the hips or peripheral joints. Identifying the problem early and treating the source is the best and quickest way to promote healing and restoration.

However, Smith notes that it’s safe to address the everyday aches and pains at home with low-impact strength moves and gentle stretching, being sure to target the entirety of the hip region to promote balance. For strength, he recommends moves like the glute bridge, donkey kick, side leg raise, and superman. When stretching, ease into the movement and take care not to hurt yourself.

Another great way to promote healing in the hips is to simply become more aware of lifestyle and habits and to make healthy adjustments. Over time, small changes can have a big impact.

Whether you’re working solo or with a professional, the goal in treating the hips should be to restore the balance between stability and mobility. And always practice patience — the damage didn’t happen overnight, so the healing won’t either. ■

FINDING #MOTIVATION TO MAKE BIG CHANGES

For the past year, Bayhealth’s Marketing Communications team has been hard at work on a social media campaign called #Motivated. The campaign focuses on small changes everyone can make to live a healthier life. While many people make New Year’s resolutions each year, the reality is these promises are hard to keep. The #Motivated campaign is a small reminder that each week offers a new opportunity for a fresh start. Each month, followers are asked to share their experiences on their journey to health and wellness.

One committed follower is Bayhealth Administrative Assistant Nicole Garland. At the beginning of 2019, Garland made the decision to completely change her lifestyle. She cut out all

processed sugars and foods. She also added in more activity each day. Over the last year, Garland has shed nearly 80 pounds, and continues to find success. “Towards the end of 2018 I realized I was the heaviest I had ever been. I was in pain from the extra weight and I knew I needed a change,” said Garland. “I’ve been trying to diet since my mid-twenties and it never worked. This time it was all about eating right and exercising.”

Garland has discovered a host of natural sweeteners she uses to replace sugar and has found fun ways to stay active. Over the summer she kayaked often and also does yoga and resistance training three to five days each week.

“My friends and family have been such a great support system. I couldn’t do it without them,” said Garland.

She also points to her flexible eating plan as a measure of her success. “I don’t want to be hungry, so I definitely eat. The difference is now I’m eating fruit, vegetables and lean meats. My family and I still eat out; I just make sure to pick an entrée with protein and vegetables.”

Garland says she can see and feel the difference. “I can walk now and not get winded. I did a 5K with no problems. For the first time in a long time, I didn’t get a lecture about my weight when I went to the doctor. I’ve also seen great improvement in my blood sugar. While I was bordering on diabetic, I’m now in a very normal range. I was on cloud nine to see how the changes are paying off,” she said.

Connecting with others has been instrumental to Garland’s success. She believes it can help others too.

“Social media was such a great way for me to stay motivated throughout this journey,” said Garland. “I loved when I saw Bayhealth’s #Motivated campaign. I enjoy sharing my success with others. I’m feeling so good and I want other people to feel this good too. Don’t struggle alone. Join this campaign and we’ll all do it together.” ■

Our #Motivated campaign has been such a success — and we couldn’t have done it without you! Between active community members and our own Bayhealth team members, the engagement has been incredible. Here are a couple of our most successful posts from the past year. Remember to check in each Monday to see how you can participate. Don’t forget — it doesn’t have be about big resolutions. There are small steps we can take each day to live a healthier life.

MAKE SURE TO LIKE BAYHEALTH ON FACEBOOK OR VISIT FACEBOOK. COM/BAYHEALTH TO LEARN MORE ABOUT OUR #MOTIVATED CAMPAIGN.