Hip capsule tightness of OPPOSITE hip: Sometimes a tight hip on one side may make the other hip hurt. You are running sorta lopsided and your opposite hip hurts when you try to compensate. With all our sitting, our hip joints just get tight. This has most of the symptoms of hip arthritis, but it is just a tight joint without the arthritis. YEA!
History: You do not have any history of trauma. Just a gradual onset of stiffness. You may have noticed your stride length getting shorter. You may blame it on your hamstrings getting tight or not enough hamstring strength to push-off. You usually do not have any ‘pain’ to speak of, just a gradually decrease in your stride length.
Self-Exam: Here are some things you can look for in yourself.
1) Try this stretch. If your hip doesn’t drop down to the level of the bed or table, it may be hip capsule tightness. Thomas test VID
2) Try this stretch. If your hip doesn’t drop down to the level of the bed or table, it may be hip capsule tightness. Quad/hip flex video in chair. VID
3) Try this stretch. If your hip doesn’t drop down to the level of the bed or table, it may be hip capsule tightness. Quad/hip flex video in standing. VID
4) NOTE: All of these stretches may be caused by tight hip flexor muscles. If you are not sure, ask a PT or AT to check your hips.
Treatment:
1) Manage the pain:
a. NSAIDS will help. Kinesiology taping usually does not help. LIN
b. Ice or heat can relieve your pain.
i. Ice right after you get done running
ii. Heat on non-running days
c. Continue running but pay close attention to your running mechanics.
d. Running uphill may make it worse. Also, do not stress yourself when doing your speed work.
2) Restore full motion:
a. Pain-free stretching to the hip in all planes will help restore your motion
i. Sequential short-term running will address these muscles. VID1 VID2
ii. Quad/hip flexor stretches with knee in a chair VID
b. Stretching does not have to be part of your warm-up or cool-down. But it HAS to be part of your training program. LIN
3) Begin non-weightbearing exercises to restore strength without all the pressure on the joints
a. Simple hip capsule tightness usually does not lead to a lot of muscle weakness. Your stretches should restore your running.
4) No need to begin body weight exercises
5) Correct running mechanics.
a. Gradually return to your previous running. Start on relatively flat ground or even on a treadmill. The best part of returning to running with a treadmill is that you can actually hear your footsteps. Also, a lot of treadmills are in front of a mirror so you can see your hands move and your feet move. If your arms or legs swing weird, you may want to have a physical therapist complete an evaluation before you return to full running. Listen and ‘feel’ how you run. Is one leg hitting the ground harder than the other? Does one arm swing differently than the other? Until you can run without pain and with fairly symmetrical running mechanics, you are still at risk of reproducing your old injury or creating a whole new injury to another part of your body.
b. As soon as you can run without pain and without a limp you can return to your normal running routine.
6) Return to running speedwork and hills. After you have been able to run on flat ground for a week with your with your normal training and have not had any pain, you can begin to add speed and hill training to your program.
7) My favorite step, get back to full running! Have fun. Eventually you will bust something else and be back to the website to fix that.
8) If you follow the steps on the website for 2-6 weeks (depending on how badly you hurt yourself the first time and on how long you tried to ‘run through the pain’) and your problem does not resolve, then call our clinic for an appointment and we can do something Dr. Google cannot do. We can complete a hands-on evaluation, in-person evaluation to determine the cause of your pain.