Hip osteoarthritis: (Note:  your hip is in the front of your body and your butt is in the rear.  We need to know the difference between hip pain and butt pain.) Arthritis is a fact of life.  When you were unwrapping presents for your 40th birthday, somebody slipped you arthritis. Some of us have it more than others.  Sort of like some men have good hair and the rest of us have less hair. It is how bad you have it and how it effects your running.  One of my Marathon Maniac friends has run over 30 marathons since his hip replacement.

History:  When you wake in the morning your hip is stiff for the first 30-45 minutes and then it loosens up.  Your hip may hurt to cross your legs or pull y our knee to your chest.  It may hurt when you land or with push-off, when your thigh is behind your hip.  As your hip bothers you more, you lose some strength.   

Self-Exam:  Here are some things you can look for in yourself. 

1)      When you squat toward the floor like you used to do as a kid, you just can’t squat as far.  AND, it takes a lot longer and more noise to get up from squatting it may be OA.

2)      Your hips are just stiff in the morning and don’t loosen up until about 30-45 minutes after you get out of bed.

3)      When you are sitting down, gently raise and lower your leg a few times.  If you feel it grind, you probably have osteoarthritis. VID 

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.

2)      Restore full motion:

a.      Painfree 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

                                                          iii.      The piriformis stretch.  VID

                                                           iv.      Do not forget hip rotation.  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.      Exercises to strengthen ALL the muscles of the hip.  The exercises here are just the tip of the iceberg for hip exercises.  These are just the lowest level exercises.  If these are too easy, go to the section on strength training for runners.

                                                              i.      Begin with isometric exercises to reduce the stress on the muscle.  SQS, SHS  VID

                                                            ii.      Hip abduction exercises.  VID

                                                          iii.      Hip adduction exercises. VID

                                                           iv.      Hip extension exercises. VID

b.      You will not be at this level very long; we just need to increase your strength while minimizing stress on your knee.

4)      Begin body weight exercises with emphasis on control and balance versus strength and power.  Not balance right to left, but balance is in not falling.

a.      Standing hip abduction.

b.      Step-ups, static lunges, dynamic lunges, wall-slides, sit-to-stand, lateral step-ups, etc.  LIN

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.