Everyday clients visit my wellness center complaining of hip pain and looking for relief. There are a multitude of reasons why one could be experiencing hip pain such as:
-Inflammation around the lateral hip and knee joints, often times called bursitis or arthritis.
-Soft tissue injuries to ligaments, muscles, or tendons of the upper leg and hip
-Pinched or compressed nerves in the low back or lateral gluteal muscles
-Pinched or compressed veins or lymphatic vessels that support the leg and hip.
-Taut or weakened leg and gluteal muscles (muscles along the IT band)
The consistent thread in these various causes of pain is the presence of internal or external pressure or compression causing swelling, pain and in some cases immobility.

Since 2007, I have worked on thousands of clients and over this course of time, I have been able to categorize my clients into 3-4 profiles when it comes to hip pain. These profiles are based mainly on lifestyle habits. If you currently suffer from hip pain or has experienced hip pain in the past, then you may fit into one or more of the following profiles.

The Side Sleeper

Each time a side sleeper lays down, deep direct pressure is being placed on the hip joint, upper leg muscles and knee joint. This constant compression over time continuously compacts the soft tissue structures, eventually contributing to or causing adhesions in the muscles, possible pinching or impingement of nerves, blood vessels, and lymphatic vessels. The compression or impingement of these vessels causes stagnation which results in inflammation/swelling, stiffness, and pain. If the side sleeper doesn’t work out it contributes to muscle atrophy in the gluteal, hip, and upper leg muscles which can then cause pain in IT band area, and misalignment in the hip bone structure. At this point the pain can also be felt in the low back or the other hip.

The Irreplaceable Work from Home Worker(or Pre-COVID, The Couch Potato)

This person who fits this hip pain profile has very similar symptoms and pain pattern as the side sleeper except in this case the “Work from Home”person is sitting for hours and hours on end throughout the day putting direct pressure onto the back leg muscles, and other soft tissue structures. This compression permeates up to gluteal muscles and soft tissue structures. The compression and constant contraction of the knee when sitting causes inflammation/swelling, and a dull achy pain in the calf muscle, Inflammation at the knee joints and popliteal nodes (back of knee). This swelling, pressure, and achy feeling continues up the leg causing swelling in the inner thigh and swelling and pain along the IT band. The swelling and pain continues to travel up into the gluteal muscles and hip structures. If a person is in this profile, then most likely they aren’t consistent with stretching or exercising, leading to muscle atrophy further exacerbating the hip and leg pain.
If you are an irreplaceable worker who mainly stands for a living (like me) then you can suffer the same fate, but your pain and swelling can start at the ankles. The person in this case has gravity and their own body weight causing the pressure and compression. This person’s pain is usually caused by weak gluteal and leg muscles and lack of stretching and hydration. Although this person is standing, they may not be in motion enough for their body type and lifestyle. Also, if a person falls into this profile and the side sleeper profile then the outcome is even worse.

The Invincible Fitness Guru

For every action there is a reaction and this profile type needs to practice balance. This profile type works out 5-7 days a week. They maybe an avid biker, runner or constantly lifting weights or any type of fitness enthusiast. This profile type does little to no stretching, foam rolling, massage, icing, elevating or resting of their muscles. As a matter of fact, their recovery game is weak. This profile type doesn’t rest or seek help until the pain in their IT band is killing them. Due to the types of workouts the muscles along the IT band become extremely taut as if stretching a rubber band to the point before it pops or is strained. Without a recovery regimen the soft tissue structures in the legs aren’t given a chance to properly restructure itself around the newly form muscles. This could result in your muscles being dehydrated, and inflammation from the knee joints to the hip joint and into the lateral gluteal muscles.

HOW TO RELIEVE THE PAIN

The side sleeper needs to counteract the pressure coming from below and above, and the best way to do so is to strengthen the glute muscles, hip flexor muscles, the upper leg muscles and soft tissue around the knee. Seek a physical therapist if you need assistance with strengthening your muscles. Incorporate stretching, foam rolling, massage therapy, cupping and restorative yoga to assist with pain relief by breaking up the adhesions in the muscles and the congestion and swelling in the hips and legs. Restorative yoga, physical therapy and some massage therapy can help with hip alignment. Sleeping with pillows underneath your leg or between your knees can lessen the pressure placed on your side while laying down. If you carry more weight than is needed for your frame then weight loss is beneficial and lessens the pressure from gravity when sleeping, sitting or standing.

The Work from Homer will follow the same steps as the side sleeper, but they should incorporate strengthening the lower leg muscles as well. Flex and point your feet throughout the day to mimic a pumping action to help propel lymph and blood up over your calf muscles and minimize swelling in the lower extremities.

Finally the Invincible Fitness Guru, this profile needs to do everything it doesn’t already as a part of a workout plan. This profile type needs to stretch, do foam rolling, get massages, ice regularly, and elevate or rest their muscles. Basically, this profile type needs to create and incorporate a recovery plan into their workouts.