Education and advice for lateral hip pain- what to change.

Here are examples of common positions which can create pain or aggravate symptoms in your lateral hip. If you’re wanting to learn more about the cause you can read more in this blog here.

Problem #1: pain with compression by lying on the painful side. 

This will be from direct compression from the mattress, which can be more common with firm mattresses.

Solution: trial laying on something softer, like a mattress cover, doona or a thin pillow.

Problem #2: pain with laying on the non-painful side.

Often when you lie on your side, you top leg comes forwards into adduction and internal rotation (picture 1)- this increases compression at the hip.

Solution: place a pillow between your knees and ankles to reduce hip adduction position (picture 2).

Problem #3: standing in hip hanging position. 

This position may not cause direct pain at the time, however with repetition or prolonged time in this position, it causes increased tension on the ITB which increases compression at the hip joint leading to hip abductor weakness.

Solution: Don’t hip hang! Keep even weight between each side. Can be a hard habit to break but continuing to correct it over time will help.

Problem #4: sitting with legs or feet crossed.

This is another position which may not cause direct pain at the time but with repetition increases tension on the ITB and increases compression at the hip joint.

Solution: stop crossing your legs! Another hard habit to break but continuing to correct it over time will help.

Problem #5: sitting in low chairs. 

If your knee is sitting higher than your hips, this will increase the tension on the hip flexors and ITB, causing more compression through the hip and decrease the length of the hip flexor resulting in tightness. You can then experience pain trying to stand up from this seated position.

Solution:  sit on a taller/different chair so your hips are higher than your knees; or use a cushion to prop yourself up so your hips are above the level of your knees.

Problem #6: standing on painful leg. 

If you have pain or some weakness through your hips, when you stand on one leg your pelvis drops on the opposite side resulting in hip adduction on your standing leg which will increase compression and possibly cause pain.

Solution: when very sore, modifying the activity to not load the painful leg may be the best solution eg. holding on for support, sitting down when dressing. Long term it will be increasing the strength through the hip muscles, particularly the hip abductor muscles, that will help keep the hip level and reduce your pain with single leg activities.

Problem #7: climbing stairs. 

If you are experiencing pain or have some weakness through your hips, when you stand on one leg to push yourself up a step, your pelvis drops on the opposite side resulting in hip adduction on your standing leg. This creates compression over the lateral hip and may lead to pain.

Solution: initially when irritable, using a handrail for support or going up one step at a time can decrease the load on your hip or help to maintain a neutral pelvis. Leading with your good leg on the stairs may help as well. Long term, increasing strength in your hip muscles (abductors) will maintain a neutral pelvis and reduce pain with single leg activities.

Problem #8: walking. 

If you have poor pelvic control, the hip may want to go into more adduction when walking, which will cause more compression, and possibly pain, particularly with repetition. Hills are often more challenging and may result in more pain.

Solution: initially when you are quite sore, modifying the activity may be best eg. try going shorter walks than normal, or reduce the number of hills in your walk. Long term it will be increasing the strength through the hip muscles, particularly the hip abductor muscles, that will keep the hip and pelvis level during gait and reduce your pain.

Hope this answers a few of your questions about why hips can be sore in certain positions. If you’re having lateral hip pain and these aren’t fully helping, come speak to one of our physiotherapists to get to the bottom of why yours is occurring by booking here.

Thanks for reading!

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