Hip pain can drag a person down. The hip joint is close to our bodies’ center of gravity and becomes involved in almost any movement we make. When a painful hip becomes tight and restricted, it can also lead to arthritis. This means that successful treatment of hip pain not only offers pain relief but an improved quality of life and more long-term mobility. 

My practice focuses on the connective tissue called fascia and its role in causing pain and dysfunction in the body. A high percentage of hip pain issues start with fascia restrictions, but we can help resolve this pain by treating those restrictions. The reasons behind hip pain can be complex, so I will take you through the case of a real patient to offer insight into my process of helping to heal this difficult, but treatable issue.  

A patient I will refer to as Mary came to my office complaining of pain in her left hip, which caused her to limp and limited her ability to perform daily activities. She had difficulty lifting up her legs and was not sleeping well. The pain often woke her anytime she shifted in her sleep. She had fallen on that same hip two years prior after slipping on a wet floor, but had only experienced pain for about two weeks. She had not thought much about that incident again until I asked her about previous injuries in the hip area.  

A thorough examination came next. In addition to evaluating a body part’s range-of-motion, muscle tone, strength, and tenderness, there are three specific issues I look for when evaluating hip issues. These include fascia restrictions affecting the hip muscles, fascia restrictions of the hip joint and nearby joints, and degenerative changes in the hip that can be found through an X-ray or MRI. All of these factors played a role in identifying the causes of Mary’s pain—and in successfully treating it.   

Fascia Restrictions  

The hip joint’s mobility is made possible by several different muscles, both large and small. These muscles maintain their structural toughness with a fibrous connective tissue called fascia which can become restricted from injury or repetitive stress. In this case, Mary’s fall had caused the fascia to stiffen in specific muscles.    

On examination, two of her large hip muscles (gluteus maximus and psoas) and one smaller muscle (pectineus) showed fascia. As a result, her gluteal muscle was weak, and the psoas and pectineus muscles were abnormally tight. This muscle imbalance, in turn, created instability in the hip and caused repetitive stress to the joint tissues.  

I mentioned earlier that nearby joints can be a problem, and in Mary’s case, she also had fascia restriction in the front of her left sacroiliac joint, which limited its range-of-motion. This had most likely occurred at the time of her fall. When a joint is restricted, other nearby joints often are also affected. As a result, Mary’s fascia restriction created a slight twist of her pelvic posture that caused further misalignment of her hip joint.    

Arthritis  

Arthritis and degenerative change are always possibilities when significant hip pain occurs. Mary’s pain had persisted for several months, and she had consulted with an orthopedist who performed an MRI. The images showed a small bone spur and mild loss of joint cartilage in the left hip joint. The orthopedist had prescribed her physical therapy, which is often a helpful alleviation for hip pain. However, in Mary’s case, because of the fascia restrictions, physical therapy intensified her problem even more.   

Overall, there were numerous factors contributing to Mary’s pain. At the top of this list of concerns was the bone spur because this is a relatively permanent change. The question in a situation like this is whether the bone spur causes the pain, or if it is something else entirely.  To find the answer, I performed a basic test.  

I took Mary’s hip through its range-of-motion to see which directions of movement were painful. The most intense pain occurred with a combined flexion and rotation outward (lifting her thigh forward and outward). I then retested this same motion while holding pressure at points of fascia restriction. This pressure makes the restricted fascia temporarily relax. Her range-of-motion and comfort increased which told me that her pain was, at least in part, due to fascia restrictions—not just the bone spur.  

After a series of treatments to release the tight connective tissue, Mary’s left sacroiliac joint returned to normal motion. Her hip muscles regained tone and strength, and her hip could move freely again with just mild discomfort at the far end of its range-of-motion. I find it typical that arthritic changes like spurs and joint narrowing can cause some minimal discomfort, but are not usually the main source of chronic pain.   

Scar Tissue  

When it comes to hip pain, Mary’s case is not uncommon, but another form of hip problem I also treat involves pain after surgery. This was not a consideration with Mary, but is one I see often in my office. Sometimes the scar tissue from incisions made during an operation can distort or restrict fascia, resulting in painful motion and weight-bearing in the affected hip.    

Fortunately, this issue can be easily treated with gentle fascia release in the scar tissue. I find that treating fascia restrictions is helpful for all kinds of hip pain issues. Even in the occasional case of severe arthritis that requires surgery, treating fascia problems can restore function and improve the success of rehabilitation after surgery.    

Making sure the joints and muscles in the area are functioning correctly allows for a smoother recovery. Mary returned to all her normal activities, including a two-mile daily walk without pain. This type of success is common, and I recommend fascia therapy as a conservative treatment for successful and sustainable hip pain relief.   

Dr. Eric Winder has been practicing chiropractic for 27 years. His practice emphasizes relieving pain and restoring alignment and motion with gentle fascia release therapies. For more information, call 941-957-8390 or visit https://gentlebay.com/