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Hip Pain? Hip Tips...

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One of the common complaints I see in my office is that of hip pains, which come in two varieties:  

ACUTE hip pains:   We see these cases a lot as injuries to the groin muscles on the inside aspect of the hip.  These are usually pretty obvious in their origin, for example when a hockey player collides with legs straddling the ice, or when a football player is tackled with one leg extended out to the side.  (Hip fractures are the subject for a separate blog).  These cases often respond quickly, as long as there is no serious tear in the muscle/tendon structure as it inserts from the inner thigh.  Other cases involve the outside of the hip joint, seen with cases of bursitis or capsulitis from extended exercises like rowing, biking, or running.  Treatments include rest, physical therapies like ultrasonic vibrations, electro-stimulation, and medical acupuncture are often all that is required. An anti-inflammatory medication can also help settle things down.  If this is not working, then further investigation with images can prove helpful, and more aggressive treatments like cortisone shots could be considered.  Gentle movements are encouraged, along with a graduated program of stretching and toning of the inner thigh muscles to rehab the area. Assuming the root cause was a one-time injury, recovery is usually excellent.  If continued trauma occurs, then the problems become more chronic.    

CHRONIC hip pains: These occur if the root cause is repetitive, such as the constant pounding felt by rodeo riders, snowmobilers, or moto-cross cylclists. This can lead to the destruction of the cartilage and the build-up of extra bony growth causing osteo-arthritis.   l More commonly, the root cause is just the repetitive effects of gravity as seen in the daily movements of an obese patient.  Especially with the morbidly obese ( 100 pounds or 45 kilograms over their ideal weight) this means the simple acts of standing up, walking, and stair climbing all cause daily damage to the hip joint.  Other conditions such as systemic forms of arthritis can certainly also affect the hip joint itself, leading to “bone-on-bone” instead of smooth surfaces where the hip joint is supposed to move.  Again, we look for any correctable root causes.  This would entail routine blood-work and images, to assess underlying diseases.  It would also involve corrective action for the obese patient, with proper diet and exercise regimens.  In severe cases, that are beyond any such help, replacement of the hip joint may be needed. 

In the meantime, here are some hip tips:

  • Watch your posture: Sitting is hip-hostile.  Try to stand up a few times per hour if you can.  We have already written about the benefits of sitting on a pilates ball for back pains, 
  • it also helps hip pains by introducing some movements into an otherwise frozen posture.  If you can, try to rig your work station for standing up all the time. 
  • Select non-impact exercises, like the bike or elliptical machines in the gym.  Also try yoga and pilates to help with toning and flexibility.
  • Watch your weight.  One of the rules of medicine is that pain is fattening.  If you are in pain, you can’t move much to burn off your daily calories.  This becomes a viscous circle, where any excess calories are simply added to one’s fat stores, adding to the pains of simple movements.  To compound this, junk foods such as white sugar, white flour, etc are all known to cause more inflammation, further adding to the damage to the hips and other joints.
  • See your doctor to seek out underlying diagnoses, from systemic diseases to simple things like one leg being significantly longer than the other.  Depending on the underlying causes, you may also benefit from massage, physical therapy, or chiropractic treatments. Follow their exercise tips to stretch and tone the surrounding hip structures.

For more info,  

http://www.mayoclinic.org/symptoms/hip-pain/basics/when-to-see-doctor/sym-20050684

http://orthoinfo.aaos.org/PDFs/Rehab_Hip_3.pdf

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Osteoarthritis and the Cherry: The latest Joint Venture

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Joint inflammation,  or “arthritis”, is very common with today’s active public.  As opposed to a disease that travels through various joints in the body, osteo-arthritis is one condition that is physical in nature.  In other words, “osteo” form of arthritis is a “wear and tear” or “rusty hinge” phenomenon, usually caused by repetitive trauma in any joint, which can vary depending on the activity in question. 

For example, runners often get this in their great toe joint, where the toe meets its metacarpal.  This form of repetitive motion is certainly aggravated by poorly fitted shoes, or by running on concrete (instead of grass or soft ground).   When this joint is inflamed by gout (a systemic condition where millions of crystals of uric acid deposit in joints and kidneys), we call it “podagara”.  Coincidentally, Sports Medicine researchers are now finding that an old-fashioned natural remedy for gout can also work wonders for any “osteo” joints in the body. 

Tart cherries have long been suggested as an anti-inflammatory aid to gout patients, as part of their treatment protocol.  But recently researchers at the Oregon Health and Science University studied twenty women between the ages of 40-70, all of whom had osteoarthritis.  Each was asked to drink tart cherry juice twice a day for three weeks.  They were tested for markers of inflammation in the blood stream.  It turns out that excellent results were seen, especially with those who had the worst inflammation to begin the study. 

Principal investigator Kerry Kuehl  M.D. of the Oregon Health and Science Universtiy, was delighted to confirm that a natural food could offer such anti-inflammatory help without any of the side effects associated with drugs.  Since most people who exercise are also health conscious, this is particularly good news for athletes, including the weekend “warriors”. 

Leslie Bonci, Director of Sports Nutrition athe University of Pennsylvania Medical Center for Sports Medicine, has incorporated tart cherries into the training menu for all of her athletes. 

The active ingredient in the cherry is the antocyanins; antioxidant compounds that reduce pain and inflammation at levels comparable to many well-known pain pills.   Available in dried, frozen and juice forms, tart cherries are versatile, and easy to find.

So if you are aching in any joint, don’t be intimidated by all the pills at the drug store.   Sometimes the best treatment can be “cherry-picked” right from your local grocery store. 

For more reading: Reduce Chronic Inflammation in People with Osteoarthritis 

And for another good way to treat pain without drugs: Acupuncture: An old treatment gets to the point!

 

 

 

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