Do you experience back pain, pain under your kneecap or pain along the side or front of your hip while walking, hiking or running?
If so, you may be compensating for a weak muscle group by overworking another area.
Many people with chronic re-occurring injuries such as hip flexor strains, hip bursitis, iliotibial band friction syndrome, patella femoral pain syndrome or increased tone in their back extensors often also present with significant weakness in their gluteal muscles. A muscle imbalance can occur when certain muscles surrounding the hip joint are weak, tight or over activated.
The hip is a ball and socket joint, similar in structure to the shoulder joint. The ball in the hip is known as the femoral head and the socket is known as the acetabulum. Ball and socket joints allow us to move in many different directions. Since these joints give us more mobility, they rely on stability from passive structures, including the capsule and ligaments, and active structures including the muscles.
The deep gluteal muscles, including the gluteus minimus and the gluteus medius, are responsible for a great deal of stability and control around the hip joint by compressing the femoral head into the acetabulum.
Without this compression to stabilize the hip joint, other muscles have to work harder to control the pelvis which can result in an overuse syndrome. This is especially true when performing activities requiring you to be standing on one leg for part of the activity, such as walking, hiking, running, dancing and skating.
Treatment involves a gradual progression of exercises to activate the deep gluteal muscles without the quadriceps, hip flexors and back extensors becoming over activated. This conservative treatment through muscle re-education is important to encourage the weaker muscles to activate so the overactive muscle is not overworked. It is a gradual series of learning to change how your body moves by recruiting the right muscles at the right time.
If you are experiencing hip pain, a physiotherapist can perform a detailed assessment to determine which muscles may be tight, overactive or inhibited and advise you on a hip stability strengthening and stretching program based on your condition, your goals, your activities and your current ability to activate certain muscle groups. To be successful with this program, it is important that the exercises taught in the clinic are practiced regularly at home and progressed every few weeks.