Hip & Pelvis Pain

How to Fix Anterior Pelvic Tilt with Stretches & Exercises

When you have an anterior pelvic tilt, it often comes from tight hip flexors, and/or weak hamstrings. These stretches and exercises should help.

The first two stretches are for your hip flexors and your quads. There are many ways to stretch these, and it will help loosen up your hip and pelvic area in general.

Next, to strengthen your hamstrings, you can do a bridge or a single leg bridge. This also helps strengthen your glut muscles as well.

Then you will strengthen your gluts and hamstrings together with some quadruped exercises, or getting on all fours. Leg extensions, and heel raises are a great way to strengthen the whole hip area.

Also, stretching your low back can give you a lot of relief as well. A good stretch for this is the prayer stretch or child’s pose.

You also want to strengthen your core and abdominal muscles. Crunches and crunches with rotation are a great way to get them stronger.

The last two exercises are a little higher level, and you might not be ready for them in the beginning. If you can’t do them with proper technique, then you are not ready for them. Squats and lunges are a great way to strengthen your hamstrings, gluts, quads, and all the muscles in your lower body.

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Greater Trochanteric Bursitis, aka Hip Bursitis

Greater trochanteric bursitis or hip bursitis is the inflammation of the bursa on the outside of the hip, which can cause hip pain. The greater trochanter is the bony area it sits on. There are many bursae in the hip which can cause hip pain, but the greater trochanteric is the most common one.

These stretches and exercises should help you find pain relief.

The main muscles to stretch are your hamstrings, IT band, piriformis, and gluteus muscles. When these muscles are tight, they can cause a lot of pressure on the bursa which will irritate it can cause pain.

Strengthening the hip is very important as well because weakness can also cause bursitis. Clamshell and side planks do a great job of strengthening the hip in general and the gluteus medius muscles. Planks are also great to strengthen the core in general, and this will help as well.

Straight leg raises, hip abduction in sidelying, and prone extension are also great ways to strengthen the hip and pelvis area. When you strengthen these muscles, it helps to get everything working normally again.

Finally, a leg extension in quadruped not only helps with hip stability, but it also helps strengthen the core, hamstrings, and glutes.

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Hip Tendonitis Stretches & Exercises

Hip tendonitis stretches and exercises can help relieve many types of hip pain. Hip tendonitis is a very general term basically meaning inflammation in any one of the tendons at and around the hip. Hip tendonitis can cause hip pain, which is usually gradual. It can also cause tenderness in the hip over the affected tendon

These stretches and exercises should help.

A hip flexor and quad stretch in the lunge position is a great way to loosen up the hip joint. When these are tight, they can also cause problems walking and pain in other joints as well.

A figure four stretch for the glutes and piriformis muscles help loosen up the back of the hip. Sometimes this pain is misdiagnosed as sciatica.

After you have stretched, you want to strengthen the hip muscles. One of the best ways to do this is a 4-way hip on the floor. This strengthens the hip flexors, hip abductors, hip extensors, and hip adductors.

While you are on the floor, you can do some higher level exercises. Side planks with a hip drop is a great way to strengthen the hip as well as the core in general. These can also be done modified if you are not quite ready for full ones.

Finally, this stretch/strengthening combination movement really helps with hip strengthening, balance, hip stability, and hip flexibility. Make sure you hold onto something for balance, and you might not want to try this until you are almost ready to return to all activities.

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Hip Impingement (FAI) Pain Stretches & Exercises

Hip impingement syndrome, or femoroacetabular impingement (FAI) is when the hip joint rubs abnormally causing damage to the hip joint. This can affect your hip range of motion, and can also cause hip pain and hip weakness.

It can also cause damage to the hip cartilage, also known as the labral cartilage. This can happen often in young athletes and runners. If you don’t see much improvement with stretches and exercises, check back in with your doctor for a possible labral tear.

Stretching all the muscles around the hip area is very important. These muscles include the hamstrings, IT band, quad muscles, glutes, piriformis muscle, and groin muscles. By getting more flexibility around the hip area, you not only relieve pressure on the hip joint, but you also can help reduce the abnormal wearing on the joint which will help reduce the hip pain.

Strengthening the muscles around the hip will also help reduce hip impingement pain. Some great hip impingement exercises are a four way hip routine lying down. This includes hip flexion, hip adduction, hip extension, and hip abduction. They help keep the hip strong. Finally a clamshell exercise will help strengthen your hip abductor muscles including the gluteus medius, which is very important in hip stability and walking.

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Total Hip Replacement (Posterior Approach) Recovery Exercises

For a total hip replacement, it’s very important to know, and abide by, your precautions after surgery. Listen to your surgeon and physical therapist and do what they tell you to do because they are the most familiar with your particular situation and know the things you should do to recover as quickly as possible. Always check with them first before doing any rehab or recovery exercises.

There are three big precautions for a total hip replacement with a posterior approach. These three precautions are don’t bend past 90 degrees of hip flexion. So that means no bending down to tie your shoes or pulling your knee up towards your chest to put on socks. The next one is no hip adduction. This is crossing your leg across your body, like crossing your leg over your knee. The last one is no hip internal rotation, which is turning your foot inward. All of these put a lot of pressure on where the surgery site is and where the muscles are very weak, so they are important to follow.

Now I will show you some isometric exercises you can do very soon after your surgery. The first exercises are quad sets. Sit in long sitting with your legs straight out in front of you. If you want, put a rolled towel underneath your knee to give yourself a target. Then squeeze your knee down into the roll towards the ground. Hold it for 3 seconds, and do ten of them. 

Now is a hamstring set. Bend up your knees in a hooklying position. Push your heel down into the ground and hold it for 3 seconds, do this 10 times.

Then you will do glut or butt squeezes. You are basically trying to tighten your buttocks muscles, almost like if you have to go to the bathroom, and you are trying to hold it. Start off with 10 of these with a 2-3 second hold.

The next two are hip adductor and abductor isometric exercises. First take a ball or pillow folded in half, and put it between your knees. Squeeze into the ball and hold for 3 seconds, repeat 10 times. Then take a belt and wrap it around your thighs just above your knees. Push outwards toward the belt like your legs are opening up like a clamshell. Hold for 3 seconds, and repeat 10 times. 

Then you will do an ankle pump. You can prop your ankle up on something if you want, but keep your heel free to move around. I am using a roll, but you can just hang your foot off of the bed or stool. You are going to pull your toes up at your ankle, and then push down like you are pushing on a pedal. This is dorsiflexion and plantarflexion. It works as a natural pump to get the fluid and inflammation out of the leg, so you can do this several times a day. It can also help prevent DVTs, so this is very important.

Finally, you want to focus on the way you walk. Getting back to a normal gait pattern is very important. When we walk normally, our heel hits first, we roll through our foot, and then we push off with our toes. If we don’t get the heel strike in the beginning of the step, we tend to limp. If you are still limping, then you still need an assistive device like a walker or cane. If you walk with a limp, then your muscles will get in the habit of doing it, even when your muscles are strong again.

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