Personally, I have had left sciatica issues and low back spasms since my early 20’s. In 2005 I had a bad fall and dislocated and fractured my left femur. That led to a 2016 full left hip replacement. So, I’m very familiar with hip injuries, nerve and sciatica pain, and rehabilitation.
How big is the pelvis?
|Transverse diameter (of inlet)||Between extreme lateral points of the pelvic inlet||13.5–14 cm|
|Oblique diameter I||Right sacroiliac joint||12-12.5 cm|
|Oblique diameter II||Left sacroiliac joint||11.5–12 cm|
|Anatomical conjugate (true conjugate)||Pubic symphysis||~12 cm|
2–4. Hip bone (os coxae)
1. Sacrum (os sacrum), 2. Ilium (os ilium), 3. Ischium (os ischii)
4. Pubic bone (os pubis) (4a. corpus, 4b. ramus superior, 4c. ramus inferior, 4d. tuberculum pubicum)
5. Pubic symphysis, 6. The acetabulum (of the hip joint), 7. Foramen obturatum, 8. Coccyx/tailbone (os coccygis)
Dotted. Linea terminalis of the pelvic brim
The pelvis is not actually a single body part but a term that refers to a collection of bones, muscles, and organs below the waist. Katherine Gillogley, department chair of obstetrics and gynecology with Mercy Medical Group in Sacramento, California, has seven facts about the pelvis.
1. SO WHAT IS THE PELVIS, EXACTLY?
“The pelvis refers to the lower abdominal area in both men and women,” Gillogly says. “An important function of the pelvis region is to protect organs used for digestion and reproduction, though all its functions are crucial,” she says. It protects the bladder, both large and small intestines, and male and female reproductive organs. Another key role is to support the hip joints.
2. THE PELVIC BONES FORM A BASIN.
Four bones come together to form a bowl-like shape, or basin: the two hip bones, the sacrum (the triangle-shaped bone at the low back), and the coccyx (also known as the tailbone).
3. YOUR PELVIC FLOOR IS LIKE A TRAMPOLINE.
At the bottom of the pelvis lies your pelvic floor. You don’t have to worry about sweeping it, but you might want to do Kegel exercises to keep it strong. The pelvic floor is like a “mini-trampoline made of firm muscle,” according to the Continence Foundation of Australia. Just like a trampoline, the pelvic floor is flexible and can move up and down. It also creates a surface (floor) for the pelvic organs to lie upon the bladder, uterus, and bowels. It has holes, too, for the vagina, urethra, and anus to pass through.
4. IT PLAYS A KEY PART IN WALKING.
Anyone who has ever broken a pelvic bone or pulled a pelvic muscle will know just how key a role the pelvis plays in such functions as walking and standing. “The pelvis also acts as a solid foundation for the attachment of the spinal column and legs,” says Gillogley.
5. THE FEMALE PELVIS STARTS OUT LARGER BUT NARROWS OVER TIME.
Gillogley says that the female pelvis “tends to be larger and wider” than the male, most likely to accommodate a baby during pregnancy and to make childbirth possible. However, women’s pelvises narrow as they age, suggesting that they start out wider to accommodate childbearing and then shift when that is no longer necessary. A shifting pelvis shape is thought to be a key part of our evolutionary history, as it changed when we began walking upright.
6. PREGNANCY CHANGES THE PELVIS FOREVER.
During pregnancy, the body secretes a hormone known as relaxin to help the body accommodate the growing baby and soften the cervix. However, what happens is, “the joints between the pelvic bones actually loosen and slightly separate during pregnancy and childbirth,” Gillogley says. Sometimes, however, relaxin can make the joints too loose, causing a painful syndrome known as symphysis pubis dysfunction (SPD), causing the pelvic joint to become unstable, causing pain and weakness in the pelvis, perineum, and even upper thighs during walking and other activities. Many women with the condition have to wear a pelvic belt. It usually resolves after pregnancy is over, though physical therapy may be necessary.
7. IT’S ACCIDENT PRONE.
According to the American Association for the Surgery of Trauma, about 8 to 9 percent of blunt trauma includes pelvic injury, Gillogley says. “These accidents include falls, motor vehicle crashes, bicycle accidents, and pedestrians being struck by moving vehicles. With these serious injuries, pelvic bones can fracture or dislocate and sometimes bladder injury even occurs.” So take care with your pelvis—in worse-case scenarios, breaks of the pelvic bones can require pins, rods, and surgery to fix.
What are the types of hip pain?
Your hips are an integral part of your ability to be mobile, When they are painful, moving around is a problem. So what are common causes of hip pain?
One cause is Tendonitis or Bursitis
When the tendons surrounding the hip that connect the muscles to the joint become inflamed you end up with tendonitis. Tendonitis causes tenderness and pain just outside the joint. Bursitis is a condition that affects the small fluid-filled sacs that cushion the bones, tendons, and muscles in the hip joint. Bursitis causes you to feel achy, stiff, and your hip will hurt when you touch or press on it.
Another cause is Arthritis
In fact, arthritis is the most common form of chronic hip pain in women. Osteoarthritis happens in the hip when the ball and socket joint of your hip get worn as you age. Osteoarthritis pain is mostly felt in the front of your thigh or in your groin because of the swelling and inflammation in the joint. Rheumatoid arthritis is a chronic progressive disease that causes inflammation in the joints, and it usually affects hands and wrists before moving to larger joints like hips and knees. With RA hip pain, you’ll experience discomfort and stiffness in your groin and thigh. Psoriatic arthritis is another inflammatory condition that affects people with a skin condition called psoriasis. Pain from these types of arthritis will exhibit itself as stiffness, inflammation, discomfort, swelling, and tenderness in the joint.
Another cause of anterior hip pain in women is sometimes caused by femoral and inguinal hernias in the groin. This is called a sports hernia which is a strain or tear of any soft tissue in the lower abdomen or groin area. This type of pain happens when sustaining a sports injury and usually goes away with rest, however it can return when sports or other exercise starts again.
If you fracture or dislocate your hip that can cause great pain
Snapping hip syndrome
A snapping hip or dancer hip is a condition where you feel a snapping sensation or hear a popping sound in your hip while walking, standing up, or swinging your leg around. This snapping hip or popping sensation occurs when the muscle or tendon moves over the bony structure in your hip.
A traumatic hip dislocation is when the ball of the hip joint is pushed out of the socket. This injury most commonly occurs during an auto collision or a high-impact fall, workplace, or sports injury, especially those that also result in a broken leg or pelvis.
Fractures can stem from osteoporosis or because of a fall or both. If you have a hip fracture you will experience pain when you straighten, lift, or stand on your leg, and the toes on your injured side will appear to turn out.
A pinched nerve, which is when too much pressure is applied to a nerve by surrounding tissues like bones, muscles, cartilage, or tendons, can cause pain, tingling, weakness, or numbness. The most common type of pinched nerve is sciatica.
- Labral Tear. The labrum is the seal that “glues” the ball and socket—the femoral head to the acetabulum. …Most commonly, a labral tear is the result of repetitive stress (loading) irritating the hip, often due to long-distance running or performing repeated, sharp, sports movements, such as twisting and cutting.
- Loose Bodies. …
- Iliopsoas Impingement and Snapping Hip. …
- Avascular Necrosis. … Avascular necrosis is the death of bone tissue due to a lack of blood supply. Also called osteonecrosis, it can lead to tiny breaks in the bone.
- Bursitis. …inflammation of a bursa, typically one in the knee, elbow, hip, or shoulder.
- Gluteus Medius Tears. …Gluteus medius tears, also known as the rotator cuff tear of the hip, involve tearing of the gluteus medius muscle from its attachment to the greater trochanter, commonly known as the “lateral hip bone”. Gluteus medius tears may cause persistent pain mimicking trochanteric bursitis.
- Hip Instability. …Hip instability is a loose or wobbly hip joint that’s usually caused by problems with the ligaments (the bands of connective tissue that hold bones or joints together). In hip dislocation, the ball at the end of the thighbone is pushed out of the socket.
- Hip Fractures.A hip fracture is a break in the upper portion of the femur (thighbone). Most hip fractures occur in elderly patients whose bones have become weakened by osteoporosis. When a hip fracture occurs in a younger patient, it is typically the result of a high-energy event, such as a fall from a ladder or vehicle collision.
- Each year, more than 300,000 people in the United States sustain a hip fracture. Most of these fractures occur in patients 65 years or older who are injured in household or community falls.Hip fractures can be very painful. For this reason, prompt surgical treatment is recommended. Treating the fracture and getting the patient out of bed as soon as possible will help prevent medical complications such as bedsores, blood clots, and pneumonia. In very old patients, prolonged bed rest can also lead to disorientation, which makes rehabilitation and recovery much more difficult.
- Sharp pain in the hip or pelvis after trauma.
- Sudden hip pain.
- The upper leg feeling tender and sore.
- Muscle spasms.
- Swelling and bruising on the thighs or hip.
- Tightness and stiffness after long periods of rest.
- Cramping in the upper leg.
- Pain when lifting your leg to the chest.
- Resting the muscles to help them to heal while avoiding activities that could cause further strain.
- Wearing a compression wrap around the area. …
- Applying an ice pack to the affected area. …
- Applying a heat pack to the affected area. …
- A hot shower or bath.
- A joint that appears deformed.
- Inability to move your leg or hip.
- Inability to bear weight on the affected leg.
- Intense pain.
- Sudden swelling.
- Any signs of infection (fever, chills, redness)
Hip Replacement Video
Exercises for Hip pain
- Knee lift.
- External hip rotation.
- Double hip rotation.
- Hip and lower backstretch.
- Hip flexion.
- Hip extension.
- Hip abduction.
Benefits of Massage for Hip Pain
Deep tissue massage focuses on the realignment of the connective tissue layers and the deep muscles. It is helpful in controlling chronic hip pain.
Deep tissue massage helps in breaking down the adhesions in the hip regions thereby reducing pain and restoring normal hip joint mobility.
During the early stage of the deep tissue massage, individuals may feel pain and discomfort, which will gradually subside as the frequency of the massage therapy increases.
Deep Tissue Massage can:
- Reduce Tightness
- Reduce Tension
- Increase Circulation
- Reduces trigger points (trigger points are the knots in the muscles, tendons, ligaments, and fascia).
- Improved muscle recovery after exertion.
- It also reduces scar tissue from tears and injuries, allowing for normal, smooth movement of muscle fibers.
- Improve range of motions in the hip
- Pain from spasms or trigger points in the muscles affecting the hips is relief and allowing the distorted gait and movement pattern to return to normal.
Hip pain can be a result of several things including:
- Injury from overdoing various activities
- Problems in the muscles in the legs
- Gluteal muscles – The piriformis is a small muscle in the center of the buttock. This muscle is active during running and walking and is susceptible to stress. When the piriformis is stressed, it can tighten and cause pain in the hip and buttocks.
- Abdomen – The abdominal muscles can impact the hips by pulling the hips forward and up when they are tightened and shortened. If they are unbalanced or uneven in strength due to postural habits, they can pull the hips off balance as well.
- Low back – When they are unbalanced or uneven in strength, they begin to affect our posture and movement. They also begin to pull on the pelvic bones and this tension often results in pain in the hip.
- Tight Hamstrings and Quadriceps – When the quadriceps are overly tight, they pull the pelvic bones forward and down, anteriorly tilting the hips.
- Leg Muscles – Muscles in the legs can often cause hip pain because they can impact the way we move, walk and even sit. For example, flat feet (especially common in women) can result in the foot over-pronating (rolling in).
- Lateral Rotators – Known as the six deep lateral rotators, which run from the sacrum to the upper femur. These muscles, including piriformis, rotate the leg laterally (toes out).
- Hip Flexors – Located in the abdomen, the hip flexors are what enable you to lift your legs. Spending a lot of time seated with hips flexed can result in shortened hip flexors, which may result in hip pain.
- The Psoas – Another muscle in the abdomen is the psoas or iliopsoas. This muscle runs from the transverse processes of the lumbar vertebrae and inserts deep in the groin on the lesser trochanter of the femur. This is one of the deepest muscles in the body and stabilizes, joining upper and lower body and flexes the hip.
Pain in the hip area can be relieved by massage therapy. Massage can help to increase mobility in hip movement, relieve some pain and stress on the hip joint itself, and help assist in correct pelvic alignment.“Massage helps relieve pain and eases the muscle stiffness associated with arthritis by improving circulation, helping to reduce inflammation. That translates to enhanced blood flow to arthritic joints, improved movement, and reduced pain,”.
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*Disclaimer: This information is not intended to be a substitute for professional medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider.
Please consult your healthcare provider with any questions or concerns you may have regarding your condition.
The information provided is for educational purposes only and is not intended as a diagnosis, treatment, or prescription of any kind. The decision to use, or not to use, any information is the sole responsibility of the reader. These statements are not expressions of legal opinion relative to the scope of practice, medical diagnosis, or medical advice, nor do they represent an endorsement of any product, company, or specific massage therapy technique, modality, or approach. All trademarks, registered trademarks, brand names, registered brand names, logos, and company logos referenced in this post are the property of their owners.