Early hip pain or something laughably simple?

[Globalti]

For a couple of weeks now I've been worrying that I was getting the first signs of arthritis in my left hip, a sort of dull ache around the back of the joint deep inside my thigh. However I thought this was unlikely because there's no grating, creaking or pain on walking or cycling and I've never been overweight, nor is there any history or hip joint disease in my family.

This morning I had a revelation; sitting on the loo I finished reading an article in a cycling magazine and reached for the loo paper for the concluding cleanup. Transferred my weight to my left side then it hit me... thanks to the design of the loo seat all my weight was bearing down sharply on the back of the hip joint, which was aching under the stress. Moved the weight outwards a little to take it on the pelvic bone and the ache disappeared. I'm in the habit of using the loo 2 or 3 times a day and it suddenly strikes me that I may just be causing low grade bruising of the area around the posterior of the hip joint. Anybody got any thoughts on this?

 

[brockers]

I've been here and don't worry, you don't have arthritis! I'd say it sounds like a tight glute medius - the muscle around the joint which among other things rotates your toes from outside to inside as you look down at your feet. There are exercises you can do to alleviate the ache involving hanging your leg off the side of the bed and twisting your toes upwards, but I'd recommend a sesh with a sports masseur, because it won't go away on its own.

I'll now bore you with my story because this sounds identical to what I've had. At times, I could hardly stand on one leg to put my trousers on without almost collapsing. I had put up with it for a couple of years, and as it limited, and was exacerbated by my running, I ended up changing to a midfoot strike so that I could continue. After finally going to the GP, and with a trainee specialising in biomechanical issues sitting in, I was told I had a weak glute max and advised to do lunges. I questioned this as I'm able to perform straightforward one legged squats with both legs, but as soon as I needed to stabilise and balance for example when running or standing to put on trousers, then the aching occurred. They then came up with the genius suggestion that I stop running and cycling for a few months, take up swimming, and prescribed co-codamol painkillers. I wanted a referral but they fobbed me off with long waiting times and all that guff, so it was essentially another utterly pointless visit to the GP. So I booked myself in with a trainee osteopath who checked for Trendelenberg Gait*, any imbalances, and not seeing anything particularly wrong, dug their thumb deep into my hip. It hurt, but Boy!, it hit the spot. My hip is now ache free, and I still occasionally get a lovely tingle in it from it being 'loosened off'.

As to what caused it, that remains a mystery. It could be heelstrike running, where the jarring action goes up your leg and your hips take the force; position on the bike; or crank size. Who knows?. For some reason, I'm using 175mm cranks, when I should by most calculations, be on 170s. Or there might be overuse injury issues combined with a tiny leg length discrepancy. Short of forking out for an expensive bike fit and orthotics, I'm not sure how to prevent it apart from regular stretching and the occasional deep-tissue massage.

* your hips becomes so weak as you walk you end up waddling.

 

[PK99]

For a couple of weeks now I've been worrying that I was getting the first signs of arthritis in my left hip, a sort of dull ache around the back of the joint deep inside my thigh. However I thought this was unlikely because there's no grating, creaking or pain on walking or cycling and I've never been overweight, nor is there any history or hip joint disease in my family.

This morning I had a revelation; sitting on the loo I finished reading an article in a cycling magazine and reached for the loo paper for the concluding cleanup. Transferred my weight to my left side then it hit me... thanks to the design of the loo seat all my weight was bearing down sharply on the back of the hip joint, which was aching under the stress. Moved the weight outwards a little to take it on the pelvic bone and the ache disappeared. I'm in the habit of using the loo 2 or 3 times a day and it suddenly strikes me that I may just be causing low grade bruising of the area around the posterior of the hip joint. Anybody got any thoughts on this?

I had food poisoning last year (actually exactly a year ago...) and was on the loo literally dozens of times a day for 3 days. Ended up with severe hip pain which the doc diagnosed as hip bursitis

 

[Globalti]

Fascinating, thanks both!

I spoke with my mum who is retired physiotherapist. She said almost exactly what Brockers writes above and recommended I see a chiropractor. My response was that I thought chiropractors were considered a little "wacky" by classical physios but she disagreed, mostly based on good experiences at the hands of chiropractors in her recent years as a very fit 80 y.o. walker.

 

[brockers]

If I had a mum who is a retired physio, I'd have asked her first before risking a diagnosis from here!

I understand that physios, osteos, and chiros have a lot more mutual respect than in years gone by, as their core training is now very similar.

 

[Fiona N]

I've had similar problems on long rides - my hip starts to ache, particularly the right side.

I assumed this was yet another problem emanating from my back problems but it seems that it's yet again glute medius - not tight but lazy. I haven't been using my glutes enough when pedalling - basically I make up for them by over-using hamstrings and calf muscles. As the physio pointed out, someone with tight hamstrings would have noticed before now but because I tend to have long flexible muscles, it's only at fairly extreme distances, 300km and over, that I experience the problem as the hamstrings and some adductors get tired.

An interesting point is that although I've been doing glute medius strengthening exercises ('clam shell' exercise, protective against ITB syndrome), it seems that I can do the exercise only minimally using glute med. and making most of the effort in hamstrings, quads and adductors instead (so total waste of time, in effect). I've been learning to isolate the glutes and exercise glute med. alone - I tell you, you've never concentrated so much on your bum before as when doing these exercises

Only time will tell if this solves the problem. But the physio did suggest that weak, or more specifically, lazy glutes (i.e. they aren't fully engaged when they should be) are a factor in many problems around the hips. Like brockers mentioned, people think they're strengthening their glutes using exercises like lunges but if you're not using all the controlling / stabilising muscles correctly, you can just add to the problem by strengthening muscles without making them act in the correct way. In particular using the hamstrings too much instead of glutes could be a big factor in hamstring cramps on the bike.

 

[Hilldodger]

Have you made a will? Can I have your slippers?