When Hip Pain isn’t really Hip Pain

When Hip Pain isn’t really Hip Pain

Dr. Addison Nichols, DPT

Is it really your hip or could it be your sacroiliac joint?

I often hear from people “My hip hurts” and they point to a very specific spot on one side or the other just above their buttock. Sometimes their pain could even go into their buttock or even down the outside or backside of their leg. The sacroiliac joint can very easily be located by either feeling for that boney part just above your buttock close to your spine or feeling for that back dimple in the same location. This is not the hip, it is the sacroiliac joint or SI joint. When individuals have true hip joint pain or arthritis the pain is typically a deep pain you can’t touch in the front side of the hip, just below your belt. When individuals have pain in the back side of their “hip” it is very often the SI joint.

What are some activities that will typically aggravate the SI Joint?

Activities that will typically aggravate the SI joint are walking for long periods of time, sitting in really deep or tall seats, and even bending forward or backward. This is  typically due to weakness and laxity (too much movement) at the SI joint that could cause the joint to not move like it should. Sometimes the pain is often difficult to reproduce and won’t create the achy feeling everytime you bend over. Often the pain will come on moments following an aggravating movement like bending forward. 

“I still think it’s my hip”

There are a number of tests we can perform in the clinic that will help isolate true SI joint dysfunction and help differentiate between SI joint and hip. One test we perform is called a “supine to long sit” test. In this test we are allowed to determine if you have an SI joint dysfunction involving rotation at the SI joint. I’ve often had clients that will come in wearing a ¼ inch heel lift they’ve worn for years because they have a leg length difference when the true issue was at the SI joint. This can often be easily corrected and the individual no longer needs the heel lift. There are circumstances however, where clients do have a true leg length difference and need a heel lift but this is not always the case. 

No matter your pain, there is an answer

At Empower Physical Therapy we perform thorough examinations in order to determine what exactly is causing your issue. We make it our job to make sure you understand what is causing your pain, how to change it, and how to keep it away for the decades to come. We combine functional exercises, hands-on manual interventions and pride ourselves on educating our clients. We equip you with the tools you need in order to be your own advocate and overcome any obstacle. 

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