This article is a transcribed edited summary of a video Bob and Brad recorded in June of 2024. For the original video go to https://youtu.be/xYIYE0B98-Y
Mike: Are you struggling with hip pain, and not sure what's causing it?
Brad: Well, today we're going to discuss a major issue that most people overlook, including therapists, on why the hip is painful.
Mike: Now the problem we're going to discuss today is called anterior femoral glide syndrome, and we actually learned about this from our friend Rick Olderman, who is a physical therapist we work with, and has even co-authored a book with as well. For more findings on him, you can go to rickolderman.com, and check out his program sections and other things there.
Brad: We're going to skip that, and go right to it, show you what this syndrome is, and then exercise to correct it.
Mike: So for a more detailed explanation of what anterior femoral glide syndrome is, Brad's going to take over.
Brad: Yeah, I'm just going to call it AFGS because I have a hard time enunciating the full thing. We're looking at the hip right here. The ball of the hip into the socket, and anterior femoral glide. Anterior means forward on the body so the ball of the hip actually moves forward, which can cause pain. And even more, there is something called the labrum, which is a cartilage rim. And if that rim, if that labrum gets torn, or irritated, that can even cause more pain, and really a syndrome that you want to avoid.
Brad: So we need to figure out how to strengthen the muscles in the back to pull the ball of the hip back where it belongs in the joint so it's stable, eliminating the irritation and the pain. Okay, so here the hip is in an anterior position. In other words, forward, like I had mentioned. We need to mobilize or bring it back. So if I were to take this belt around the femur, and pull it this way to bring it back, that would be a good thing. And then we need to maintain it there. We're going to show you how this is done, and it's amazing how it's similar to exactly what I've just done here. Go ahead, Mike.
Mike: So to perform this mobilization, you can use a belt like that. You're going to need to wrap it around something sturdy, whether it's a stair railing, bedpost, heavy kitchen table, or whatever can hold your weight. You can also use a loop band like we have here. Now there's more stretch to this, so I need to pull the slack out of it. But what we're going to do is you're going to get it roughly in the crease of your groin here. And I like to hold onto it, because sometimes it can drop, you don't have to. Whatever works for your body. I find thicker bands work a little bit better. Again, with the belt, it's fine, you're just going to be closer. So once you get in this position, simply go forward. Almost, you're not going to do a full lunge, but just kind of slightly lunge forward. This is going to help pull that femur head back into place and get it out of that anterior lock position. With the belt, you're not going to have this amount of play to move forward. So just go by feel, just do a few reps.
Mike: Some people you actually kind of feel it pop back a little bit. That's a good thing. It's kind of getting back into place. If you're not noticing much here, you can certainly try doing it at a different angle, so sideways. This will give a kind of a distracting feeling, but this is a good little stretch you can just try as an option.
Brad: So you see Mike does do this with good posture. He's up tall, he's not leaning way over. And also if this does by chance create some pain, any sharp pain, stop doing it. This is not one of those things that should create pain, but typically what we're looking for like Mike said, if it feels good, a good stretch or you get that little movement feeling pop in there, and it feels good, then you're right on.
Mike: So after you perform the mobilization, we want to do some exercises to help keep that femoral head back in place. So what we need to do is strengthen the hip abductor muscles. Their focus is to kick the leg out to the side or keep you upright when walking. And we also want to strengthen the glute max. So we're going to go over two different exercises now you can do at home. So if you're really new to this, you don't need a resistance band, however, it's good to have one as an option. We'll show you how to do that in a second. All you're going to do is stand with a nice upright posture. My stance leg, I'm going to have a slight bend in my knee. I'm not going to lock it out, and I'm simply going to kick out to the side about six to eight inches. Come back in. You don't have to kick up way high if you don't want to. Keep it nice and low out to the side. Focus on keeping your foot off the ground. It's going to make your hip abductor work on your stance leg as well as the leg that is moving. We're going to shoot for 10 to 15 repetitions on one leg, and then we're going to switch and go to the other side. Now if you have poor balance, Brad is holding onto a Booyah Stik here. You can do this at a countertop, or behind a chair if you want for balance sake.
Brad: You can hold onto the wall too.
Mike: Yes, you can.
Brad: Use it for support.
Mike: Just make sure you have good posture. Make sure your pelvis isn't hiking or dipping because that is focusing on this muscle. If this seems very easy to you, you can progress to a band right away. You can use a tube-type band with handles, or a loop band like Brad has. If you have cuff weights at home, you can certainly use those as well. Now just get a little bit of tension in the bands by pulling up. Again, you're going to do the same concept, just kick out to the side a little and then back in, and do 15 repetitions on one side. Switch after 15. Make sure to do the other side. Do that two to three times a day.
Brad: You'll get the feeling if you need more resistance, pull up, or change your... Where the feet are under the band or over the band. You'll catch on real quickly to that. And this really will make the difference, and give you good resistance.
Mike: Most bands come with options for resistance too. So you can change the band color once it becomes easy.
Brad: That's right.
Mike: Okay, now we're going to work on strengthening the glute max muscle. We're going to show this exercise in a couple of variations here because we realize some people are not comfortable on their elbows and knees. So this is a position you're going to start with. I'm going to be working my left leg here, so I'm going to bring it up slightly. We're not going to do a full glute kick towards the ceiling, the common exercise. We're going to go somewhere in between. And now for beginners, it's good to rotate your foot in a little bit. This will isolate your glute max a little more. And we're just going to do little oscillating pumps here. We're going to shoot for 30 repetitions total. If you need to break it up into sets of 10, or 15, that is fine. Once you do one side, make sure to switch to the other. Maybe you notice one side is engaging better than the other, but this is a good way to get that glute max firing properly.
Brad: That's right. Again, just for a reminder, that glute max is a powerful muscle. When that contracts, it actually pulls that femur and the femoral head in a posterior or a backward direction letting that humeral head sit right into the joint as it should if so.
Mike: If that's too easy, and you can do that position, you can certainly put a cuff weight on. You just have to put it more between your knee, and your buttock to get the right resistance on that exercise. So again, same thing, but now I have a little bit of resistance.
Brad: Yeah, good idea. If you're not comfortable on your hands, and knees like that, you know that probably is better to do on the floor, not so much on a soft bed. This is strictly for demonstration, but you go to the cupboard or a tabletop, something solid, and you're going to do the same motion except for standing position, hands here or on your forearms. Bend the knee here, this is the side I'm strengthening, and we're going to not go as high as we can, and not get this motion, but good stability. And again, that mid-range motion like Mike was demonstrating and then that rotation where the foot goes down towards the other knee, and work it there to isolate that glute max muscle fibers, and I can feel it much better. And I'm working on that here. I think it's a good idea to do both sides, even if one side's the problem.
Brad: All right, Mike, they're going to ask, "Oh, how often should we do these? How many repetitions?" Let's clear that up.
Mike: Now as long as everything is feeling good for your hip, continue doing all three of these each day. You can do them two to three times a day. Shoot for 10 to 30 repetitions with the strengthening exercises. The band and mobilization do initially. If you feel like you don't need it after a while, you can certainly skip that one. If any of these again cause pain, they're not for you, something else is going on with your hip.
Brad: So we do have another video related to hip pain, if this is not working, it's called "STOP Hip Pain. Best 5 Stretches for People over 55." So we're covering all the age groups, I think. Enjoy the day and have a good hip.
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