This article is a transcribed edited summary of a video Bob and Brad recorded in March of 2024. For the original video go to https://youtu.be/WuE9LbOcM1k
Mike: Most people think their hip pain is coming from their hip, however, in some cases, it is actually referring from the back.
Brad: That's right. We know as therapists that oftentimes people who come to us with pain and say their back hurts, we always assess the hip to see if that's actually the source of the pain and vice versa. So we treat the proper area and get the problem resolved quickly.
Mike: So today we're going to show you how to tell if your hip pain is actually coming from your hip or your back.
Brad: That's right.
Mike: Oftentimes the location you're experiencing pain, if you're having real hip pain, is in the groin region front of thigh, and sometimes it can go into the buttocks a little bit.
Brad: Also with hip pain, standing, walking, and climbing stairs can be a common irritant. However, that can be the same with back. But location of back pain, oftentimes, is more in the low back, this area in the buttock around the posterior or the backside of the hip, running down the legs, to the knee, and sometimes even down to the foot.
Mike: Now when it comes to hip pain referring from the hip joint itself, oftentimes it can be achy, sometimes sharp, but normally with activity, pain gets worse. So if you're standing for prolonged periods, walking, or doing stairs, typically the pain will get worse the more you do.
Brad: Now on the other hand, back pain, low back pain, oftentimes the more you walk, unless it's very serious, can improve the back pain, people say, yeah, after I get walking, I'm up for a little while, it actually feels better. That is a good likelihood it's the back, not the hip.
Mike: So if you are experiencing hip pain in the groin region, some common causes or diagnoses may be osteoarthritis, bursitis, tendonitis, hip impingement, or a hip labral tear.
Brad: So those are the structures that are causing the pain. Now, if it's low back, the structures or the tissues that are typically the problem are a disc. We all know about a herniated disc. The facets which are little joints between the vertebrae, stenosis, which is a common cause, typically people over 55 or 60 may have that, or just tight muscles as a result of overactivity or one of the other problems causing some protective contracting. Either way, that is where we're looking at for the back. What do you say, Mike?
Mike: We're going to get into some tests now for how you can tell if your pain is actually coming from your back, referring to your hip or it's just in your hip joint.
Brad: Sure. Okay, so now we're going to test to see if the pain is originating from the low back. Now Mike's going to do the testing in a standing position and I'm actually going to help hold his pelvis. Now you don't need to have someone do that, but it's really important we isolate movement just to the low back, no movement in the hip. So you have to imagine someone's holding your hips right here. So there's no movement.
Brad: And I'll let go now, but Mike is going to keep that in mind and he'll go through the motions and actually monitor where there is pain and take note of it. Go ahead, Mike.
Mike: So if any of these movements you're doing with your spine refer to that pain to your hip, you start feeling the pain, it gets more intense, it's a common sign that it's coming from your back. So the first one they're going to do, I'll just place my hands and my hips. So you can see my hips aren't moving. All you're going to do is flex your spine forward like you're bending over. Now don't start shifting way down because my pelvis is moving. Just slowly start flexing down, see if you feel any pain.
Mike: The next step would be extending or going backwards. Brad will show a profile here from the side. If this causes any pain, it could be coming from your back.
Mike: And the last one is rotation. So this one's important because you can really rotate at your hips but keep your hips stationary, simply rotate from your back and then rotate the other way. See if this increases your hip pain.
Brad: Good, now like Mike said, if that turns on the pain in the hip, there's a good chance it's coming from your low back. We're going to go through the exact same thing, looking at the hip to see if the hip is the source of the pain. Let's go to it, Mike. Now to test, find out if the pain originates in the hip joint, you need to do it lying down on your back. It's good on a firm surface. A bed will work, but actually the floor is a little bit better. Now, Mike is going to keep his pelvis and back isolated. There's no weight through it, so that helps isolate the back. There's no weight through the hip. We're just going to look range of motion, see if it irritates the hip joint and reproduces that pain that you are wondering about. Go ahead Mike.
Mike: So the first exercise is hip flexion. So I'm just going to bring my knee up to my chest. Notice I'm not rounding or arching my back excessively, that can change with the test. So make sure your back is flat against the mat. Just simply bring your hip up in the flexion and down, creates any sharp pain, good chance it's in your hip. We're going to go through all the motions of the hip because it's a very mobile joint and if any of these create pain, good sign it's in the hip.
Mike: So the next one is called internal and external rotation. A simple way to do it is to leave your leg straight and simply rotate your foot out to the side and back in. Now, some people may not experience pain being in a straight leg position. You can try what we call a figure four. So I'm testing the left hip and I'm going to push the leg down. My ankle is against the top of my knee here. If this recreates your pain, it's a good chance it's in the hip. And if you go the opposite direction, increased pain in your hip, it's probably your hip.
Mike: The last motions are abduction and adduction. That just means abduction, bringing away from midline and bringing back towards midline. Again, if there is pain it's probably the hip joint.
Brad: Now, one thing we did not show here and I would recommend is you test one leg and then test the other leg and compare right to left and see if you notice a difference. That can also help you identify it as well. And another big thing, these tests as a lay person, you can do 'em, but it's not always easy. This is something that to really get it right, you need to be a professional. You need to see a therapist or a doctor, and even professionals do not get it right the first time. So this is complicated, but at least you kind of understand the concepts and you can go ahead and see how it works. If you experience any sharp pain, like it's irritating, it makes your eyes open up, you stop and do not go any further. We don't want to make things worse.
Mike: Now here's a list of symptoms that if you have in conjunction with your hip pain, you should really seek professional help.
Brad: So the first thing is, if you have severe pain, it's not getting better, make sure that you go ahead and get some help professionally.
Mike: If you experience numbness, weakness, or tingling in your leg.
Brad: That's right, all the way down into the foot, that's definitely a red flag. If you have any fevers, chills, unexplained weight loss, you need to go in and see the doctor.
Mike: And if you have difficulty with walking or standing.
Brad: Now the other thing, this is a really important one, if you're experiencing saddle numbness, in other words, if you sat on a saddle and you had numbness in this area of your legs, the groin area, or if you have uncontrolled bowel and bladder experience where you cannot control that, you need to see the doctor, ASAP and actually probably go to the emergency room. That's a big red flag. Rarely happens, but if you experience it, get it taken care of now.
Mike: And just to clarify, saddle numbness means you weren't actually on a saddle, just in general every day you have that numbness in the region.
Brad: Alright, we'd like to hear Bob and Brad inform you of some of our products that we promote because we really like them. Now massage guns are very popular, and this gun actually is one of our most popular guns that we sell. And we've actually made it better in a big way. Mike, you want to talk about it a little more?
Mike: So this is the C2 Massage Gun with heat and ice massage gun attachment. Brad is holding it in his hand right now. So it can be set to feel cold, like ice or heat. So it can warm up actually, and it stays constantly warm or cold depending upon the setting.
Brad: That's right, the cold setting, which I was surprised, it stays cold after using it on your body for any amount of time. It really works well. It also does come with the typical airhead, the round head, the bullet head, and the little field goal head as well. But this separates it from the rest of our products as well as many other products out there. Now I do have it right now on the cold setting. It does have 10 millimeters of amplitude, in other words, it reciprocates back and forth 10 millimeters, which is nice and deep. You're going to get in deep. And again, I can feel that cold. It is really a nice gun, and it's gotten better because of this new head.
Mike: And it has 44 pounds stall force, meaning how hard you have to push it to try to actually get the component to stall out.
Brad: Boy, I almost got cramps doing it.
Mike: So don't push that hard normally, because I wouldn't want to massage myself that hard.
Brad: It has a really nice product. If you're looking for a gun, I would consider it as long as you're looking for these options. Enjoy the day, and Mike. All right, Mike, we've got another video that can be helpful. What is it?
Mike: Yeah, so if you actually have hip pain, we have a video, "STOP HIP Pain; Best 5 Stretches For Over 55."
Brad: For a video specifically for your low back, check out "The #1 Most Important Method To Fix Back Pain". It fits this video very well. If you want to say it piggybacks it, but the information will be helpful for you. So watch that video.
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