Stretching or Strengthening: What's the Best Approach for Hip Pain?
- Julian Simpson
- Jul 14
- 3 min read
Stretching or Strengthening: What's the Best Approach for Hip Pain?
Pain in the sacroiliac joint is a significant concern within the realm of musculoskeletal disorders, representing one of the most prevalent yet often overlooked sources of discomfort. The sacroiliac joints, situated at the junction of the spine and pelvis, are thought to be responsible for pain in approximately 10% to 25% of patients suffering from chronic lower back pain. This condition is particularly challenging to diagnose, as it can mimic or overlap with other sources of lower back pain, leading to potential mismanagement and prolonged suffering for those affected.
It is essential to understand that chronic pain is defined as low back pain that persists for more than 12 weeks. This duration signifies a transition from acute pain, which is typically associated with a specific injury or incident, to a more complex and multifaceted condition that may involve various physiological and psychological factors.
The hamstring and gluteus medius muscles play pivotal roles in maintaining proper posture and alignment of the pelvis and spine. These muscles are the primary contributors to postural dysfunction and are often implicated in muscle imbalance scenarios that can exacerbate pain in the sacroiliac joint. When these muscles are not functioning optimally, it can lead to compensatory movement patterns that further destabilize the lumbopelvic region.
Correct muscle activation is crucial for allowing normal load transmission across the lumbopelvic region; thus, the lack of movement at the sacroiliac joint due to improper muscle activations and forces is considered a significant dysfunction. This dysfunction can manifest in various ways, including altered gait mechanics and increased strain on surrounding structures, which may contribute to chronic pain patterns.
A weak gluteus medius can severely impair its primary role as a pelvic stabilizer. This weakness creates instability in the lateral hip and leads to excessive adduction during walking. Such compensatory mechanics can place undue stress on the entire kinetic chain, resulting in further dysfunction and pain not only in the hip but also radiating into the lower back.
This altered movement pattern leads to compensatory strategies, such as the hip rising to minimize foot striking on the lateral side of the foot and reduce the degree of adduction. While this may provide temporary relief, it can exacerbate the underlying issues over time.
Consequently, the low back muscle, known as the quadratus lumborum (QL), often works compensatorily, engaging in excessive hip hiking. This overactivity leads to hypertonicity in the QL muscle, which can become a significant source of pain. The resultant trigger points within the muscle can refer to pain in the sacroiliac joint region, creating a cycle of discomfort that can be difficult to break without targeted intervention.
So, what can you do to help alleviate your lower back and hip pain? Understanding the underlying mechanics is the first step toward effective management.
Research has found that the most effective approach to address these issues involves:
Strengthening the gluteus medius muscle while also focusing on the QL muscle to alleviate tightness and restore balance within the lumbopelvic region. This dual approach targets both the stabilizing and compensatory muscles, promoting better function and reducing pain.
Interestingly, this method has been shown to be more successful than simply stretching the gluteus medius muscle alone, highlighting the importance of strengthening as a key component of rehabilitation.
The research conducted on participants over a span of 4 weeks demonstrated significant improvements in pain levels and functional mobility, underscoring the effectiveness of a comprehensive strengthening program.
For more information about how we can help. Please call Health Wise Chiropractic 03 9467 7889 or book online to see one of our Chiropractors in Sunbury or Melton/Strathtulloh Today!
We are also really proud to offer our patients an APP for their Mobile- iPad. With access to your rehab exercises and our health tip blogs with over 500 articles.
Chiropractic has moved online. We offer our online program -STAND CORRECTED- To help you through the day.
We have over 30 programs on different health conditions
Each program contains
- Information about the conditions
- things to do and things to avoid
- nutrition advice
- all the stretches that are needed to help
Reference
Soomro RR, Karimi H, Gilani SA. Comparative Efficacy of Quadratus Lumborum Muscle Energy Technique with Gluteus Medius Strengthening Versus Gluteus Medius Strengthening Alone in Sacroiliac Joint Dysfunction: A Randomized Controlled Trial. Diagnostics (Basel). 2024 Oct 30;14(21):2413. doi: 10.3390/diagnostics14212413. PMID: 39518383; PMCID: PMC11544892.
Commentaires