Myofascia – part 2

Hip pain is common problem, and it can be confusing because there are many causes.  The most common cause of Hip Pain is arthritis for which you will need to see your GP for them to advise on the best treatment option of you. Trochanteric Bursitis Trochanteric bursitis is an extremely common problem that causes inflammation of the bursa, which is a protective cusion over the outside of the hip joint.  There are two main bursa which protect the hip joint, the superficial trochanteric bursa and the deep trochanteric bursa.  The superficial trochanteric bursa lies beneath the tensor fasciae latae (one of the muscles on the side of your hip) and the deep trochanteric bursa lies beneath the the largest of your glutes (gluteus maximus) both of the these muscles insert in to the Iliotibial Band (ITB).  Reduced flexibility in your gluteus maximus, tensor fasciae latae or ITB can cause trochanteric bursitis, from too much cycling or running or from running on uneven surfaces.  Another common cause is some women is an imbalance between your abductor and adductor muscles.  Trochanteric bursitis can also be caused by clients altering their posture as a result of a previous back injury. In all these cases a deep tissue or sports massage can help.  However if the cause is walking with more weight going through the outside of your foot (excessive foot eversion) then your make need to see a podiatrist for personalized orthotics. Hip Flexors Illiopsoas the main hip flexor, shortens when we sit down, so prolonged sitting can cause contracture (anatomical shortening) which can cause either lower back or hip pain.  I have personally found this to be a common cause of hip pain which can be successfully treated with deep tissue or sports massage. If you experience lower back or hip pain when standing up from a seated position then rectus femoris which is one your largest quadriceps muscle make be tight and/or your gluteus maximus which is the other muscle which helps your stand from a seated position may be weak.  If you suspect you have weak glutes you can strengthen them with squats and lunges. Fractures Hip fractures are common in the elderly with osteoporosis.  Stress fractures of the hip are common in people who participate in high impact sports e.g. long distance running, treatment is usually to avoid the high impact sport and this is usually successfully. When should I see my GP about my hip pain?  

• Inability to walk comfortably on the affected side
• Injury that causes deformity around the joint
• Hip pain that occurs at night or while resting
• Hip pain that persists beyond a few days
• Inability to bend the hip
• Swelling of the hip or the thigh area
• Signs of an infection, including fever, redness, warmth
• Any other unusual symptoms

These stretches can either be done as a complete series or individually and most of them can be done at your desk.  Some will ease tension in specific parts of the body whilst others are generally relaxing.  Please remember stretching should always be relaxing and never painful! To get maximum benefit from these stretches you should do them daily and hold each stretch for 15 seconds and repeat twice. Head And Neck

• Head rotation - keeping your head level, slowly turn from side to side.
• Slowly drop your head sideways moving your right ear towards your right shoulder and push down with your left shoulder - repeat on other side.
• Stand with your feet shoulder distance apart; look down towards your right foot (hold for 15 seconds),  dropping left shoulder - repeat the exercise looking towards your left foot.
• Drop the lower jaw and open the mouth wide.

• Shrugging shoulders in a circular movement - forwards and then backwards.
• Raise your shoulders high and let them drap heavily; whilst letting breathing out.
• Clasp hands behind your head, with elbows back - push your chin back.  Hold for 15 seconds.  From this position look down and push your elbows together at the front and hold for a further 15 seconds.
• Clasp you hands and push up towards the ceiling, palms up now look down.
• Sit upright in a chair with a firm seat.  Raise your arms as high as possible and remaining seated drop forward letting your head and arms hang heavily towards the floor.

Sitting in office chairs for long periods of time not only affects your muscles but impacts the disks in your spine. In humans over 5 years of age, there is no direct blood supply to the jelly like nucleus of the intervertebral discs. The intervertebral discs therefore rely upon fluid inflow and outflow for their nutrition: when you lie down, the pressure comes off the discs and they expand, absorbing water and nutrients as they do so (rather like a sponge expanding and sopping up a spill on the floor). Unloaded Disc Filling with nutrient rich liquid When you stand up, the discs are compressed and their watery component is squeezed out, thus removing waste products at the same time. Loaded Discs Being Compressed Similar squeeze/expand cycles are occurring every time that we move, both day and night. This means you must move in order to “feed” your discs and keep them healthy. The disc squeeze/expand cycle is crucial to spinal health.  It is well proven that your degenerative disc "disease" progresses faster over time if your discs can't alternate compression with expansion.  As sitting more than half the time at work is associated with herniated discs (or slipped discs) and sciatic nerve pain in those older than 35, so try to get up and move as much as possible.