Hip Pain

Hip Pain Chiropractic Treatment Services

Located in El Dorado Hills, you can Trust NorCal Spine & Sport with your Hip Pain and Chiropractic Treatments

Hip pain can occur due to many different causes.  There is pain on the side of the hip, the front of the hip, the back of the hip, inside the hip, and much more.  Before we can understand the how and why of hip pain, we need to understand the hip.


The hip is most importantly a mobile structure.  The hips are the wheels on the car that keep us moving.  If the hips are not working properly, we are not moving properly.  Because of the high level of mobility in the hip, there is an increased chance for injury.  The hip is stabilized above by the lower back and core as well as below by the knee.  The hip consists of the pelvis bones and the femur (leg bone).  The hip is a ball and socket joint which is held in place with a capsule, ligaments, and muscles.

Biomechanics and Gait

The hip provides support and shock absorption as well as balancing the body.  This process requires mobility and stability.  The hip moves in flexion, extension, abduction, adduction, internal and external rotation.  The more movement in a joint results in an increased risk for injury.  The his is a major weight bearing joint and is supported by muscles, ligaments, and capsules.  Hip loading is increased with wearing of hard-soled shoes.  The potential of torque on hip joint is large and can increased with poor foot biomechanics.  Hyperpronation of the foot creates more medial/internal torque on knee and leg and hip.  Hypersupination of the foot decreases shock absorption in knee and leg and hip.  Impact forces sustained during gait increase with body weight and with gait speed.

Types of pain

  • Stiffness
  • Popping/snapping
  • Crepitus
  • Locking
  • Weakness
  • Numbness and/or tingling

Locations of pain

  • Lower Back
  • Hip Pain
    • Anterior
    • Posterior
    • Lateral
  • Leg Pain
    • Anterior
    • Posterior
    • Lateral

Types of Injuries

  • Lumbar Disc Injury
  • Facet Syndrome
  • ITB Syndrome
  • Osteoarthritis
  • Bursitis

What is wrong with your hip and how do we fix it?

Most of the injuries that we treat in our clinic are associated with repetitive strain injuries.  Our initial goal is to assess the region and type of pain, the biomechanics and gait, and the history of the injury.  In most cases, the injury is actually a tear in either the muscle or the tendon of the hip. Sometimes there is a lot of tearing and sometimes there is just a little tearing (microtears) that adds up over time.  This tearing leads to inflammation (tendonitis), weakness, soreness, swelling, bleeding and eventually scarring (adhesion / fibrosis).  The key to fixing hip pain, though, is to reduce or eliminate all of the above symptoms plus the adhesions and fibrosis that comes from the tearing process.

What are adhesions and fibrosis and how do they occur?

The formation of adhesions and fibrosis (or scar tissue) is the body’s response to healing a tear. What actually occurs is that the spread of sticky fibrin, which is the sticky substance you feel when you bleed, seeps throughout the layers of the muscle and leads to scar tissue formation. The scar tissue and adhesions that forms are made up of collagen. This creates a strong bond and binds the injured tissue back together.

What goes wrong?

The scar tissue that binds injured tissue back together also binds the healthy tissue together. This causes decreased circulation and tightening of the muscle resulting in inflammation and lack of oxygen to tissues, creating biochemical changes, increasing fibroblasts and resulting in fibrosis and adhesions. More and more fibrosis and adhesions develop within the muscles causing the muscle to become less elastic (like a rubber band) and more leathery (like a belt). The more leathery the muscle becomes the more stress is placed at the tendon (where muscles inserts into bone). Too much load or force can create tearing of the tendon!

Different grades of tearing

There are different grades of tears that occur in the muscle and tendon. The most common is a Type I muscle strain or ‘Repetitive Strain’. This basically consists of micro-tears. The other grades of tearing are Type II and Type III, which can result in complete rupture of the muscles and ultimately require surgery.

How do you determine the degree/grade of tear?

There are many things involved in determining the grade or type of tear that has occurred. In general, the degree of tearing can be based on the extent of bleeding that will create swelling and bruising on the surface. It is important to note that the degree of tearing is NOT based on the level of pain!!!

Treatments – What are your options?

There are many forms of treatments for hip pain. They can include:

  • Active Release Technique (ART) and Graston Technique
  • Self-Treatment
  • NSAID’s (Non-steroidal anti-inflammatory drugs)
  • Cortisone shot
  • Orthotics/supports
  • Physical Therapy
  • Surgery

What is Active Release Technique (ART) and Graston Technique?

ART and Graston Technique address the scar tissue (adhesions and fibrosis) and works to make the leathery muscle fibers more elastic again. It is the most effective way to breakdown scar tissue.

How does ART and Graston Technique work?

The doctor locates the scar tissue and traps the scar tissue with hand/thumb or Graston tool while the patient actively lengthens the involved muscle. The trapped scar tissue is held back as the muscle moves through. ART and Graston technique is so effective because it makes the muscle elastic again and gets to the root of the problem by increasing circulation to the injured muscle and tendon.

Overview of Ideal Treatment Plan

While ART and Graston Technique is not a cure-all, removal of scar tissue is a key to a majority of cases. It addresses all hindrances to healing such as faulty mechanics of gait, footwear, poor biomechanics, hobbies (running, cycling, etc.), and allows proper rest and recovery. Most importantly, ART and Graston technique addresses the scar tissue.

Other types of treatment

  • Orthotics
  • Rolling (ball or foam roller)
  • Stretching
  • Taping (RockTape or Kinesio Tape)
  • Straps or supports

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