Shoulders Causing Hip Pain. Case of the Day, March 5, 2014: Todays case is a 14 year old baseball player who came to see me after hurting his hip during practice. I started with an initial posture evaluation, which showed his right hip to be hiked a full inch higher than his left. More telling though, was the significant rounding forward of both shoulders, especially the left. When he attempted to face me perfectly square, his left hand rested well in front of his hip, and his right hand rested well behind his hip. In other words, what his brain thought was perfectly square was actually a good 15 degrees or right rotation. After some palpation and testing, it was clear his two primary areas of pain and dysfunction in the painful left hip were the Tensor Fasciae Latae and Piriformis. The TFL tested strong and the Piriformis tested week. When he put his hand on the TFL, his Piriformis then tested strong. Thinking Id found the primary issue, I released his TFL and retested his Piriormis. Still weak. That meant that even though the TFL was compensating for a weak Piriformis, it was not actually the primary dysfunction. In a situation like that, its always good to look at what the body is telling you, and also consider what the athlete does on a daily basis. Thats when I looked toward his left shoulder, the one that was so prominently rolled forward and rotating his whole body to the right. Consider that a right handed baseball player spends a great deal of time in right rotation. Specifically, he loads that position every time he goes to throw or swing a bat. Now consider what happens at the left hip when the upper body rotates to the right. It rotates to the left, creating the spiral twist that loads the power necessary to throw or swing. Heres a simple experiment: either standing or sitting, rotate your upper body to the right as far and as hard as you can. Do you feel the front of the left shoulder working to pull you around? Now, what do you feel in the left hip? Do you feel the outside of the hip working hard to keep it in place? Thats your left Piriformis, working in synergy with your left shoulder to keep your hip in place while you coil you up and store energy. Now imagine your left hip is exhausted and decides its done working. As an athlete, do you just stop? No, you continue to demand that your brain find a way to coil up by rotating right so you can perform. And the left shoulder now has to do all the work by itself. Sure enough, by doing some release work through the front of his left shoulder (the Pec Minor, specifically), he was finally able to turn on his left Piriformis. And once that balance was restored, his left TFL relaxed as well. He then stood up and faced forward again, this time with both arms perfectly aligned with his hips, and no pain. Your posture doesnt lie to you. If it looks or feels off, its a sure bet something has gone awry. You arent going to correct it by standing up straighter, by pulling your shoulders back, or by any other conscious means. Get it checked out, figure out what compensations are in play, and get them corrected! Pain usually doesnt mean something is broken. Its usually your brains way of telling you something just isnt working right.
Posted on: Thu, 06 Mar 2014 04:38:38 +0000
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