Hip/pelvic complaints occur at all ages and both male and (pregnant) female. Complaints in the hip joint are usually pointed out in the inguinal area. Complaints related to the pelvis can be felt both at the front and back of the pubic bone, the side (generally referred to as ’the hip’) or in the lower areas of the lower back.
The following symptoms might point to hip/pelvic complaints: Lower back pain (one sided) with radiation to the abdomen, inguinal or buttock area. Sometimes radiation to the knee. The complaints might be felt when walking, sitting, standing or lying down (usually on your back). Pain in the hip (when lying on that side). The cause of the pain is often a too tight or tense muscle, an indirect result of hip/pelvic complaints.
The Orthopaedic Manual Therapist (OMT) view hip/pelvis/lower back as a whole and calls this the LPH-system. The hip and pelvis are viewed as the ‘base’ of the entire spine. Reducing hip/pelvic complaints is done before further treatment of the back or neck is started.
During the physical examination the OMT will look at the entire LPH-system. It consists of the lumbar spine (L), pelvis (P) and hip (H). You cannot move your hip without moving in the lumbar spine and pelvis and vice versa. Your OMT thinks only in these so called ‘chains of movement’. First he will examine the joints for limitations in Range of Motion (ROM) and instability, then the muscles for loss of strength and active stability. After the muscles he will examine the neural structures and reflexes.
There are a lot of diseases affecting the hip and pelvic joints. Some you are born with and require surgical interventions and training therapy. Others occur later in life, some acute or spontaneous and some after a trauma, pregnancy or giving birth or overuse. Medical specialists will be consulted if the findings of the physical examination indicate it is necessary. Depending on the medical diagnosis and the findings of the physical examination treatment is started. The treatment plan consists of restoring ROM in the concerning joints and training of stabilizing muscles when there is excessive ROM. Also you will be given ‘homework exercises’ and ergonomical advice to ensure the complaints won’t return in the future.