I’ve Got the Hip Pops
Q: I have increased my walking speed and strength training by adding hill and track work recently and have noticed my hip often “pops” when I’m sitting and I move my knees together or apart from each other. I can also make it pop when I stand on one leg and make “small circles” with the other leg. It also happens when I do sit ups. There isn’t any pain, but I’m concerned I’m damaging whatever is making the noise. Is the popping normal?
A: I frequently see patients in my practice with this question. Some have it with pain associated and most without any pain at all but mostly concerned it is something wrong. It is not isolated to walkers and is common for dancers, martial artists, runners, skiers, weight lifters, people doing Pilates, and athletes of all types. It also happens to those who spend most of their day sitting. So, what’s going on?
The muscle commonly responsible for this issue is the psoas. You have two psoas muscles, each originating on the right and left sides of your lower spine. The belly of the muscle travels on the front of the spine, and its lower tendon inserts on the top of your femur or upper leg bone. It goes right over the front of your hip joint just before attaching to the femur. This is the location which the pop can best be felt with fingertip pressure applied. The psoas is the primary muscle involved in lifting your knee upwards as in walking, running, climbing stairs, kicking, etc. Other muscles assist in this motion but rarely cause a “pop” like the psoas. In the clinic, I find the patient usually re-creates the symptoms while performing an abdominal sit-up or leg-lift exercise, identifying the psoas as the culprit.
As you train with greater intensity, all the muscles you use become tighter, and the psoas gets tighter along with all the other skeletal muscles in your body. Sitting for long periods of time will place the psoas in its shortened position, allowing the muscle to become tighter. As you stand up, the natural stretch force is placed on the front of the hip. The muscle tension results in the tendon gliding a little, creating a “pop” noise and clunk-like sensation. I often describe it as similar to plucking a guitar string.
What to do about this? Stretching and reviewing your abdominal/core program on your own or with a trained professional if you are not seeing results. The psoas can be stretched by lunging positions with extension of the low back. In yoga, the Cobra Pose often will stretch it. A well-trained body worker should be able to assess your level of muscle tension and ability to stretch and teach the necessary corrections, should you need them. Healthcare providers utilizing hands-on myofascial release techniques are also helpful when stretching alone isn’t effective.
I hope you enjoy the stepped up intensity and keep moving, keep stretching. Spring is in the air. Enjoy all it offers!
— Greg Lekas
Walking 10,000 Steps
Q: Is it really reasonable to walk 10,000 steps every day as the American Diabetes Association suggests? I kept track using a pedometer and find I average nearly 2000 steps per day. Last year I was diagnosed with type 2 diabetes, and my doctor also told me that I needed to lose 75 pounds. Having lost a long-time loved one and working 60-plus hours a week in accounting has left me isolated and out of shape. I am optimistic but have no idea how to get to 10,000 steps. What’s next?
A: Yes, you can work up to 10,000 steps. Keep the pedometer. Since you are a numbers person, you will probably find it helpful to track your progress. Start with the end in mind and have resources to maintain your goal of 10,000 steps. If you add 200 steps daily to your current level of 2000 you will reach your goal in 40 days or about six weeks. By using the pedometer everything will be counted.
To reach and maintain you goal, get involved with a walking club or set a time you and a friend can meet to walk. Also, carry or keep a pair of walking shoes at your work to use anytime you can get out. As your distance increases, pick a few events to participate in and meet more walkers to walk with. Good luck.
— Bryan Baisinger
This Issue’s Expert
Greg Lekas, DC, is a Chiropractic Physician, nationally certified Athletic Trainer, and Strength and Conditioning Specialist who works with patients of all athletic levels and abilities. He can be reached at gregl@clearh2o.org.
Bryan Baisinger, DC, is a Portland State University Athletics team physician and is the owner of Clearwater Clinic and can be reached at 503-279-0205 or bryanb@clearh2o.org.
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