Why you should stop “stretching” your hip | HIP PAIN

Do you have hip pain that you are continually trying to stretch, roll, or smash, and nothing seems to get better?  Before we get into the role of the psoas, one of your key hip flexors, let’s speak about the local stabilizers and global stabilizers of the body. This is important to understand how you are going to treat your hip flexors and hip pain.

Think of the local stabilizers as being muscles that are close to the joint. They create more of an isometric contraction versus concentric (shortening) or eccentric (lengthening) contraction. They control the joint centration which means keeping the joint centered in its axis. It’s also independent of the activity of motion so if you raise your arm overhead, the deep stabilizers in my spine are going to activate before your arm goes overhead. Essentially these local stabilizers are imperative for stabilization in the body so that we can have proper movement.

Our global stabilizers are equally as important. However, they have a different role, so they have more of an eccentric contraction. They decelerate the range of motion, are continuous with motion, and are farther away from the joint.

Now getting back to the psoas, which is what everyone wants to stretch when they have hip pain.  The posterior or the back of the psoas is a local stabilizer. Think of it as one of our deep core muscles that is helping to stabilize the spine and also prevent the femur, our leg bone, from shifting forward in the hip joint. The anterior or front of the psoas serves as a global stabilizer. So, it is necessary to think of the psoas muscle as a stabilizer. Not only is it a stabilizer but it works in an integrated unit with all of the other muscles, including the pelvic floor, diaphragm, multifidus, the deep five rotators in the hip, and the transverse abdominus. All of these have to work together, and once again in this integrated fashion to be able to stabilize the low back and the pelvis during any kind of movement.

For example, if you performed a chest press with 30 pound in each hand on a bench and then transitioned into doing that on a stability ball, your weight would naturally go down. Why? Because you now have an unstable platform to work from and therefore can not generate as much force.

There are a lot of different hip pathologies that we won’t get into today, but when you have hip pain it typically happens from losing the deep stability of the hip. There are two common muscle imbalances that will exist. One is the TFL(tensor fascia latae) muscle, which is right in the front lateral side of the hip, can get tight, especially with increased sitting. Based on this attachment, it will pull the hip forward, and that will therefore inhibit or shut down the psoas. The other common muscle imbalance is the hamstring muscles, which can get tight for various reasons, inhibiting the glute muscles. The hamstrings can push the femur forward and that also leads us to lose that optimal position on the hip joint. Overtime if we have these muscle imbalances, instead of the hip being centered in the axis, it will start to shift forward and up. This will cause all types of pain issues and pathologies. Whether that’s a labral tear, hip impingement, tendinopathy, bursitis, and so on. So, it is important to get the hip stabilized and centered in the joint in order to decrease pain and ultimately improve function.

You can begin to do this through a four-step process. This is a great way to begin to address your pain, as well as any kind of movement compensation, and most importantly, integrate your foot with your core, in a very integrated manner. First is inhibiting the tissue, in this case we inhibited the TFL muscle that typically pulls the hip joint forward and creates that inhibition of the psoas as a deep stabilizer. Then, mobilize the hip joint to center the hip joint. Remember that when it is not in that center position it’s shifting forward enough so we’re shifting it back to the center position. Next, stabilize it by activating the deep stabilizers, such as our diaphragm, pelvic floor, etc. Then we’re integrating it with the ground. This is super important because the foot is part of the core and they work as an integrated unit. To get those deep stabilizers of the hip firing, short foot, i.e. foot to core sequencing, allows us to do that in a very integrated fashion.

4 Steps

1. Inhibition

For the TFL release, place the ball right on the outside of the hip. When you lie down, you’ll naturally rotate the hip in, which will expose the TFL muscle. With the other leg, anchor it up at a 90-degree angle and come down to your forearms. Holding that position your leg will be nice and long, naturally rotated in, and breathing throughout the exercise trying to relax into it.

2. Mobilization

For the hip mobilization with a band, you’ll place the band high up in the groin. You’ll have it back at a 45-degree angle away from you. You’ll start in a table position rocking forward 15 times, making sure your spine stays nice and long, and you’re breathing. Then rock away from the band, so to the opposite side, once again about 15 times, making sure you’re breathing throughout the exercise.

3. Activation

Now it’s time to activate the deep core, so you can do this by diaphragmatic breathing. Inhale, breathing into the abdomen and into the base of the pelvis allowing the abdomen to expand 360 degrees. Exhaling, letting the abdomen contract and the belly button in towards the spine. Once you feel like you have this established, then on your inhale allow the pelvic floor to relax, so you can exhale and gently lift the pelvic floor about 20% contraction to get a deeper integration. You want to think of this as a rhythmical balance, so nice and fluid. Inhaling to the base of the pelvis and exhaling gently lifting the pelvic floor.

4. Integration

Lastly, it’s time for integration. This is to be done with short foot. Standing on one leg, sitting the hips back, knees slightly bent, taking a breath in, while your foot relaxes then exhale and gently root the tips of the toes into the ground. That will naturally lift the arch and lift the metatarsal heads or ball of the foot.

So whether you have hip pain or hip tightness and are constantly stretching your hips, hopefully, this video will give you a little bit of insight to allow you to think about your hip differently and recognize that it is part of an integrated unit. It is really important to understand how that works as it relates to stabilization and movement

If you’d like to schedule a free 15 minute virtual discovery session, please email drarianne@themovementparadigm.com or text 302-373-2394 to schdule. We’d love to help you get healthy again!

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How to start a fitness program or step up your game

Who’s excited for the New Year? You may be thinking “new year, new me,” so you want to either start an exercise program or step up your game. I am here today to help you with that! This is a time where so many people get injured because they are trying to start a fitness program for the first time or they’re trying to step it up too quickly. And nearly 80 percent of New Year’s resolutions fail. Let’s take this as an opportunity to help you think about some different aspects of fitness, so you can prevent injury and get the most out of your fitness and your health this year.

Know your baseline

The first and most important thing is knowing your baseline. Are you a beginner, intermediate, or advanced fitness enthusiast? Do you have any pain or discomfort, or any potentially old injuries that you’re dealing with? What is your mobility/ stability, or functional movement, baseline? Working with a qualified professional to properly screened and know exactly what your starting point is highly recommended.  If you don’t have that opportunity, then you really want to be able to seriously reflect on your true baseline, your starting point, so that you know how to systematically progress safely from there. Once you figured that out, now we can jump into what to include in your fitness program.

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1)Warm-up and prepare

This does not mean jumping on the treadmill for five minutes to get your body warmed up for your workout. It means taking the time to tune into your body. Notice what pain or tension you might have that day. Are you tired? Did you eat well that day?  Really take a deep inward look to see how you are feeling that day and how that will affect your workout. Once you’ve established that, then you can think about how can you prepare yourself best for the demands of the activity that you are about to embark on. If you are going to do strength training for example, then doing some static stretching, ie holding a stretch for 30 seconds, is not beneficial. Instead, think about how you can prepare your body for the demands of the activity. For example, instead of jumping on a treadmill and walking for five minutes, you could do lunges with a reach. This will help to activate and wake up your whole body and nervous system, so you are fully prepared for your workout. 

2) The systematic progression of your activity.

For this to be successful, it is vital to have a preparation period. One to three months preparation time is recommended to prepare for it, so that you can just go into it with ease. The last thing you want it to do is create stress, ie. Inflammation, on your body.  You’ll want to make sure it is the right time in your life and things are relatively calm. It is extremely challenging to eat out when you are on the Elimination Diet. Lastly, it’s often easier if you slowly work out one to three foods at a time and find replacements for them before you begin. You want to be fully prepared, which is why it is strongly recommended to work with a professional to guide and support you through the process.   

How to do this for a running program

If you are just starting out with a running program, running for 30 minutes three times a week is unrealistic, especially if you haven’t done that in months or years. That will set you up for injury. When, starting a running program, or any program for that matter, you want put stress on your body, and then take it off, put stress on your body, and take it off, and so on. This will create an adaptation, which means you are getting your body familiar to a certain exercise or training program through repeated exposure. This will help to create fascial elasticity in our body, like a rubber band, which can really aid in preventing injury. If you want to start a running program, make sure that you can walk for 30 minutes three times a week first without any symptoms before you progress to running in any capacity. You encounter 1-1.5 x your body weight in force with walking and almost double that with running. When you’re symptom-free and ready to progress, you would slowly start with a walk-jog interval. You could start with the one minute of walking and one minute of jogging. I would suggest starting at five minutes total, so it’s only a few minutes total running time. Once you feel comfortable with that, then you can slowly progress to 10 minutes, and then 15 minutes and so on. This is going to take weeks to months to get you to 30 minutes of running. On the other hand, if you’ve already been running, and you want to step it up you could follow the same protocol, but you would just have a different baseline than a beginner does. For example, if you want to go from 20 minutes to 30 minutes, then every other day you can add a few more minutes to your run assuming there’s no symptoms, pain, discomfort, or injuries. You can continue to progress that way to achieve whatever goal you have.

How to do this for strength training program: If you’re strength training for the first time, I would suggest starting at two sets of eight to 12 repetitions two times a week. Then you can slowly progress that towards three sets of 10-12 repetitions three days a week.

How to do this for a yoga program: There are a lot of different yoga classes out there, but you need to make sure that it’s a yoga class that you can do safely. For example, a Hatha yoga class may be more appropriate for a beginner as opposed to a power yoga class. It doesn’t mean that you can’t ever do that, it just means to start with something where you can learn how to control your body and coordinate your movement with your breath first before you go into something more advanced.

How to do this for a HITT training program: Please reference the video on for pros and cons of HIIT training here or read the blog post here. For the intermediate to advanced fitness enthusiast, this can be great way for you to step up your program. Beginners have a higher injury risk because they really need to develop a basic fitness or strength baseline before they move into something more advanced like HITT training.

3) Cool-down

A cool-down is different for every person. It could be a short walk, stretching, basic breath work, or even meditation. It can also be a great way to reflect on what happened in that session. That means reflecting on what went right and what didn’t go as well.  Does your body feel energized and revitalized or does it feel kind of worn down and sore? Did you work too hard or not hard enough? Use this information as an opportunity to change your next session.

Summary

Fitness is a journey, no matter if you are a beginner, intermediate, or advanced. You are always fine tuning, and reflecting on how to maximize what your doing.  Do you need to add yoga in because you’re doing too much strength and HITT training? Do you do too much yoga and need to add in strength and  power exercises? I definitely encourage you to reach out to a professional that can help you reach your goals while staying injury- free. It is important to take ownership of your health and movement to be able to continue to stay pain-free for a lifetime.

If you are interested in feeling your best and you need help, reach out to schedule an appointment to get you started on your journey.

Pros and Cons of HIIT

With the holidays coming around, many of you may want to get fit as fast as you can. We all know deep down that’s not the best solution. But, part of improving your fitness quickly probably includes some kind of speak of high intensity interval training (HIIT). As with anything, there are pros and cons of HIIT and I’d like to educate you on making an informed decision of whether or not it’s appropriate for you.

What is HIIT?

You may be asking yourself what is HITT ? It is essentially a vigorous activity, followed by a low to moderate intensity activity in an interval format that is often done between five to 30 minutes, and the intervals can range from 15 seconds to two to three minutes. There are many options to perform HITT such as using bodyweight, calisthenics, free weights, or even a machine like an elliptical or stair climber.

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Pros

First, it can help to decrease body fat, as well as improve overall metabolic rate. Metabolic rate is really important because it helps you to burn more calories throughout the course of the day when you’re not working out, which is really powerful. Second, it can help improve oxygenation, which is the muscles ability to use oxygen. This means if you do 60 minutes of HITT training versus 120 minutes of steady state cardio you can have the same benefits. This leads me to my next point, which is that you get maximum benefit for decreased time investment. Since we are all super busy and stressed for time, and can’t find the time in the day to exercise, this can be very valuable. It has been shown to also increase muscle growth, however, that is not the gold standard of muscle building.  Strength training always wins. Even though there has been shown some benefit, it’s not the most valuable way to build muscle.

Cons

Let’s shift gears now and talk about some of the disadvantages. First, it can lead to a higher injury risk. Some of the reasons why I think this happens is because many people that choose to do HITT training are often deconditioned at first and they think ” this is a fast way to get in shape”. So, they begin doing it at a high volume, high intensity and often do not have a solid movement foundation, or even a fitness foundation to support it. This is why I would recommend starting out slow and then gradually building yourself up. Second, recovery time is always important in exercise, but it is especially important in HITT training. This is because it is a physical stressor on your body, so you need more time to recover. HIIT four to six days a week is extremely high because the it may take two to three days to recover from a session.  I typically recommend my patients and clients do it no more than two to three days a week if they are an appropriate candidate. Lastly, if you are training for a sport or a movement skill, you need to make sure that you’re really focusing on the specificity. HITT training is not geared towards specificity whatsoever. It is general conditioning, so you may want to consider that with your training goals.  

Other considerations:

  1. Stress? Are you experiencing a tremendous amount of acute or chronic stress in your life. If so, I do not recommend HITT training, because again, it is a significant stressor, a physical stressor. This can contribute to a constant cascade of stress hormones which also can further impact hormonal and immune health.
  2. Beginner? If you are a beginner, I do not recommend HITT training. Learn how to develop the proper movement patterns, learn about your body, and really understand what’s happening to be able to recognize if you are feeling discomfort or pain. Tune in through mindful movement and develop a basic level of fitness first before volume and intensity is added.
  3. Intermediate to Advanced? If you have been working out for a while and you want to take things to the next level to really boost your cardiovascular fitness and fat loss, then I think HITT training can be really valuable.

Summary

Nothing is black and white. It’s really about understanding the different pros and cons of this or any other fitness program to see if it is appropriate for you at this time in your life. If it is not appropriate for you at this time in your life, then just hold off and revisit it later.  It will always be there.  Movement is a skill that you keep refining your whole life. There’s so much to learn. You really want to continue that journey forever, so there’s always room for improvement.

If you are not sure where to start, please reach out to schedule a private session to begin your movement journey.

3 Simple Informal Mindfulness Practices

Let’s chat about some informal mindfulness practices that you can do in your day to day life to become more aware, more present, and more connected. Often times we think about meditation as sitting in a meditative seat for 30 to 45 minutes. You might think, “how on Earth and I am going to do that?” I want to reinforce how important that practice can be in an overall mindfulness practice, however, that’s not for everyone. There are many things that you could do in your daily life to become more present in your own life, become more connected, more aware and hopefully help you to live your best life.

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Three Informal Mindfulness Practices

  1. Find an anchor.
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How to decrease sugar cravings in 3 days

With the holidays in full gear, many of us struggle with those darn sugar cravings. Some people suffer with some type of sugar craving or even a so-called sugar addiction all year long.

We know that sugar cravings cause a dopamine response as well as other neuro chemicals that ultimately creates a biochemical and neuro chemical response in the body. The addiction of sugar can cause a similar response in the brain as in drugs, alcohol or cigarettes.  However, there’s a little bit more to sugar cravings than just that.

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Sugar Cravings and Gut Bacteria

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Are you overpatterned?

Did you know the body is actually very asymmetrical in its structure? This is due to the organs which are oriented in a very calculated way and separated from our right and left side of the body. We have our liver and gallbladder on the right, and our pancreas, spleen, stomach, and most of our heart on the left. We have different functions of our hemispheres in our brain, too. So, there’s so much asymmetry in our body, and it’s really powerful.

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Asymmetry in athletes

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