How can I avoid getting "tin hips" (hip replacements)?

Gary
During the last 18months or so I have had several (3 or 4) instances of hip joint soreness.This has been after more than two hours of exercise :running,tramping and skiing. It has not been a severe pain merely an irritation causing minor limping. Talking with peers who have had hip replacements makes me wonder whether I'm in for a tin hip myself - if I don't prevent this getting worse.

Years ago I used to have knee pain problems but with regular glucosamine (currently Nutralife Joint Factors 4500) use the knees have been totally painfree. Any recommendations re tin hip avoidance? I'm 67,running 1-2 hours about 3x a week,tramping 30-40 days per year (no more heavy packs) and ski also some 30 days per year...and would like to continue for some time yet!
Regards
Peter
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Gary responds:
Peter, itis all good news: The pain you are describing and the kind of activities you are involved in suggest that the cause is probably spasm of the backside muscles, radiating down the outer side of the hips.

Often called "runner's hip", "iliotibial band syndrome" or "hip bursitis" and sometimes "sacroiliac joint pain". You probabaly have a bit of the lot!

That the taking of glucosamine and chondroitin with MSM has alleviated your knee pain but not your hip pain is a further indication of the causes being soft tissue rather than bone and cartilage.

The solutions lie in reducing the inflammation and spasm which you will feel as a tenderness upon firm pressing or rubbing deeply into the affected areas:
Nutrients

• Reduce inflammation by taking plant antioxidants three times daily (In this case the best one at best value is Nutralife Fruitful Greens).
• Reduce muscle spasm with a 3 times a day dose of Agewise Coenzyme Q-10. Q-10 is at the heart of mitochondrial function and the closest yet to the Fountain of Youth. It is also a powerful antioxidant.
• Complete an Active Elements assessment via this website and take the tissue salts formulation that is prescribed for you.
• Keep taking the JF 4500 for healthy joints (all available off this website store).

Massage
Get a once weekly deep tissue massage of the backside, low back and all of the thigh muscles. Look for a strong and experienced massage therapist. Give preference to a large, hairy person with meaty hands and a name like Olga or Igor. Start this about two weeks after you have started taking the nutrients.

You may feel sore for 3-5 days after the first few sessions; but there should be a notable improvement in pain levels after about the 3rd. Give it about 6 sessions to be sure it is going to work.

Stretching
I am displaying several exercises that are beneficial for stretching and mobilising the muscles about the hips and low back. Do these most days.

Please let us know how you get on.

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I am suffering hip and buttock pain - Please help!

Dear Gary,
I am praying you can help me. I have suffered hip and leg pain for the past 9 months. Anti-inflammatory medicine has not worked and a recent cortisone injection into my hip does not seemed to have improved it. If I don't do too much during the day, I have minimal pains here and there but as soon as I try to lead my normal life i.e. cleaning my house, 30 minute walk, gardening etc, the pain comes back severely, in my hip and buttock area, around my kneecap, tight calf muscle and aching ankle. I also cannot sleep on my affected hip. My ankle on this leg is weak from spraining in my twenties. I am 43 years old, 3 kids. I am desperate to get my life back. Could you please advise me on what supplements may help me.
Yours sincerely, Cathy (USA)
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Gary
Cathy, I am not surprised that cortisone has not relieved your pain. Refer here for more about cortisone injections.

The most likely cause is you have chronic inflammation and spasm in the buttock and iliotibial band which extends down the outer side of the knee to the tip of the fibula. Refer the diagrams to the right - look at "Gluteus Maximus", "Tensor Fascia" and "Iliotibial Tract of Fascia Latae". Being unable to sleep comfortably on the affected hip gives the best clue as to the cause.

Solutions:

• Ensure your body is extremely well nourished and therefore able to heal. Complete an Active Elements Assessment (I will report back with the results several days later). Ensure your diet is rich in all the essential fatty acids and you have a little protein with each meal. Ensure you have a rich supply of all the fat and water soluble vitamins.
• Be drugs free. If you are on medication such as heart and cholesterol drugs, antidepressants, anti reflux and many, many others, these are probably interfering with healing in many ways, including interfering with liver function (causing toxins to build up). You may need to talk with your doctor about getting off medication (I can suggest natural, healthy alternatives to specific medicines)
• Get a weekly deep tissue massage to the lower back, buttocks and legs - both of them. But do not commence this until you have had the nutrition in place for at least 2 weeks and drugs free. If you can not heal quickly and thoroughly, deep tissue massage will be somewhat akin to little more than a ritual weekly beating. If the massage is done well and healing processes are responsive, you should notice a significant improvement in your hip and leg pain by the 3rd session. Carry on weekly until completely pain free and then have the occasional "maintenance session".
• Stretch Gently. Do so about every 2-3 days rather than daily. My book on Back Pain has a good selection of safe stretches for the low back and hips.

Cathy, you may find the same processes going on with the muscles of the weak lower leg and ankle. Apply the same principles of massage. You have a "weak side" possibly due to the flow on effects of that old ankle injury.

Please let us know how you get on and wishing you all the best!

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Have you any stretches for illiacus and the fascia covering the hip/ thigh area?

Hi Gary,
I just wondered if you had any stretches for illiacus and the fascia covering the hip/ thigh area. I am a former elite runner and now can barely jog the leg seizes up and has a dull ache with tingling/pins and needles.
I would appreciate any help
"J"

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Gary comments:

Stretching this muscle group (iliotibial band) is not the solution, although some relief may be felt.  

The most likely cause is the buttock muscles being in spasm.  These muscles include the Piriformis which can impinge on the sciatic nerve causing pain, spasm and pins and needles down the back and side of the leg.

Anything other than gentle stretching of a muscle that is chronically in spasm risks overstretching the healthy muscle at the borders where it merges into the gristly unhealthy muscle, extending the length of the affected area.

I find the best approach is a series of weekly deep tissue massages, easy exercise that takes the

 muscles through their range of motion, gentle stretching and nutrition (An imbalance in MgPO4

 and other tissue salts, fat soluble vitamins and essential fatty acids may cause spasm).  Of course, the iliotibial band may be affected with knots and adhesions and these require attention at the same time as dealing with any buttockand low back spasm.

Your Trainer or Physiotherapist may tell you that you need to "Activate your Glutes".  Do not worry about this - it is just one of those misinformed fads that will pass.  If one's Glutes are inflamed and in spasm, attempting to tense these muscles will be a waste of time and may even make matters much worse.

I can help further with the nutrition - You will need to complete the Active Elements Assessment on this website, tell me about your, exercise patterns, diet - what you have eaten and drunk over the last 24 hours and list any health conditions, medications and supplements and their purposes.  

Massage: Locate an experienced sports massage therapist in your area.  3-4 sessions should be sufficient to gain significant relief.  It is best to commence the massage therapy about 1-2 weeks after commencing any nutrition programme.  When I employ this approach I have most athletes back running within a day or so and they never look back.

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Low back pain, cycling and the iliacus and psoas muscles

Hi Gary. I had a recent recurrence of the lower-back pain that has plagued me on and off over the last 12 years of my life.
Funnily enough it usually turns up when I stop riding my bike so much.
To cut a long story short, my usual physio was on holiday, so I tried an osteopath for the first time.

His diagnosis was pretty swift. He said I had weak hip flexors. A bit of deep massage on the trigger points and instruction on how to do it myself, or get my wife to do it, and I was away.

My improvement was very rapid. Straight away I was able to sleep in past 5am, which is when my back would generally start to ache so much that sleep was difficult.

Googleing on the "psoas" muscle, which he said was in a weakened (contracted state) turned up the kind of exercises I could do to help my rehabilitation when the pathway between my brain and the muscle had been re-established. Funnily enough they were the same exercises I was given way back when my back first failed in 1995.

Can you comment on whether or not you think cyclists have a higher risk of getting weak hip flexors because of the repetitive motion of cycling, and the sitting, or in my case, very extreme aero position I spend a lot of time in?
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Gary Moller comments:
I think your osteopath was right on the button when identifying your iliacus and psoas muscles being the source of your back pain. The diagram of this muscle group makes it pretty self evident why these can cause back and hip pain. The other related possibility is your gluteals and piriformis muscles. I do not think the problem is to do with weakness. The problem is probably more to do with the muscles being inflamed, knotted and bunched up.

Exercises to strengthen these muscles are largely a waste of time as long as the muscles are in an unhealthy state. Gentle stretching may give some relief; but anything more may exacerbate the problem because the hard, knotted tissue is not what gives when stretching - it is the softer margins that give. The consequence may be that the area affected may be extended. I have seen one example where the scarring in a calf muscle has been extended the full length of the muscle belly as the result of excessive stretching as commonly prescribed for calf injuries.

Be the problem with the psoas, the gluteals or the piriformis, or all of them, the remedy for all is the same:

• Attempt to deal with the underlying causes of muscle spasm and toxicity at the biochemical level. Start first with balancing tissue salts with the Active Elements Assessment. I now have over 100 people on this programme which allows me to make a fair assessment of its worth as a therapy and the results have been very good for most participants.
• Arrange for several vigorous massages of the affected areas, especially the butt muscles. If the psoas and iliacus muscles need to be massaged, this is done via the abdomen and must only be done by an experienced massage therapist for the sake of safety. Your osteopath could do this; but these sessions need to be about an hour long to be of much use and about 1-2 sessions for as many weeks as it takes to be completely pain free.
• Once the tissue salts therapy and the massage begin to kick in (You will know because the massage will not hurt as much!) you can commence gentle and regular stretching.
• While you can do special strengthening exercises, I am ambivalent about these. As the muscles restore to good health, they will begin to work properly and the resumption of normal exercise, including cycling, will strengthen the muscles specific to the sport.

And, to answer your question: YES! Cyclists are definitely at risk of these kinds of injuries. Cyclists are my most represented group, next to distance runners!

When you have a complete resolution of your pain, you then need to put in place an ongoing prevention programme such as ongoing tissue salts and a massage every few weeks for as long as you go on doing abnormal activities like competitive cycling.



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Running can be a real pain in the butt!

Long distance runners don't retire - they just slowly grind to a halt. One of the most common causes of this painfully slow grind to a halt is buttock pain and sciatic pain that radiates down the back of the leg.

The cause of this pain may be the piriformis muscle which is located deep in the buttock. When this muscle locks up, so does the whole hip and the underlying sciatic nerve can be impinged, thus causing pain that radiates down the leg. An inflamed piriformis is often associated with a previous or current back injury. An experienced therapist is able to palpate this muscle and determine if it is in spam.

Once a muscle is in spasm, it will tend to stay that way. In fact, it will begin to adapt to that condition so that spasm becomes its norm. The environment of a muscle in spasm is toxic due to the very poor blood flow through it. Over time, the muscle becomes hard, gristle-like, crunchy, swollen and very tender to press. It is weak and prone to cramping.

The usual treatment is trigger point therapy in the form of acupuncture, acupressure and maybe deep tissue massage. Stretching the gluteals and piriformis are mainstays for prevention and treatment.

In my experience, the most effective remedy is deep tissue massage of the affected muscle and all of the associated muscle groups. It works; but it must be given time: An hour per session and repeated at least 6-8 times every 4-5 days until pain free. This must be supported by nutritional strategies to ensure that there is maximum healing between sessions. In most cases, there must be measures to reduce body acidity because the body may be overwhelmed by the sudden influx of metabolic toxins that are being squeegied out of swollen muscles. It is not unusual for a person, such affected, to feel ill for a few days following this kind of massage.

Once full function and health is restored to the affected muscles it is a good preventive measure to have weekly massages to keep the body in good health. This is of increasing importance as we get older.