Hips Don’t Lie When It Comes to Hip Drop
Whether you’ve got back, pelvis, hip, knee, or lower leg pain – you may find that your pelvis and hips can give you a lot of information about weakness in your legs and how it can relate to your injury / area of pain.
You need to have good control and stability on one leg – to function efficiently (that is if you plan on walking around at the least)
Running and walking requires that you stand on one leg, whether you’re a running doing sprints, or long distance marathons, or actually everyone because life requires you to walk and that involves standing on one leg.
If your pelvis or hips are ineffective in transferring load in that single leg stance – we might say you’ve got a hip drop (or a positive trandelenburg sign if we’re being technical)
What is hip drop?
Ideally when you stand on let’s say your right leg, your pelvis should stay level, and not dip lower on the left side (or rise higher – we will talk about thi
s later)
If you transfer your weight to your left leg, obviously your pelvis will move a little to the left to maintain your center of gravity (the bulk weight of your body) over your new base of support (left leg, instead of over both legs). But is should stay controlled – meaning we shouldn’t see a dip.
If you notice this dip, or hip drop – chances are your glute med and/or min are not doing what they should be (probably a bit lazy, weak, or not activating well).
If you’re interested in how our anatomy differs from our primal ancestors, and how it actually enable us to stand efficiently on 2 feel and walk (a big part of this is how our glute min/med muscles are placed and developed) – have a read of this blogpost.
This can lead to hip pain, knee pain, shin pain, foot pain!
Keep in mind these symptoms may not come on till you add more load to your single leg stand (this might be increased distance/speed running or walking, or even if you are fatigued or carrying weight)
Hip pain
If we get a hip drop when you do are on one leg, we are lengthening your glut med/min muscles since they are being lazy and not contracting. Because of the position they are now in, with the pelvis also tilted – what we can get is some shearing forces between the glute med tendon and the greater trochanter (part of your thigh bone). This can lead to a glute med tendionapthy! (click here to learn more about tendinopathies)
Because of these increased shearing forces around the greater trochanter, we can develop trochanteric bursitis.
A bursa is a normal fluid sack between tendon and bone that helps cushion impact, but with increases forces around this area (in a non optimal position) – this can lead to inflammation and pain!
Knee pain
Normally with this hip dip, we tend to see more internal rotation of the femur (knee caving in). When this happens, there tend to be more forces through the inner surfaces of the knee joint – which can lead to medial knee pain (pain on the inside part of the knee) or patello-femoral knee pain (fancy way of saying pain in the front of the knee).
Shin & foot pain
If this cave in can continue to your tibia (shin bone) it can lead to symptoms such as spin splints. This cave in can travel further down the foot, causing rolling in/pronation and lead to issues such as increased risk of plantarfasicities.
Like I said before – the hips can tell a lot!
Reverse Trandelenburg
Reverse trandelenburg is the opposite of hip drop, it is when if you stand on ® leg, the left side of your pelvis moves higher to maintain control.
So the opposite Quadratus Lumborum muscle (and possibly some obliques as well) try to take over for the weak link (glute med) – and you might start to get back pain (from spasming QL’s due to overuse) OR this pattern may bring on some facet joint pain from the compressive forces they might experience because of the over-worked trunk musculature.
Where to go from here:
I don’t want you to turn into a hypochondriac after reading this – just be aware of how problem areas that come on may come to be. And that if you have knee pain – just treating and being nice to the knee might not get rid of the pain for good!
We May have to look further!
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