It is unlikely that what was causing my hip and lower back pain is what is causing yours. However, I am going through what I did to fix my own and what online references helped me solve my problems that I think could provide a decent start.
Just a disclaimer, I’m not an expert on these things. This will mostly consist of me pointing you to people who know a lot more than me.
To quickly summarize, I was dealing with a terrible internal hip pain that would keep me up at night. The pain would be accompanied by weakness that would seemingly accumulate the more I walked. For example, every night was a bit of a reset, but if I didn’t have a weekend of less walking, it would be even worse the next week. Rarely my leg became so weak I felt I had to stop during a walk, but the pain nagged at me, even when sitting and laying down. I also had some hip impingement- it would pinch while sitting and I completely stopped squatting from the discomfort. If I had to get closer to the ground, I’d either take a knee or so this weird leaning-over to one side “squat”. I noticed I could no longer do cobra pose in yoga as my back would instantly seize and I developed lower back pain that felt asymmetrical. I also had a bit of scoliosis (which I had diagnosed as a young adult), probably from the same problem I’m getting to.
The mistake I made repeatedly in trying to correct my movement is not thinking holistically. If you have hip or back pain, my first tip is thinking of your whole body and not hyper focusing in on the area in pain. The pain is absolutely telling you something, but it may not be at its source. In my own case, my hip pain was caused by a rotation set in motion from stepping through one arch more than the other (I have one very flat foot, and one less so). I realized that it was flat feet that were probably the origin, however, just focusing on building my arches wasn’t the solution either! Because my body was stuck in a rotated state, I wasn’t using my muscles properly to walk, and I’d often lean to one side to become more comfortable while sitting.
I’m going to go backwards through my path of solving my internal hip pain because I became more general and holistic later, after being focused on the area of the pain and its source. I figure this will be the most useful to the most people.
Do you have internal hip pain and/or lower back pain? Have you investigated the following things?
1. Are you using your glutes to walk?
If I had to start to address my hip pain over again, I’d start here: What are the best ways to sit and walk and how am I deviating? Esther Gokhale’s view on how humans should be sitting, and walking has helped me a lot, mostly in the understanding I was using muscles asymmetrically. Squeezing your glute at the top of a forward step not only helps propel you forward, it seems to protect your lower back. I’d compare squeezing your glutes while walking to adding a suspension system to your car. Walking is pounding away at your joints and wearing out the ligaments and tendons if you aren’t engaging your suspension muscles!
It seems trivial, but seriously, get up and try walking around. Are you able to isolate the top of the glute as you step? I’d recommend watching this video in full, especially if you have lower back pain, but I’ve jumped to the timestamp where Gokhale explains how to engage your glutes:
In my case, I was only engaging my glute on one side. The leg with the flatter foot that started the chain of rotation, made it harder for me to use my glute to propel me forward and my quad was much more robust.
2. Do you have flat feet?
This was my big epiphany. I mean, I knew I had flat feet, but I didn’t make the connection between hip pain and stepping through my foot arch causing rotation throughout my body.
Mark Wong has a lot of great information on PostureDirect on how to fix flat feet.
At the end of this article he describes the origin of flat feet can also be caused by an Anterior Pelvic Tilt or Knee Valgus.
For myself, it is more of a bottom-up type of thing. I’ve found the less support I have in my shoes, the more I can engage the right muscles in my feet and calves to counteract the rotation. My feet are very flat but get a bit better when I wear minimalist shoes. There is a caveat here, though. If you cannot engage your glutes while you are walking barefoot or close to barefoot, you may need a bit of a heel. Having a bit of heel on your shoe does help this along and engaging your glutes while walking should take priority.
If you want to explore the minimal shoe route, go slow, especially if you currently walk like a duck. My favorite minimal shoes are Xero Shoes, for price and fit.
3. Is your pelvis rotated?
Again, I’d point you to Mark Wong’s website to figure this out: how to fix a rotated pelvis.
One of the most useful exercises I’ve learnt is the pelvis reset. I do it every day, before and after walking.
If you did click on some of the PostureDirect links, you probably noticed the use of foam rollers and massage balls. These help A LOT.
4. Do you have a Hip Impingement?
This is the place I started when searching on Dr. Google “hip pinching while sitting” and “internal hip pain”. The FAI Fix guys are good at encouraging exploring your pain and trying different exercises, rolling and stretching different muscles for a personal solution with the belief the muscles and tendons that are supporting the joint in the socket are a priority.
Strengthening my abductors did help a bit, but nothing really improved until I started addressing the rotation in my pelvis.
5. Do you have arthritis?
This was my own starting point. Since I cut out gluten, casein and whey, specifically, I have no arthritic flare-ups. However, if I eat too many inflammatory foods- grains, vegetable oil, sugar and seeds and nuts- I do get achy. My response to body pain usually is to look at my diet.
This time I tried a carnivore diet to determine the culprit of the aches. Mikhaila Peterson has had enormous success just eating beef and she had her ankle and hip replaced from arthritis! My plan was to add eggs and some plant foods back in after a week or two and judge my body’s response.
The internal hip pain did not go away. I felt a bit better overall and had a better go of being in ketosis but the pain did not subside. Now I knew it was not from my arthritis and, frustrated, I continued down the rabbit hole.
I hope that someone gets some benefit from the experience I wrote out here, or at least gets a lead in the right direction. Living in pain made me desperate and irrational at times. As I said, one of my biggest mistakes was not thinking holistically enough and if I did it all over again, I’d try address things starting at this post’s #1. Good luck and may you find some relief!