Everything You Need to Know About Hip Pain

Discover important concepts about hip pain and its common causes in our Hump Day Conversation 16!

00:02-03:01Normal Hip X-Ray
03:02-09:32The Kinetic Chain
09:33-10:59Hip Bursitis: X-Ray
11:14-15:15Hip OA X-Ray
15:16-20:52Hip Replacement
23:23-25:16Taking Control of Health

Bedford Chiropractors Show A Normal Hip X-Ray

Dr. Ben Boudreau: [00:00:03] So today’s topic is, of course, the hips and the hips. Of course, the hip joint is a ball and socket joint so they can move in multiple different directions. The hip should be very free to move. The hip is actually made of three different bones, the ileum, which is the sharp part at the top of the hip. There. The ischium and the pubis at the bottom, and so Dr. Roach just put a nice red marking there right on the ileum and as well there’s the ischium and the pubis. So those are the three bones. It’s also made up of the sacroiliac joints, which are the side joints for any chiropractic fans out there. People have been to chiropractors in the past. They may have heard the diagnosis of a SI joint dysfunction.

Dr. Clayton Roach: [00:00:51] So let’s point those Ben. Yeah, this is the sacrum from here. I might as well draw it, Ben. Yeah, sure. And it goes all the way down here into the coccyx. OK. So the side joints are formed by the ileum. The sacrum, that’s why it’s abbreviated sacral iliac Joint and the joint is right here. You can follow it all the way up and you can see it over here as well. And I kind of went off the track here, but you can see it over here as well. So those are the S.I. joint. So when we say you’re excited about joint sort of alignment. This is what we’re talking about here and how this articulates when you’re walking and goes front and back along with the hip. So go ahead, Ben.

Normal Hip X-Ray Continued

Dr. Ben Boudreau: [00:01:49] That’s right. It definitely acts as the base of the column. And so it’s critically important that the joint is aligned. The next portion that we’re going to talk about is the acetabulum, which is the hole that the actual femoral head sits in to create a ball and socket joint. And then there’s the femoral head, which is just the big rounded part of the top of your femur that sits in that nice deep socket to form a beautiful joint. And on this X-ray here that we’re seeing in front of us, this is a normal X-ray of the hip. Later on, we’ll be talking about when things go awry. But right now, these are this is a perfect image of the hip. So this is the ball that Ben was talking about.

Bedford Chiropractors Discuss The Kinetic Chain

Dr. Clayton Roach: [00:02:39] And this is the socket right there, so the spacing is what you typically will look at in a degenerated hip, and this, as you said, is a normal hip. Everything is good. No issues there. This is the pubic bone. Right. That is what’s right in front of you. And this is a lumbar spine. Let me touch on this image here, Ben. This is what we’ve been talking all along about, the importance of how everything is connected from the point where when we’re taking a look at your posture in the clinic. What we’re looking at and what we’re making note of, if one shoulders lower than the other, one hip is lower than the other.

All that has consequences on how these grown reacting forces get dissipated. Throw the body everywhere. There’s a weakness, whether it’s the fact that the foot is what’s called pronated or flattening out and there’s no arch in the foot or the fact that the knees are turning in or the fact that the hip is lower. All those are basically points where energy gets lost in your ability to transport the force from your feet all the way up to the spine. And what ends up happening is these areas can’t take on that weight because they’re not functional. So they’re not functioning very well. And over time, they start to degenerate and show wear and tear, whether it’s your knees, whether it’s your hips, you do not get it.

The Kinetic Chain Continued

Dr. Clayton Roach: It’s funny because I had this conversation not too long ago with the lady who came in from a car accident and we took an X-ray of her neck and she had arthritis. And she said I knew that a car accident caused me to have arthritis. Well, that is impossible because the car accident was last week. So you do not get arthritis from a car accident last week. So it’s a process that takes time and usually because of faulty mechanics along the way.

Dr. Ben Boudreau: [00:04:43] Definitely. So since we’ve talked about this first image, we can then go into more of the topic of the hip joint. When we have these misalignments that start again at the foot and then the knee begins to turn in the muscles because we have to think about this as well, the muscles begin to tighten up over the top of some of our more prominent bony processes. One of the conditions that will commonly come out of the misalignment in the ankle-foot region is something called foresighted hip bursitis. So hepatitis is caused when there is a mal alignment and where the muscles are pulling over the top of our bones.

The Kinetic Chain Continued

Dr. Ben Boudreau: And so if you look in the second image, you can see how closely related the muscle is there and it’s a tendon. This, by the way, is called the Iliotibial  Band, and it runs all the way down to the knee joint. And so where it’s rubbing on the hip, that’s exactly where your hip bursa sits and when that person gets inflamed, it causes us extreme pain, inability to walk, maybe limping, perhaps. But the start of it isn’t necessarily a cause. It’s more of an effect. Right. So when we take a look like we’re going to talk tonight about things that could create that thing,

Dr. Clayton Roach: [00:06:09] The bursts are basically fluid-filled sacks that create cushioning in the area. But because they are fluid-filled sac, they take up space and there’s not a whole lot of space in this area. And as Ben mention, these muscles and tendons pass over here. So the tents are found. A lot of muscle. Here is a good example that becomes the IT band. So what ends up happening if you don’t have good foot mechanics, your knees turning in that it and is being pulled and when it’s being pulled, it gets tighter and it squeezes up against this Bursa and Bertha’s right next to the bone of the hip right here.

The Kinetic Chain Continued

Dr. Clayton Roach: The greater trochanter is just basically a bump here. So when you going to lay down at night on that side, the bursa’s right next to the skin, so you get skin and boom, you got the Bursa and if it’s inflamed, it’s going to be bigger than what it’s supposed to. And obviously sleeping on that side is going to hurt. So the bursa’s is one of the things that you can actually calm down fairly. Quickly, if you catch it early with ice, because the ice doesn’t have to penetrate that far in the bursa right there, but again, as Ben alluded to, if you have bursitis, you have other issues that are more important than just bursitis because there is something that has caused that Burset to get inflamed.

Always ask why. And definitely, that could be a misalign kinetic chain right here that is created a step by step processes that have not been able to dissipate the ground reacting forces and things are rubbing and things are in alignment. And now you’ve got an inflamed Bursa.

The Kinetic Chain Continued

Dr. Ben Boudreau: [00:07:50] Yeah. And to give an example, just to add to this great point, so if we have runners, runners come get bursitis as well. And the reasoning is, is that over the course of their run, when they begin to fatigue, the legs begin to knock together. So if you ever see a runner fatigue, their legs are really close to knocking together, this is because of that extra force that they can’t dissipate. Now it’s getting all dissipated into the knee, putting extra pressure on the hip, and then the runner will come in and say, well, I’ve got this really severe hip pain and also I’ve got plantar fasciitis. Yeah. So these are things we have to think about and it only happens at the end of my run, et cetera.

Dr. Clayton Roach: [00:08:33] And they’ve got outside knee pain and the knee pain is where this it then inserts. Right. So too many people and we’ve got to stop doing that. Too many people treat where the pain is. Right. So you got knee pain on the outside. So they’re doing an ultrasound and they’re doing all the stuff where the pain is. But nobody is actually affecting the structure and the mechanics which really created the problem, to begin with. Right. Anybody can do this at home, and I get that.

The Kinetic Chain Continued

Dr. Clayton Roach: It’s going to make you feel better and everything is good for the moment. Then you go back to running, you go back to doing the things that you do and the mechanics are still wrong and the conditions come again. And lo and behold, if we don’t fix the mechanics over time, you will eventually see a hundred times out of a hundred times changes on an x-ray that showed degeneration, because, over the years of not treating the structure, the structure deteriorated. OK, so what has gotten this x-ray there be good.

Bedford Chiropractors Discuss Hip Bursitis: X-Ray

Dr. Ben Boudreau: [00:09:35] Yeah. So this x-ray is actually photo evidence of somebody who has chronic bursitis. So just like when we talk about our enlarged EOP, just like when we talk about the bone spurs on the bottom of the foot, the x rays will begin to show chronic bursitis, chronic pain over that, that greater trochanter of the hip due to that person being inflamed. And actually, if you go just lateral to the head, you can see calcified densities just in that muscle there, just in very slightly. And that is calcifying density in the actual bursa.

Dr. Clayton Roach: [00:10:12] Here Ben. Yeah. Yeah.

Dr. Ben Boudreau: [00:10:15] Which is really, really cool to see on x ray, because you’ll see bursa calcifies sometimes, but this is definitely evidence of chronic bursitis.

Hip Bursitis: X-Ray Continued

Dr. Clayton Roach: [00:10:25] And you might ask, why does a Bursa calcify? Because when the bursa’s inflamed all these chemical irritants and these, you know, you got a bunch like Leukotrienes and all these things that create inflammation, they’ll also create this process of calcification as well. Right. And you can get that not just here, but you can get it in any joints, any tendinopathy and chronic like Achilles tendonitis. You can start getting some calcification there. So you know what’s been going on for a long time when you start to see bone in a soft tissue area. Right. So, guys, tell us a little bit love. I think this is good information. Right. If you can give us a few thumbs up, especially if you feel that you’ve learned something so far, hopefully this has been useful and. Yeah, this is good stuff Ben.

Bedford Chiropractors Explain Hip OA X-Ray

Dr. Ben Boudreau: [00:11:15] So structure dictates Function, the left x-ray is the normal joint spacing and so very similar to that first hip x-ray that we were looking at earlier. You can see how there’s a good few centimetres in between the superior aspect of the acetabulum and the superior aspect of the femoral head,

Dr. Clayton Roach: [00:11:38] So this superior aspect of the femoral head. So this is the head here. This ball. And this is the inferior aspect of the bone above that creates that arc and that. What’s called the fossa, where the hole where the head can articulate with and compare it to the other picture that we had. You see, the outside here is very smooth to the Bursa is very healthy there. And there haven’t been any calcification rates. I can see the linear edge here is perfect. Right. So no issues there at all. And then we get to this guy who’s never been to a chiropractor before, never been adjusted, and he looks like this. Right, go ahead. What do you see here?

Hip OA X-Ray Continued

Dr. Ben Boudreau: [00:12:24] So what you can see here is the reduction of that space between the acetabulum and the femoral head. It’s become sclerotic, calcified. There may be some control system there, but it’s so sclerotic that it’s difficult to see. So there likely is. So what is parodic mean? The sclerotic is is basically calcification begins to build to protect the bone from what it’s suffering from. And it’s also a process of when we start to lose the cartilage in between the small layer of cartilage in the joint. So elbow joint there and so ossify.

Dr. Clayton Roach: [00:13:05] So basically the body’s trying to protect itself. So with the layer that’s that was supposed to protect, it is gone like the cartilage.Then the bone starts. The body starts to build more Bone in order to try to protect itself from losing more bone. Right. So it’s basically basically, Wolf’s Law where there’s friction bone is going to start to form there. And what about the bright white here, Ben? What does that mean?

Hip OA X-Ray Continued

Dr. Ben Boudreau: [00:13:15]  Yeah, the bright white is, of course, sclerosis and the snowballing sort of effect that begins there when you get that bone on bone. And like Dr. Roach is alluding to, the sort of the bone that begins to get built up a sort of in Wolf’s Law, in this case, is actually not as strong as the original bone that was there previously. And so a lot of people who begin to get arthritis there in the hip joint, start to not use their hip as frequently and as properly. And so they begin to suffer from other things as well to come along with that, whether it be osteoporosis or vascular necrosis, dead bone, etc.

Dr. Clayton Roach: [00:14:09] Yeah, so one of the things that people it’s going to be hard for me to explain that one of the things that people with an osteoarthritic hip when they lie on their back and they try to bring their knee to their chests, the knee doesn’t really glide straight. It tends to go out to the side. So that is a pretty accurate test. To determine if there are some osteoarthritis in the hip is when you lay on your back and you bring your knee to your chest, the knee will not be able to glide straight and will you’ll tend to go off to the side like you’re opening your hip up because what happens, there is no space at the top.

Hip OA X-Ray Continued

Dr. Clayton Roach: So the joint comes up in a jam. So in order to make more room, your leg goes out to the side. And very typically been if they have a lot of osteoarthritides, the pain is going to be in the hip, but it’s also going to radiate right into the groin. Right, and that’s a very important aspect, too, and trying to determine what kind of hip pain is this? Is it arthritis? There are many different signs. And of course, if you have bursitis, the pain is going to be on the outside of the hip into this area right over here. So very much different presentations. All right, I like this.

Bedford Chiropractors Talk About Hip Replacement

Dr. Ben Boudreau: [00:15:19] Yeah, so this is just sort of a story, I guess we’re telling a story of improperly taking care of alignment, which can lead to a sore foot, which can lead to a sore hip. Eventually, as that begins, the pain becomes so severe that people begin to look for four other options or maybe the only option that they know or arthritis has gotten so severe and things so beat up that you just can’t handle the pain anymore. So the photo here is a hip replacement. You can see on the left-hand side there, they put an artificial socket in and they put an artificial femoral head.

And so one surface is metallic and the other surface more of a plastic. And so they can rub congruently onto each other and they’ll never grind. So if we had to bone on or two metal on metal, bit too much grinding going on if we had plastic on plastic wouldn’t be good. So they always do the metallic and plastic types of material.

Hip Replacement Continued

Dr. Clayton Roach: [00:16:18] Yeah. This is definitely the end of a process that was never addressed, right. And there are many things that can, you know, that can lead down the path of hip replacement trauma. I will say it can definitely be the arthritic process. Right. But short of trauma. The non-dramatic reasons why you would end up with a hip replacement are exactly what we’ve been talking about the last few days about the kinetic chain. And basically, you think about this when you’re walking a thousand, 10000 steps in a day on a hip, that sort of alignment on a knee that’s rotated inwards on a foot that has noarch. Imagine the impact that has on the forces coming right up into this hip. No wonder it eats up space over time.

Right. And then erodes the ball, erodes the top and all of a sudden there is no point of return. Now, one thing I will say is this bone. And this is kind of like a side topic. The reason a hip fracture is quickly touched on this in terms of people that have osteoporosis, the reason a hip fracture is so, so dangerous is that inside here in the femur is bone marrow. And what happens is that when you fracture a hip, there are pieces of bone marrow that can then fly off, go into the bloodstream and get caught in smaller arteries where you will die from what’s called a fatty embolism. Right. Because it’s fat.

Hip Replacement Continued

Dr. Clayton Roach: The bone marrow is fat, which is why people that have a hip replacement, what’s dangerous is them dying because of this piece of fat flying off and getting caught into smaller vessels. Right. So I just wanted to touch base on that because, you know, I had a hip fracture that is very, very dangerous. What happened can happen afterwards, and that usually occurs because of osteoporosis. And what we are talking about here is osteoarthritis. Sometimes you can get those two confused.

Dr. Ben Boudreau: [00:18:36] Yeah, great point, Dr Roach, to bring up.

Dr. Clayton Roach: [00:18:41] Anything else here, Ben.

Dr. Ben Boudreau: [00:18:42] Well, I mean, just hitting home on the fact that you know, it’s not a cause of the pain, it’s more of an effect of the issues that are going on. And so it’s critically important that if you’re in these beginner stages or even long before that, just taking care of your body, coming in and getting your body checked like this is what we mean. We’re checking all of these little things.

Hip Replacement Continued

Dr. Ben Boudreau: We’re moving the spine into the proper area that needs to be in so that you’re in less pain or at least preventing a future episode, just like you go into the dentist to have your teeth cleaned or have your mouth checked for cavities. You’re there to protect your teeth for future episodes. And so, again, it’s more of an effect and the alignment has to be taken care of.

Dr. Clayton Roach: [00:19:29] And we had a question there about chiropractic help if you’re not yet at the point where there’s a need for a hip replacement. And my answer to that is absolutely yes because you want to prolong this as much as possible because these have a lifespan. Right. So if we can fix the structure and the kinetic chain so that we’re creating better movement and dissipating, these forces will be better if we can.

Dr. Clayton Roach: [00:19:57] Get your hip replacement to be pushed out like five years from now or three years from now. This is all time you gain in the end because these hip replacements don’t last forever. So for sure, we can help with this.

Hip Replacement Continued

Dr. Ben Boudreau: [00:20:11] And before anything, even if you’re waiting or you’re on the waiting list for something, I know I’ve see a few patients already who said, you know, I’m on a wait list for this. Well, the results of doing something before you have a surgery. The results in your post-operative phases are much better if you prepare your body for the surgery rather than just waiting or saying, you know what, I’m just going to wait until after. It’s always better to be active in your approach because your results would be much better and it’s easier for a body to respond when it’s already done some of the movements.

There’s actually a direct correlation between how healthy you are before and how the rehab, in the end, your success is going to be. I’ll quickly just touch on the supplement of the month, just reminding everyone that we are totally in we are all in on vitamin D and K2. And so again, if you haven’t gone out and gotten your vitamin D drops, it’s always best to do so. They’re really easy to take. It’s not like you’re taking a pill every day or anything like that. It’s just a quick couple of drops in the mouth or in the drink and you’re good to go for the rest of the day if you want to get it from your food. Salmon, sardines, egg yolks, shrimp, yogurt, orange juice. And of course, what we’ve been getting a lot of lately. The sun.

Hip Replacement Continued

Dr. Clayton Roach: [00:21:30] Guys, I think this was this was good.

Dr. Clayton Roach: [00:21:35] Yeah, let us know if there’s any questions were obviously there to the field questions, and when you come in in the office, I mean, we want to be there for you guys and we appreciate the questions. We actually like getting questions like we’d rather not talk about hockey and rather not talk about stuff that is totally irrelevant to your health. I really appreciate it when people come to me with a great question that sometimes may stun me. And I see. And what I got to get back to you. I don’t really know that that question or the answer to that question. So we appreciate the questions. We’re not the ones going to say, oh, don’t look on Google and we get all upset when you question us. We’re open to that. We want you guys.

Hip Replacement Continued

Dr. Clayton Roach: This is why we do Humpday conversation. So you guys learn and you learn, you know, thought processes that go into when you have a problem or why is that problem there? And asking the question why? So that when you go to your doctor, you go to your chiropractor, physiotherapist, whoever you’re seeing that you’re having, you have the ability to ask intelligent questions because quality, the life you live depends on the quality of the questions you get to ask. So I think that’s important because we spend time on our patients. We want to make sure that we’re spending time answering questions that matter to them and not just who won the hockey game last night, but that, you know, I don’t mind that either. But we want to spend time that it’s valuable time.

Dr. Ben Boudreau: [00:22:54] Definitely, and, you know, being able to change your function ultimately changes who you are and your outlook in life and and it will change your life when you look at yourself in the mirror every morning and say, you know, I know what I’m doing today is good for me and I know that I’m going to see this outcome. Yeah. And being able to look and say this is what I want to do and this is why I’m doing it, and having that certainty is so powerful.

Bedford Chiropractors Examine Taking Control of Health

Dr. Clayton Roach: [00:23:20] You know, to me and doing this for a while is what bugs me the most. What almost makes me tear up is when people kind of give up and they feel like they’re just passive human beings that have no control over their health. And they just say, you know, I guess, you know, I’m getting old, you know, I’m getting back pain. My mom had it, so I’m going to have it, too. They’ve kind of given up on the active approach of what can I do to make things better? I think, unfortunately, there’s too much on stuff being hereditary. And, you know, here’s a pill for that.

So we’ve taken away the role of the human being to take care of himself and controlling his or her destiny. So, you know, as chiropractors, we want you to be active because we feel that inside of you is the biggest pharmacy in the world. Because your body’s ability to heal itself is huge. Sometimes the environment doesn’t allow that to happen because the environment is not conducive for your body to heal itself. So as chiropractors, all we’re doing is creating that environment, that better kinetic chain, so that your body can better function. And then when you come in and you say, my back pain is gone. Well, we didn’t do it.

Taking Control of Health Continued

You did it. Your body, you know, did better because of the elements that we change. But you’re the one doing the healing. I think that’s taking it that gets taken away because the minute you feel it, you’re dependent on a bottle of pills. Then you’ve lost the game in the sense that you no longer control your body. Now there is a place and time for everything. And I get that. Thank God, we have these drugs and pills at times, but too many times it is the first option. That’s where I think our health care system is failing us at times when we don’t get exposed to other options or we’re not given time to ask questions or given content that allows us to know what questions to ask. This is why we did Humpday conversations

Dr. Ben Boudreau: [00:25:15] Amen.

Dr. Clayton Roach: [00:25:17] So like you do always and you’ve been serving us extremely well. Oh, please share this episode.

Taking Control of Health Continued

Dr. Clayton Roach: [00:25:25] This is probably more common than plantar fasciitis. Hip pain is huge, so I’ll take it upon yourself to help others. And you can do that by simply hitting the share button. Please do that. You’ll help people that you probably don’t even know. You forgot that they were on your fenceless. You guys have a fantastic week. We’re going to post this again. If you’re on YouTube right now, make sure you hit the subscribe button and that way you can follow us when we’re living. And again, thank you so much. You guys love and appreciate you. We will see you guys again next week at nine o’clock. Any final thoughts about it.

Dr. Ben Boudreau: [00:26:03] Peace and love, take care of everybody, enjoy your week. It was great seeing everybody leave and stay healthy. So you.

Dr. Clayton Roach: [00:26:12] Take care. See you later. Bye bye. What’s up? Listen, if you like this episode, you’ll probably like the other ones are pretty good. So here’s what you need to do. You need to like us and follow us on Facebook. Following means you get notified when these two guys are alive. Next, family, friends. You need to share these episodes because you never know. You might help them because they need this information as well. And guys, if you ever miss an episode, make sure you subscribe to us on YouTube. That way,

Dr. Ben Boudreau: [00:26:37] You can watch the episode over and over and over again.

Dr. Clayton Roach: [00:26:40] Guys, we love you and appreciate you. Take care.