In my 23+ years in the fitness business, there is one area of the body that gets little attention, even though it needs it desperately. I’m talking about the pelvis, also known as the hips. Consisting of two mirror image bones (the right and left), the pelvis is the root system for your branches (arms and legs). Any strength and conditioning program needs to start HERE. Since most of our daily tasks involve sitting for extended periods of time, the hip muscles, especially involving those that flex the hip and pull us forward, get tight and short. Those hip muscles that allow us to stand up and extend our hips get weak and lose their tone. Aesthetically, people don’t have a rear end anymore, but there are worse issues than looks. In my practice, more than half of all back pain issues are due to weak, unstable hips. The spine sits on the hips (think of the beams supporting a bridge), if the hips are too weak to support the spine, the bridge collapses. Additionally, the largest muscles in the body attach to the pelvis-if there is a weak base, there will be reduced force production (think about trying to shoot a cannon from a rowboat).
I’ve found that when the hips get stronger and more stable, improvement in several areas occurs. 1) back pain is reduced (my own has improved by 50%), 2) knee pain reduction (after all, the knee can only do what the feet or hips tell them to do), 3) shoulder pain improves. The shoulder works in conjunction with the opposite hip (think about arm swing during walking), and 4), hip pain improves.
I’m putting together a short video this afternoon with 4 or 5 exercises to get the hips engaged. The video will be on my website this week.
Beware of the quick fix for tendonitis (actually the new term is tendonopathies). Cortisone injections have provided immediate relief for overuse injuries like tennis elbow, shoulder bursitis, and Achilles tendonitis for years. There has always been a concern that there may be some long-term damage to the joint cartilage, but treatment has remained the same. But, a new major review article published last friday in Lancet, should renew the debate of cortisone’s efficacy.
What they found was that, yes indeed, the cortisone did reduce pain substantially in patients for several weeks. However, when theses patients were re-examined at 6 and 12 months, the results were totally different. The people who received shots had a much lower rate of full recovery than those who did nothing or did physical therapy. They also had a 63% higher relapse rate than those who took a wait and see approach. What the research has found was that cortisone actually impedes the structural healing process, and can actually cause greater damage. For a comprehensive review on this study, see Lancet, 10/29/10.
Stay well, John R Blilie, M.S.