Hip Pain

The hip joint is a weight bearing joint and thus is subject to large biomechanical forces, especially during sport and exercise.

From the outset, the weight-bearing function of the hip joint means it will be less flexible than say, the shoulder joint, yet more stable. There is always this trade-off in joints between strength and flexibility.

What causes tight hips?

People often complain of tight hips. From the patients perspective this might be due to one or a combination of hip pain, reduced range of motion (for example during squatting), or perhaps uncomfortable clicking in the hips. For the treating practitioner, however, what does this actually mean?

The most obvious reasoning for a person complaining of tight hips would be due to a shortened state of the hip musculature (tight muscles).

Examples include: bending forward reduced because of tight hamstrings and gluteals; restricted thigh abduction due to tight thigh adductors on the same leg; or reduced hip extension because of tight hip flexors.

What is more difficult for the patient to perceive on their own however, is the possibility that their hip range of motion may first be limited by the ligaments binding the bones of the hip joint or the very shape of the bones themselves.

It is much easier for the patient whom has little understanding of joint anatomy to assume their condition is related to superficial structures (the muscles). What most people do not realise however, is that hip range of motion is first determined by the shape of the bones of your pelvis and your thigh bone, specifically the femoral head and the acetabulum.

In short, because of anatomical variations of the hip joint, some people will always be more flexible at the hips compared to the next person, regardless of how much stretching, exercise or mobilisation they receive.

Here is a great article that covers this in greater detail Why people have to squat differently.

The second determinant of hip range of motion is the joint capsule.

The joint capsule is formed by the major ligaments of the hip joint. These ligaments serve to fasten the femoral head securely to the inside the acetabulum. The muscles then overlie this capsule and contract in various sequences to bring about movement. As the capsule is so tightly adhered to the surface of the bones of the hip joint, any tightness within the joint capsule will limit range of motion before that of the muscles.

Unfortunately, there is little to nothing one can do to alter the shape of the bones forming their hip joint. In extreme circumstances, hip replacements are carried out where the hip has become biomechanically unsound due to degenerative change. One would be severely misinformed to consider opting for surgery to alter the shape of their hip articulations – if it ain’t broke, don’t fix it!

Tight hip capsules are likely in those individuals who perform repetitive tasks throughout the week.

For example, prolonged sitting will lead to reduced ability for the hip to extend. Prolonged sitting is also commonly blamed for tight hip flexors. Both are likely results of prolonged sitting, but the tightening of the joint capsule is often overlooked.

Similarly, people seldom have much reason to squat these days. In western society, we have chosen to sit during activities which once saw us squat such as eating meals, desk work or even going to the toilet. This lack of folding our bodies to the ground sees a general tightening of the posterior hip capsule, not to mention the capsules of other joints too. Again, the muscles overlying these joints ultimately become tight as well.