"Is My Hip Out of Place?"

By Jake Francis

This is something I hear a lot from people: "my hips out of place", "my spine is misaligned", "I've got one leg shorter than the other"...

I find it quite frustrating to hear to be honest with you, because this isn't normal thought.. It has come from someone else. Whether, it is from friends or family, or another professional whom has mis-spoken, it doesn't really matter. The point is, that these statements won't be the real reason you have come to see me - a musculoskeletal injury specialist. Let's go through each of these statements and try to dispel a few myths.

"My hip's out of place"

Right, lets look at the anatomy of the hip. The hip joint is a ball and socket joint (perhaps the most stable joint in the body). It is made up of the head of the femur (the ball) and a very deep socket for it to insert into, called the acetabulum. The ball of this joint, is very unlikely to be out of place because the socket encompasses it and surrounds it in such a way that it is extremely difficult to shift it out of place. If it is out of place, you have probably had some quite severe trauma, such as hip dislocation. If this happens, you'll probably be in searing acute agony and unable to move from the floor - you certainly won't be able to walk into a clinic and calmly explain what your issue is.

Now, sometimes people aren't actually referring to the hip joint, but more their pelvis or sacroiliac joint (SIJ). The SIJ is the articulation between ilium (your pelvis, which contains the concavity of the acetabulum) and the sacrum, which is the lowest portion of your spinal column and is completely fused vertebrae. This joint has very little movement (2-4 degrees), which would suggest it is very stable. When we look further at the anatomy, it has a lot of thick ligaments surrounding the joint... and ligaments a designed to hold things together, and not allow much movement. Of course, it is possible for your SIJ to be misaligned, but it is very unlikely this will cause you a great deal of problems. It is far more likely that you have some muscular imbalances that may be referring pain or discomfort around your hips and SIJ.

"My spine is misaligned"

Ok, so I was recently reflecting on this one. Your spine is made up of 24 vertebrae (not including the fused vertebrae of the sacrum and coccyx). These all have the ability and freedom to move, through bending, extending and rotating. I'd like to note at this point, they wouldn't have this ability if they were not meant to move - so move your spine! Now, in terms of mis-alignment of your spine, there are already three natural curvatures in your spine that should be there. There are also a few other curvatures that might be interpreted as misalignment. One in particular is called scoliosis. This for many people won't cause any problems whatsoever, and doesn't even need to be mentioned. If it doesn't affect your life, your sport, and you have no pain, it really isn't a problem. Scoliosis is usually congenital anyway, so if it hasn't caused an issue throughout your life, it is very unlikely that it is the cause of your injury or pain when you walk into clinic.

I would also like to point out that genetically, every human in the world is different. That will include things like body shape and bone structure, amongst other things. So, you could say differences in your spine's alignment are normal. If we look further at our spinal anatomy. It is surrounded by ligaments, muscles and tendons, keeping it stable and resilient. And let's remember that, although the spine as whole can move a lot, individual vertebrae have small amounts of movement. So again, misalignment is unlikely to be the cause of your injury or pain.

"I've got one leg shorter than the other"

This one is particularly frustrating. Think about the common sense of this. Having one leg shorter or longer than the other is like wearing a shoe on one foot and not on the other - we've all done it, don't deny it. So, you would be walking around all the time with a weird and uncontrollable limp. Don't get me wrong it is a very possible condition to have differing leg lengths - I, myself have an ulnar that has grown half a centimetre too long, which means I have trouble rotating my hand upwards, amongst other things.

However, leg discrepancies are extremely obvious, and a therapist should know pretty instantly that this is a problem when you walk through their door. They should not need to measure your leg length to determine this as a problem. Although, if they do think it is a problem, they should measure your leg length to confirm it. It is possible to have fractional differences in leg length, but this has a negligible affect on everything. Essentially, if you are walking with out that one shoe on limp then your issues are most likely not due to your leg length.

So, in conclusion, stop focusing on misalignment, limb length... These are possible but very unlikely if you are walking in fairly normally and calmly explaining your issue. There is more likely to be some muscle imbalance or lack of movement somewhere. So don't fear, your issue is fixable!


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