I am asked this question over and over again.
Hip pain is a fairly common reason people come to see me and purchase the CoreWalking Program. There are many many people who suffer mild to severe hip pain and don’t really do anything about it, thinking a hip that hurts is simply a part of their life. “It’s not that bad, I can deal with it.”
There are many different reasons why hips hurt. My favorite muscle the psoas if often if not always involved. The next door neighbor of the psoas, the quadratus lumborum usually has a role to play as well. Let’s add gluteus maximus and piriformis to the mix and a picture begins to form. When your hip hurts it can be any or all of these muscles.
But for today’s discussion we will cover the IT band and the tensor fasciae latae as a reason why someone’s hip might hurt. The truth of situation is if you have a problem with one of the muscles I have listed, you probably have a problem with all of them to one degree or another.
Poor standing posture which usually translates into poor walking, running and sitting form is why I think most people have hip pain problems. The way many people stand pulls the IT band in the opposite direction that it should be in naturally.
The IT band is a long tract of connective tissue that runs from the ilium of the pelvis to the tibia of the shin. The tensor fasciae latae is a small muscle that runs through it, situated towards the thigh and acts as tensor of the fascia latae of which the IT band is a part. The gluteus maximus, our big butt muscle, connects to both the back of the thigh bone and the It band.
The IT Band functions to stabilize the knee when it is in extension. Because it is connective tissue rather than a muscle it can accomplish this action over the long distance between the pelvis and the shin. It also extends and abducts the hip. The tensor fascia latae works to abduct (pull away), flex and internally rotate the hip.
Because the IT Band is connective tissue as opposed to muscle it is much less forgiving when it comes to poor postural alignment. Thighs that leans forward of the pelvis, a trait common to almost everyone’s standing patterns, pull the IT band out-of-place creating the environment for the hip to hurt.
From my perspective a majority of thighs are situated forward of the pelvis. If this is the case the IT band tends to get pulled backwards towards the butt. Also if the gluteus maximus is tight, and we are a tight assed people, that it will also be pulling the IT band backwards.
These dual forces—thighs forward and a tight butt—put a great deal of strain on the IT band. If it were a muscle it would simply be pulled out of alignment. Because it is connective tissue it has way less give and postural misalignment affects it more than most soft tissue structures in the body.
You can feel this in a subtle way by putting your hands on your outer hips and shifting the thighs back and forth. While the bones and the muscles will move, the taut , strong IT band will not. The illustration above is an example of this. The IT band maintains its position as the bones shift theirs.
So todays answer to the age old question, why does my hip hurt, is that poor posture puts and large amount of torque on the IT band affecting the hip and knee in equal measures. Get your thighs back under your pelvis and there will be a lot more room for the IT band to live happily and there will be much less stress and pressure placed on the outer hip.