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Won the lottery?

Jan 12th, 2014

Kate asked The Guru for the following Physiotherapy Advice:

Dear Guru,

I get right sided pain round the iliac crest area when I stand for long periods of time (walking is fine). When I shift weight onto the right side when standing my hip feels like it clunks (can’t think of a better way to describe it!). I also get pain in the lower back (mainly centred around the PSIS) which is worse with sitting and some sciatica/back of thigh shooting pain. I think my right quad is also a lot tighter compared to the left. Sometimes it feels like my right hip has been pushed back, making me feel a bit wonky!

It started in a mild form a couple of months after a bad ankle sprain in Feb which is still unresolved but has become more persistent. It tends to ease with total rest. I exercise 3x a week using the bike and cross trainer which can exacerbate the aching afterwards.

Thanks in advance for any advice.

Jan 12th, 2014

The Guru Responded:

Hi Kate

I think to win the lottery once is doable, but to win multiple times is very, very unlikely. You’re describing a load of different symptoms, but I think you have a single cause.

When something is made to over work or over stretch (such as your ankle) the body (being naturally lazy) will exploit this extra movement but allowing other bits to move less. You won’t notice the bits that move less because other bits will move and as it’s a closed system you take from 1 and add to the other.

OK, here goes. When you’ve sprained your ankle [get sport physiotherapy info] you still need to get from A to B. So to limit the movement in your overstretched ankle you’ll point your foot out when walking. This’ll make you knee and hip roll in. You’ll now loosing range into hip extension (behind movement) and rolling out. Your gluts (med) usually do this and so don’t have to. The stiffer and tighter at the front of your hip you become, then move you’ll have to twist your pelvis to the right when your left leg goes forward. This twisting happen around your low lumbar spine. The more you move here, the less you need to move in your thoracic spine.

The more sedentary and slouchy postured you are/have been will increase your thoracic spine stiffness which will make your lumbar spine move more with less control coz your gluts don’t fire……

Get more thoracic spine movement relative to your lumbar spine and increase your weigh bearing glut control and make sure you can get enough length through your right hip…..

Rock on!

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