I’ve been  working on an upcoming book, Fixing You: Foot & Ankle Pain, and have been experimenting with a new approach to fixing foot problems. The interesting thing is, since I’ve been trying this new approach to walking, my pelvis has not become rotated,  resulting in no back pain. Before, I’ve always been able to prevent or fix my back pain with the techniques from my book, Fixing You: Back Pain. But one thing I hadn’t been able to do is identify the habit that is continually causing my pelvis to become rotated, contributing to recurrence of my back pain. Now I think I’m on to it! This is an unexpected benefit I hadn’t counted on. Of course, we all know that everything in the body is connected but we don’t know yet, the best way to use these connections to reduce pain. I think, in the course of applying a new understanding of our foot and lower leg anatomy, that I’ve figured out a way to reduce chronic pelvic rotation which is often at the root of pelvic pain, sciatica, SI joint, and back pain.

This was reinforced when I asked one of my clients with a perpetually rotated pelvis and a history of back and sciatic pain to try this new walking technique. He also has hip pain due to arthritis that has gradually become worse over the years of his pounding sports. Additionally he has knee pain on the same side. We’ve been able to fix all these aches and pains but I have not been able to get him to fix his walking pattern which is contributing to the recurrence of these problems. Immediately upon fixing his gait (walking) pattern his leg and pelvis corrected themselves without his even thinking about it! He also reported his hip pain had vanished! We both looked at each other stunned.

I’m still experimenting with this and working out the nuances for different foot types but I’m excited at what I’m finding. Finally, I think I might be getting to the bottom of a more complete approach to fixing ailments from head to toes, beginning with the toes!

I’ve had a couple people in recently with back pain. During my evaluation, I noticed the head of one of their femurs glided forward in the hip socket. Both of these people had rotated spines. Correcting the gliding femur head eliminated their back pain in both instances.

I think the mechanism here is that when the head of the femur is in the wrong place, the axis of rotation has changed for the hip joint. While bending over, that axial change then alters how the pelvis contributes to forward flexion, causing a rotating pelvis. The spine then responds to this by rotating as well.

Correcting the femur head tracking not only eliminated their back pain but also increased the range of motion of forward flexion. Suddenly it appeared their hamstrings were longer. In my mind, the hamstrings were never short, it was the altered hip joint mechanics that restricted forward flexion instead.

The body is so fascinating!

A recent NY Times article discusses the alarming fact that hip injuries are on the rise. They point out that this may be due to changes in usage, early introduction into  sports causing bony changes in the hip socket, and better imaging detecting labral tears earlier.

All of these are feasable explanations but in my experience, hip pain and specifically labral tears are often caused by poor femoral head tracking in the hip socket due to poor strength of muscles responsible for the tracking as well as poor walking or running biomechanics. Labral tears are only one symptom of this problem. Others include hip bursitis (greater trochanteric bursits), ITB friction syndrome, chronic groin strain/pain, sciatic pain, and knee pain.

Poor tracking of the femoral head typically results in the head sliding forward. This impinges tissues in the front of the hip and can eventually break down the labrum causing tears. Especially in high level athletes, which the NY Times article is primarily concerned about, precise tracking becomes even more critical due to the extreme forces acting through the joint. Minor alterations in the quality of femoral tracking while walking or running become major problems for professional athletes due to the frequency and force they undergo. Others who don’t make a living playing sports typically don’t put their bodies through the same stresses and therefore can get away with minor tracking problems.

Very often these tracking problems can be resolved with proper diagnosis and training. Treatment centers around specific muscle testing combined with gait analysis to observe the person’s walking and running habits. Specific exercises to correct muscular weakness is only part of the answer. The real key is learning how to walk and run while activating the correct hip musculature.  This is simpler than it sounds. I just worked with a marathon runner with these tracking problems and consequent pain who resolved her issues within a week. Her leg would begin to drag after 15 miles of running and now she has just qualified for the Boston Marathon.