Hips

"Quiet, restful and motionless sitting, as in relaxed and functional meditation posture, is very good for hip joints. Artificial fixity is very bad. Yet, the two things look identical to the untrained eye. You will find many hints on this website.” -SH


Hips 

I’m not interested in giving corrective exercises or a maintenance program for painful hips. There are plenty of people giving out exercises and yoga postures for that purpose. Go to YouTube.  I don’t much believe in such things.

I am interested in another angle. For instance, when I heard that Indian women (from India who live in India from birth) have less hip replacements, I was interested, why is that?  Living in India, as I do now, has given me ample opportunity to observe Indian women and compare them to western men and women (in a somatic sense) and form many conclusions.  Indian women are doing many things very differently than western men and women. It certainly seems logical to me that if western men and women would start to do some of the same things as their Indian sisters, they’d find improvement in their painful hip situation.

This type of thinking – get smarter in a larger, more strategic sense, rather than try to fix things with exercises -  has been a point of faith for me. It has never failed to produce good results. And I very much like the simplicity of doing less, giving up therapeutic exercises and yoga and instead just stop doing harmful things and include in your life a few basic hip-friendly practices (such as I will enumerate here).

It is not so much the waste of time I object to, with corrective exercises and stretches. It gives us more rope to hang ourselves with our bad habits. Better that we look boldly at what we are doing, and change our behaviors. Even a little of this has a surprisingly huge effect.  When we do corrective or maintenance type exercises or stretches (to keep hips or neck or back from getting worse etc.) we automatically think that the hips or the neck or the back is a problem, as proof of that, just LOOK at all the work I am doing just to keep them from being just a little less painful! We automatically blame the hips or whatever.

 

Here is what I might tell a client (but more diplomatically):

Your hips are innocent. Your habits are NOT innocent, and you need to take a hard look at them.  And that includes, first of all, resentments  - when we carry these around, the whole body stays tight and painful. There is a book about that: Healing Back Pain by DR. John Sarno. If you’d rather keep blaming your body parts, like most other people, better stop reading here. It is a deep addiction and I understand fully if you are unable to give that up. But it is irresponsible. You are not looking at deeper causes.

It’s a near certainty, that if you have a painful hip (or two) you are doing at least several things to either cause or perpetuate that situation. And the flip side is, if you stop doing those things, you’ll effortlessly find that your hip situation has greatly improved, as if by magic. This falls under the category of: “If you stop butting your head against the wall, maybe your headaches will go away.”


We’ll take these in the order of importance:


  1. How do you stand?  Do you shift weight slowly from side to side, as I teach elsewhere on this site? Do you practice this every time you are standing like a gentle slow dance with a relaxation response in the non-weight bearing leg? If not, you are standing, forever without end, on two legs, neither one of which EVER RELAXES. That means both your legs – including all the muscles around your hip joints – are getting tighter as every year passes. It is a WONDER that you have not already had that double hip replacement, if this describes you. There is a lot to learn about side shifting in standing; please read my books and go through this website to see the bigger picture. In quiet standing, more weight should be over the heels, not the ball of the foot. This takes an attitude of patience, or acceptance, as in being present in the act of standing (not ready to jump ahead and do or go somewhere else). Even a little bit of impatience (as in I have THINGS to do) in standing will tighten all the muscles around the hip joints, and take your body weight into the ball of the foot/feet, not the heel. If you stand, STAND, and let go of grabbing the hip joints as if you have to be ready to run or walk fast, to go somewhere else. Do not carelessly stand on one leg, resting your weight on the opposite hip, which is being pushed TOO FAR to the side. Stand TALL on the standing leg; this takes competence and practice using the muscles around each hip joint to have that ability. Most people with hip pain need to learn this.
  2. How do you walk? There needs to be some shifting of weight side-to-side (as you should be practicing in standing, every single time you stand up in one place longer than 30 seconds) in walking. There needs to be a relaxation response (fully empty leg) in the non-weight bearing leg. You should not thrust a leg in front of you like most western people, in fact, do. This is like a brake to forward movement, it shears the hip, ankle, and knee and tightens the low back and makes the head go forward. It is extremely dysfunctional and a prime cause of hip pain and trouble. Please go to my YouTube channel (Google Steve Hamlin YouTube) and see the many clips on walking.
  3. How do you sit? First of all, the knees (in chair sitting) must be shoulder width apart. If you keep knees together, you are scrunching the hip joints, especially as you stiffen your low back to sit up straight (knees together pulls you down into a slump necessitating the stiffening). Second, the chair should be the right height (hips slightly higher than knees), the surface flat with minimal cushioning.  Forever avoid bucket-type seats as these scrunch the hip joints. The pelvis is compressed inwardly. Cars did not have bucket seats in the 1950’s. Those were saner times. All cars had BENCH SEATS which are much more friendly to the hip joints. Use a car board on top of your car seat? Measure and have it cut to size. You need to practice and learn, with those basic starting points, some degree of functionality in chair sitting. First priority would be to learn to sit with an independently dynamic pelvis, that can move into extension without stiffening your entire back (almost nobody with back pain or hip pain can do this). You probably would need mentoring from a Feldenkrais teacher to help you with this one. But until you learn this point, you will otherwise, guaranteed, be over-tensing and fixating your deep hip flexors (psoas, ileopsoas, etc.), which severely compresses the hip joints. Quiet, restful and motionless sitting, as in relaxed and functional meditation posture, is very good for hip joints. Artificial fixity is very bad. Yet, the two things look identical to the untrained eye. You will find many hints on this website, regarding sitting, on my YouTube Channel and in my upcoming e-books.
  4. How do you treat your ankles? Your ankles will protect your hips, if you know what to do. They are the first line of defense. We need to make it a life project to continually be educating, challenging and upgrading our ankle status, especially as we grow older. We need to get smarter about ankles! And quickly. Elsewhere on this site and my YouTube channel I have much to say about ankles. At age 70 I can tie one shoe by standing on one leg only. I can hop on one foot for 30 seconds with eyes closed. I can jump rope for many minutes, bouncing high using just ankle joints. I keep working on such things! You need to learn about the talus, the sub-talar joint, why arch-supports can be harmful (long term), what kids do to mentor their own ankles (lots of variety, play, jumping, dancing, hopping) and why barefoot is best.
  5.  Learn the Basic Anatomy. Without this, movement and posture can never be deliberately intelligent. The hip joint, ball and socket, is located at the crease of the bent leg, half way from the outside to the middle. It is a ball and socket joint. It is formed by weight bearing as an infant; so the geometry of your pelvis and hip joints will depend on how long you wore Pampers (makes you bow legged), whether or not you sat cross-legged in your formative years (if so, it will be much easier for you to sit cross-legged now). The ball of the femur goes into the hip at an angle; this means, for example, that if you stand on your right leg, the support is more clearly given to the diagonal left shoulder. You can reach up high with your left arm, if you are standing on your right leg, not your left leg. Try this out, feel it in your body. Try the other leg the same way. The hip joint is designed to make the toes turn out a bit in standing. To force the feet to be parallel in standing can be a stress to the hip joints. In slow walking the toes will naturally turn out, while in fast walking, if there is counter-rotation of hips and shoulders, the feet will be parallel effortlessly as you walk.
  6. Create a child-like variety of movements in your daily life, in walking, sitting, standing, running, dancing and working. Change out your chairs. Use a wooden stool as long as you can, instead of your office desk chair – which is designed to wear out your hip joints. When we get into a rut of one way to do anything regarding weight bearing in gravity, we wear out our joints, especially our hip joints, in exactly that way. You may notice, as I have, that the people who need a double hip replacement are very driven, and often successful people. They drove themselves “straight ahead” their whole life. I think it is OK to be compulsive like that as long as you know how to turn it off. Walk backwards whenever you can. Walk on all fours, even up to one hour per day. Live more on the floor, use pillows, and minimize chairs. Get a small floor-table such as they use to eat in Arabic countries; they eat while sitting on the floor (did you know that digestion is better in floor sitting? – in a chair too much blood is pooling down the legs). Give up being self-conscious about all these things, if you can (I can’t, so I do it a little bit of walking backwards and crawling around in my room, alone, or in little pieces of backwards or sideways while taking a walk). Walk side-ways (side-stepping like a soccer player running sideways) up or down stairs, or a steep hill. This will also be very healthy for your ankles and knees. In India there is a common joke In American cars pass each other on the left; in India cars pass each other any way they can. And it is true for Indians even as they walk, in crowds they mingle and flow and any westerner is usually not as comfortable doing like that as the Indian counterpart. In other words, to keep it simple, don’t be so doggedly, unconsciously invested in always walking and looking and staring and thinking straight ahead. You are going to be wearing out your hip joints in exactly that way.  A good way to begin is to regularly mobilize your eyeballs, and expand your auditory awareness while standing and walking.
  7. Imitate Indian Women. There are many reasons why they have less hip trouble than westerners. It is a lot to say here, so don’t try to do it all. Maybe one or two things you could try out for a week or so. You’d need to be born into the Indian culture to do every item on this list; either that or take a few Feldenkrais trainings. Gradually you could incorporate more of these ideas:
    • They wear long and flowing clothing; therefore there is no stigma to sitting with knees shoulder width, nor in bending the knees while sticking the butt out in standing and lifting boxes, nor in having a normal, human relaxed belly and abdomen (unlike us westerners who are WAY too uptight and compulsive about our tight flat bellies; it is truly a cultural neurosis we have in the west) nor in squatting should that be necessary. All these things are very healthy for the hips.
    • They walk with shifting weight clearly from one leg to the other; the non-weight bearing leg is fully relaxed and they spend a LONG time in each step on ONE FOOT with GOOD BALANCE on that ONE ANKLE and with the other, non-weight bearing leg “empty” and relaxed completely. Indian women have much tougher, more supple and intelligent ankles than most western women, by FAR. The contrast is quite remarkable.  
    •  They walk barefoot in the home, and often, outside the home. They wear simple and flat sandals or other similar footwear; it is rare to see them with heels and arch supports (although the more modernized Indian women unfortunately are going in this direction).
    • When they walk they are usually looking at the horizon. They are not habitually and neurotically studying the ground, looking down with tilted head, as are most western men and women. There is rarely a need to look down in walking. The feet know what to do. Keep your posture tall, look around at horizon level; otherwise you are crunching your hip joints by the postural distortion that comes from tilting eyes and head down like that.  
    • The sit cross-legged regularly and for long periods. Floor sitting is their second home. They did this from a very early age, so their hip joints are BUILT for this. As a western man or woman, you cannot expect to sit full lotus with no stress on the ankles, like they do. No amount of yoga will achieve this for you. The more you try, the more you will get hip pain, the kind of unrelenting hip pain that makes you want to take pain killers.  It is OK to sit full lotus, but only if your hips are comfortable, and the ANKLE not the feet is taking all the pressure. Otherwise you will be continually creating hip and ankle pain (and mal-alignment) every time you sit like that. Most westerners, when they sit in cross-legged postures, are grossly overstretching their feet, into inversion (like spraining an ankle). The tendency is for the ankle to stay like that, prone to being sprained easily by turning in. Indian women have looser joints, their feet are not so stretched when sitting cross-legged or even full lotus, as they have sufficient flexibility to bring their feet up and out of the stretch, letting the ankle press against the leg, not the foot.  
    • Indian women spend more time on the ground, on hands and knees, doing gardening or washing floors (use a mop and a rag to clean floors from now on; your hip joints will THANK you). Hip joint cartilage and bones were formed with knees bent, out of weight bearing (first) and secondarily, in creeping and crawling on all fours. Standing and walking, and sleeping with legs long (in extension) or any kind of exercises done in standing weight bearing mode is not, repeat not, what we need to do in order to facilitate hip healing, and regeneration of cartilage. Rather, crawl on all fours, spend your exercise time on all fours – that is a different, more primal angle of weight bearing for the hip joint, 90 degrees different from standing. It is crucial to know this, if you are really interested in healing your own hips. In Feldenkrais Training, by the way, you spend countless hours doing things on all fours, out of standing.
    • Indian women somehow have learned to be less body-attached and don’t “hold onto” their own legs (by tightening their hip muscles), as do western women, who don’t seem to understand how to let go of those muscles.
    • Indian women have a pelvis floor that is innocent – like what we see in very young and playful children - and “dropped down” not neurotically held up against gravity, as if they were still being toilet trained. One cannot see this unless one has had somatic training to observe such things, and not until one personally has also learned to relax down his/her OWN pelvic floor. Perhaps half or more of western adults, men and women, are continually holding WAY too much tension in the pelvic floor, at least in moments of stress, and I suspect the causes for this are many, including psychological, too early toilet training, imitation of adults, shame and guilt around sexual issues (including abortions), memory of the pain of childbirth, etc. And such holding up against gravity in the pelvis floor is totally unconscious. It puts continual mechanical compression on the HIP JOINTS. Why Indian men and women don’t have these issues showing up as pelvic-floor tension (like westerners) is beyond my ability to comprehend, at least for now. I am sure there is more to it than just “the Indian people are less uptight” as some of my friends have told me. I suspect the reasons go deep into their history, their philosophy, their religious practices, and cultural norms.
    • Indian women and also men, clearly have more somatic awareness of their own tailbone, bottom of their spine; They don’t feel squeamish about that area and it is not being artificially held or controlled as is usually the case in western men and women. I suspect their practice of washing the anus with water and the left hand, with a cup, after defecation, has something to do with this. The average western person, like me, is uncomfortable just thinking that thought. In the west we’d prefer to cut down trees and use toilet paper and smear it around; in India they use water. It may not be as primitive a tradition as we think. Also (you can Google this) we absorb B-12 from our own excrement when we touch it. You can cure B-12 deficiency by making “mud packs” on the skin, using your own excrement. Did you know there was a study about B-12 deficiency in vegan Indian women who moved to America? In India, no B-12 deficiency; in America, yes!   They had the same diet, both in India and America. So Why?
    • Indian people, young and old, male and female, are often seen holding hands, or resting a hand on a friend’s shoulder; this rarely crosses sexual boundaries (not in public, there is a strong taboo; but it is also true the young Indians who are more westernized are crossing that boundary), it is always men to men or boys and women to women or girls. To my eye, such touch is completely innocent, not selfish, human, friendly, non-sexual and has much to do with the fact that Indian people seem more comfortable in their own bodies than do their western counterparts. The average westerner is suspicious of touch, and one must be careful (or we’d get sued), and for the most part, the average western person (especially men) is familiar with only sexual touch, athletic touch, parental touch, formal social touch (shaking hands) and every other kind of human touch falls into the category of no, I’m suspicious, why are you touching me, keep your hands off, etc. I recognize that in myself; I am a typical westerner in most ways. The kind of “on guard” feeling this creates means constant body tension and vigilance (not exactly that, but more like never really letting go and trusting gravity, trusting life, trusting our own skeleton to hold us up, and keeping our joints loose and decompressed) including hip-joint tension. I am not saying it is not necessary in western culture to have that kind of attitude, probably it is necessary; but I am just pointing out the somatic consequences.
    • I don’t mean to imply that all these “India hip virtues” are a good thing for all westerners or even for all Indians. Most of us (western or not) don’t know how to be proactive, responsible, and keep moving ahead in all areas of our lives without some kind of constant mental buzz and body tension, including hip joint tension (as in I am ready to walk, to run to do what needs to be done) instead of having relaxed hips as you stand more back on your heels. That can be body language congruent with laziness and ineptitude (which is not to say Indian women are like that; I am just trying to point out the balanced somatic viewpoint, both sides of the coin).  It is a true somatic statement if a person is resting back on their heels, in standing, they are not as ready for action as a person with more weight towards the balls of the feet. If you are more interested in accomplishment, drive, will power and success, then perhaps a double hip replacement at age 65 is not too high a price to pay. I’m serious. But I believe that fully-relaxed readiness and competency to act, from a global constellation of choices, can be learned and a Feldenkrais Training or Feldenkrais involvement at some level is the best way, in this present modern culture, where all the wise and ancient ways to learn this are evaporating. An accomplished master martial arts teacher would also be able to teach this skill, also, for sure.
    • Indian women (and men) are more auditory. They are not seen with their heads buried in a book, or a cell phone, not as much as a typical westerner (unfortunately this is quickly changing as India becomes more westernized).  True, this may be because they are more “primitive” or less educated; I am just pointing out the somatic side of things here. (But I, like Moshe Feldenkrais, would contend that “primitive” in this sense is actually a mark of superior intelligence, just not the kind of intelligence we value so much in he west). They walk with a more global awareness, soft and wide-angle vision, without the downward-gazing and close-focus eyes that most westerners display. All of us, in fact, were born and learned to stand and walk in auditory dominance, with a rather global awareness (instead of locked into the frontal visual field only) and movement, joint-decompression and mental function are all optimized with less visual vigilance and more auditory connection. You want to avoid neck surgery, and decompress that pinched disc? Try this! This is a good advice, and harmless, with a certainty of doing you much good, one way or another.
    • Unclench your hips. It sounds easy, but it may take years of somatic work. Just like softening a clenched fist, we can relax the muscles around the hip joints. Most every person with hip trouble is clenching his or her hips. It is just not conscious. And that is because they are doing so many behaviors that require clenching their hip joints – how they stand and walk and posture themselves. Eventually, in a Feldenkrais Training, as people expand and refine their body-awareness, it will just “come to them’ how easy it is to just stop tensing the shoulder, or the hip or the belly etc. Once those habits are raised to the level of conscious awareness, it becomes very simple. Until then, it is all dark, difficult and frustrating. The real work is not more stretching, or strengthening, or prolotherapy injections, or yoga – but rather, more awareness, which will enable us to discontinue the unnecessary tension in the area.  

 

Finally there is the issue of hip pain in one leg, not two. This hints at a skeletal alignment issue (or scoliosis) or else habits which are abusing one hip joint and not the other.

As well, I have to confess I have had no luck helping clients with bone-on-bone hip joints that need a total hip replacement. They are too far gone for me to help them; perhaps others could do so. If you’ve been told by an orthopedic physician that you have “bone on bone” and you need a hip replacement, I can’t help you. My experience has been that you do need the surgery, and you’ll be glad you did it; your pain will be gone and your mood will lift.

To manage and improve one-sided hip pain is not so simple and my opinion is that it requires working with a qualified professional, or else long term involvement in the Feldenkrais Method. 

© Copyright 2015 Steve Hamlin  www.mybodycanlearn.com