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Hip Pain? Cant sleep on your side? What is going on and what can you do about it.




Pain on your hip when sleeping on your side? Hips aching the day after being on your feet a lot?


If you are experiencing lateral hip pain (outer side of your buttock and hip) and have been on a fitness kick recently - then you probably need to now about load management and the tolerance and capacity of tissues - and i will try to explain this using coffee as an analogy. 


Now i am sure you think that it is only serious athletes that need to worry about this - but its not.


I can not tell you how many times i have had to have a conversation about lateral hip pain with patients who have come in thinking something is out of whack and needs to be put back in - only for them to discover it is from doing too much too soon on their fitness kick and overloading the tissues.


One of the most common presentations for this is women who have started to take up walking again in there 50’s or later  - and have gone from the occasional walk on a weekend - to walking 5 times a week.


This sudden increase in exercise is to be commended for the effort and motivation - but for some of the big muscles of the hip - this sudden increase in load is too much - and pain and aggravation is often the result. 


So how does it work.


Lets use the coffee cup analogy and see if it makes sense.


Lets say the muscles on the outer part of the hip have been use to just holding you up, walking around the house and work, sitting down and getting back up again, the weekly grocery shop pushing the trolley, and if your lucky a walk down the street for a coffee and a chat with some friends.


Then one day you wake up with the motivation to get fit and start walking 5 km 4-5 days a week, on top of the usual stuff you are already doing.


Great  - but its asking a lot of the tissues that havent seen this sort of demand for the last 20 years. They can and will adapt, but they need some time to do it well.


Now , lets think of the muscles and tendons of the hip like the takeaway coffee cups lined up on the counter of your favourite coffee shop. 


(My wife loves “Harley and Hem” in Orange if you havent tried them!) 


You have the Piccolo size, the small and then the large (and in some cases the Jumbo! depending on what sort of day you are having).


To start with the capacity of your hip muscles is like the piccolo - its a cute little size, it does the job and gives you your caffeine hit - but it doesn't hold much before it starts to overflow.


Basically, your hip muscles and tendons do the job, your happy enough with them - but when you just want a bit more from them  - there is no capacity or room for it to cope with any more.


So the solution is to upsize - to a small. 


With your muscles and tendons,  the only way you can do that is to slowly expose them to just the right amount of load, over a period of time, with adequate rest for recovery. 


However - if you keep trying to overfill (or in the case of muscles  - overload) you may end up with a mess. 


So how can you upsize safely then?


The good news is that you can do so in several ways - but a lot of it comes down to load management.


What is one of the simplest solutions that everyone can try?


Use rest days . Start with a walk of your chosen length and do twice a week for 2 weeks, then if no sign of discomfort other then muscle use, increase to three times per week for 2-3 weeks.


If you then want to push more - you could increase the length of one of your walks, whilst keeping the other two the same, and so on - all the time just monitoring your body for how it is coping.


And remember, its not just the walking you are monitoring - what if you had a huge weekend in the garden?


Do you think you should still do the same amount of walking in the week following that - or could you perhaps shorten the walks or have another rest day?


I know its not sexy - but it works.


If you are already active and have been doing a lot of exercise already and only recently become sore  - then perhaps the 24 hour rule  is worth paying attention to.


Basically you pick the load (or exercise amount) by how you feel the next day following the exercise. 


If you feel no worse, or better, the load (exercise or reps etc)  was fine and can be continued with.


 If you feel worse - it was too much, and you need to recalibrate, use rest for recovery and adjust the load back a bit. 


Simple right.


Great - and before long  - you might just have a large coffee instead of a piccolo.

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