Physio Myth Busting

My Hips Feel Out of Alignment

  • This is a common statement that patients present with, and although a common notion, simply put your hips (for the most part) do NOT go out of place.
  • If your hip was actually “out of place” it would be dislocated, which would be extremely painful and you would be in the emergency room, not a physiotherapy clinic. FACT
  • When people say their hip is “out of place” or “out of alignment” what they are really experiencing or meaning to express is one sided low back pain.
  • It is usually a perception of their back being locked, not moving properly or the unilateral imbalance throwing off the sensation of where their hips are in space.

I Slipped my Disc

  • A disc can not, does not and will not slip.
  • To disprove this myth, we must first understand the anatomy of intervertebral discs, as it sits within the spine.
  • The disc itself is tightly held between the vertebra (your spinal bones)
  • There are many, many connective fibres called sharply fibres which act as anchors, weaving the disc into the bone like small anchors.
  • Secondly, the disc itself is designed to act as a cushion between the spinal bones allow for shock absorption and improve range of motion.
  • The inner contents of the disc is a gel like structure which gives the spine much of its flexibility and strength.
  • If you think of the disc as a water mattress, loading the spine with repetitive, sustained or excessively loaded flexion will cause the water-like content of the disc to be displaced posteriorly.
  • However, as the disc contents is fluid, loading the disc oppositely – with extension, will work to ‘push’ the contents back to their usual position.

I Have Weak VMO’s

  • VMO stands for vastus medals oblique and refers the obliquely arranged fibres of the vastus medialis muscle, which is the medial muscle within the quadricep group and sits to the inside of the knee.
  • The issue with this myth is referring to the VMO as a seperate muscle that you can strengthen in order to aid in knee stability or improve patella tracking.
  • In the human body, joints move towards strength. This means that whatever muscle/ muscle group is exerting the greatest force when shortening, the joint will go in that direction (much like in a tug of war).
  • If in a squat, your knees cave in, they are tracking medially, this means there is strength pulling the knee medially. But isn’t the VM (and supposed VMO) medial to the knee??
  • If the medial part of the knee was the weakness, your knee would move away from it.
  • The weakness is therefore lateral (on the outside).
  • The culprit – glutes!
  • When observing the knees “fall inwards”
  • In most cases, when the femur rotates inwards/medially and adducts, it makes it look like the patella (or whole knee joint) has moved inwards, however the knee has actually relatively remained in the same position and it is the femur that has moved- the weakness causing this- glutes.
  • Here, the adductors and hamstrings are acting as hip extensors and over powering the glutei in this role- leading to the internal rotation of the femur.
  • Therefore rehabilitation should focus on the glute muscles.

Treatment Through Physiotherapy

Physiotherapy has several goals including promoting healing, reducing pain, avoiding aggravation, optimising physical function and global strengthening to restore normal movement patterns. To see how we can help you with your back pain  BOOK ONLINE TODAY

For more information on Hip Pain – CLICK HERE 

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