The Pain Free Athlete :: Hip Joint

At 38 I was diagnosed with severe (grade 4) bone-on-bone left hip osteoarthritis. Too young for a joint replacement, I was advised by my doctor to reduce my activity level and avoid any movements that hurt. When the pain was excruciating enough, and my activity limited enough, I would be considered for a new artificial hip.

Osteoarthritis is a thinning of the cartilage within your joints that creates symptoms of pain, swelling, and stiffness. In the image to the right, the left hip is affected with osteoarthritis. The osteophytes labeled in the image are bone growths that often accompany cartilage degeneration. Osteoarthritis is not a necessity of aging. It can be overcome without drastic surgery.


What I want you to most consider about the image to the right is why does only one hip have osteoarthritis? Why did that hip alone become bone on bone?


We often accept that osteoarthritis is the cause of our pain and the reason why we need a hip replacement, but we fail to consider why the hip cartilage broke down in the first place. This is understandable, as we just want to move forward with a treatment plan that will eliminate the pain. But aren’t you just a bit curious as to why only one hip was affected–and how you might prevent this from happening on the other side? I was! I wanted to know what was different about my left hip from my right that contributed to the degeneration of my joint.


The Pain Free Athlete :: Move Your DNAIn her book, Move Your DNA, movement biomechanist Katy Bowman explains, “Every unique joint configuration, and the way that joint configuration is positioned relative to gravity, and every motion created, and the way that motion was initiated, creates a unique load that in turn creates a very specific pattern of strain in the body.” So, how your hip, or any joint, is positioned–aligned or askew–determines the load and strain on the joint structures that are generated with movement.



What is slightly misleading about the image of the pelvis above is that the pelvis is depicted as being perfectly symmetrical. All three bones of the pelvis–right and left hip bone and sacrum–are aligned, and the femurs are balanced without rotation. In my experience, clients with hip joint deterioration do not have a neutral and level pelvis or femurs. Rather, their structure represents something more like the image to the right. In this view of the pelvis, you can observe that the right hip bone is higher, the right hip joint looks bigger and closer to the screen, indicating some possible pelvis and/or femur rotation, and the bottom holes in the pelvis are slightly asymmetrical, indicative of a pelvic tilt disparity. Each of the three bones on the pelvis can move separately and can become fixed in an unbalanced position. When this happens, movement is altered and joint deterioration can happen. This is what happened to my hips, with the left hip being positioned in a more compromised posture.


When the bones are not in proper position, stress and friction develop within the joint with motion, which wears away the delicate soft tissues. I was told I had a hole in my hip. My misaligned hip bone had worn through the cartridge in one spot. If you take your fist, put it in the palm of your opposite hand, and continually rub the same spot, eventually the skin will turn red, then bleed, and so on. To fix the problem, you’d stop rubbing the same spot.


To remove the continued stress on my cartilage, I had to move my hip and femur bones to take away the pressure and continued damage. The bones are positioned by the muscles and soft tissues. Muscle imbalances create postural asymmetries. Therefore, corrective alignment exercises, which move the bones, can relieve the symptoms of osteoarthritis. This misaligned posture is the underlying cause of the joint’s decay. And just like any other structure in the body, cartilage can regenerate if the environment is suitable, meaning the continued rubbing from the bone is eliminated.


Since embarking on correcting my alignment, I have not had a joint replacement and no longer have debilitating hip pain. Rather, I have strengthened my body and gained confidence in its capacity to heal and support my athletic and everyday activities. After four joint surgeries, all on the left side, three knee and one hip arthroscopy, I am no longer anticipating the further decline of my body, but rather enjoy greater resilience.


When evaluating your treatment options for osteoarthritis, consider the most basic first: your structural alignment. Postural correction can alleviate your symptoms without drugs, injections, or surgery! Isn’t that worth a try?

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