I have been asked recently in a massage continuing education class if I have many clients who have had hip replacements. I answered I have a few clients in my practice who have had the surgery. Some the older approach where the muscles are cut, and the newest approach that have been performed at John Hopkins where they are not cutting the muscles and the recovery times and range of motion are incredible!

The illio-femoral joint is a deeply cupped ball and socket joint with very strong muscles attached to it. Consequently many of the impacts and pulls that it experiences creates pain and dysfunction distally from it or superiorly in the lower back. Dr. Ida Rolf believed that the hip joint was the greatest determining factor in postural symmetry. 

For any massage therapist who is pursuing insights into the hip and lower back pain in a massage continuing education course, should explore methodologies and approaches that bring balance into the joint because of the long term wear and tear that usually leads to the necessity of a replacement. Often times when I ask my clients if there was anything that precipitated their painful condition that necessitated the surgery, there was no determining factor that could be addressed that was responsible for the replacement…only conjecture. So, its extremely important for the massage therapist to begin to educate their clients to the necessity of focused work in the hip as a preventative measure.

How did we end up in our society with so many hip replacements in individuals that might be considered elderly or athletes who participated in violent sports that accelerated the demise of their hip joint? The problem in diagnosis of the situation of hip replacement is that there isn’t always a correlation between overuse and those that have been overly sedentary.

 There are about 30 muscles that are responsible for the hips symmetry and if we want our clients to have  a long life with the biological equipment in tack, its important to keep the muscles balanced. So, I can’t tell you how important it is to attend the hip and keep it balanced for its longevity. You should throw in sessions where only the hip is attended to for that hour or hour and a half in your sessions.
 

 If you opened your anatomy books to look at the joint, it isn’t always easy to visualize the three dimensional aspects of the joint. Get in front of a skeleton to really grasp the concepts of balancing the “figure eight twisted” hip joint. When you look down at the hip the iliac crest is angled at 45 degrees moving out from the spine and widening at the front. The ramus is wide at the back, moving medially as it comes forward until it meets its opposite at the pubic symphysis which is a fibrocartilage disc. Each hip is also joined to the sacrum at the sacroiliac joint.  TO BE CONTINUED.