Knees don’t wear out because they are old. Hips don't wear out because they are old, and the same can be said for every part of our body. But when you visit your doctor because you have an unexplained pain in the hip, and he or she then provides you with an X-ray or MRI or some other diagnostic test of the affected hip joint, you discover that your are “bone on bone”. Your hip is worn out. And like many, you find you have a hip replacement recommendation in your future. In fact, great orthopedic folks will often recommend putting off such a procedure until the last possible moment, until you can’t stand the pain. Father time has worn out your poor bones, and you need an upgrade to something titanium, or something ceramic, or something synthetic that acts like bone. In fact, there are some really amazing things that physicians can do with joint replacements these days. These types of surgeries have really changed for the better over the years.
So why are we replacing joints? Oh right, cause they’re old and worn out. A quick question for you…How old is your other hip? If age, or time, was the problem, shouldn’t we see the other parts of our body start to need the same level of replacement? Do we come with an expiration date like a carton of milk? It seems to me that we might be missing the cause of the problem while we offer solutions that prevent us from problem solving. Something like age, doesn’t actually explain the wear and tear, but old things do break. So I guess it’s something. However, the quick surgical route to removing pain may not end up being the easiest.
I had a client years ago, who happened to be a Doctor, and he came to get therapy for his own hip pain. After describing the upcoming treatments, and eventual hip replacement for his “old hip”. I asked him about the cause of his hip problem. And right on cue, he said “ it’s bone on bone, I’m just getting to that age”. I asked him what he expected from me since “bone on bone” is the default way of saying that this is a permanent condition and cartilage doesn’t regenerate. He explained that he was just looking to get some movements that created relief for the next few months while he waited for his eventual hip replacement. In his mind, the cause of his problem was no cartilage brought on by age. And at some point, he might even have to get the other hip replaced.
In the course of our time together, I noticed that he was walking with a limp. I asked him about it and he said, “of course I have a limp, I have a bad hip”. What he didn’t realize was that he was limping as if the other leg had a problem. He was limping on the wrong leg. He was actually carrying his weight on the side that had all the pain and was apparently, completely, unaware of it. He was overloading his painful side with his imbalanced gait pattern (walking pattern), and was actually wearing out the hip, creating the “bone on bone” condition. I asked him “Doc, is it possible that the limp is actually causing the joint to wear out, and not that your just old?” What we found was the real cause, and now I just had to figure out how to let him feel it.
So here’s what we knew: 1) The Doc believed his pain was coming from not having any cartilage along the surface of his hip joint. 2) Cartilage doesn’t grow back and therefore he believed he was in line for a hip replacement. 3) I had to illustrate that the pain was coming from the way he moved, rather than the condition of his “old, no cartilage hip” if I was going to be of any help to him.
So here’s what we did…
I asked him to walk across the room and feel how his feet were hitting the floor. I wanted him to clue in on what part of the foot was hitting the hardest, and whether it was. equal on both sides. I wanted to know if he could begin to feel “the limp” which was plain as day for everyone else to see. After a few times going back and forth across the room, I asked him to put his hands behind his head and pull his elbows back. This has a couple of quick impacts on the body. First, it will change the position of the upper body, thus changing the curvature of the spine slightly and the position of the pelvis. And second, it will temporarily force both sides of the body to bear the same amount of weight while he walks. I asked him to walk across the floor in that position. He took about three steps and stopped, lowered his arms, turned around with a look of disbelief and said, “WTF was that…the pain in my hip is gone. What did you do?”
I said, “Well, we didn’t grow any cartilage back. We just took away your limp… which took away the imbalanced wear and tear on your hip joint…the imbalance is what was causing the pain.” The problem wasn’t the condition of the hip. The problem was how that hip was being used. And the cool thing is that once the imbalance was addressed, the movement produced no more pain. That episode was 24 years ago, and the doc still has his original hip. Great work Doc!