Hip impingement, labral tears and hip pain questions answered

Hey, clinicians, before we start, I'm going to draw your attention to the premium version of the podcast that we have that we released back in January. It's going very well. It releases once a week and it's all the stuff that you care more about than some of the general conversation you might get in some of these free version podcasts. So it's about 15 minutes long. We do case presentations, all of the stuff that we tried, things that work, things that didn't work, and a little bit more specific to you and the things that you wish might be in there too. It's very affordable. You can quit at any time. There's a link in the description below.

Go check it out. You'll love it. Now onto the podcast. You're listening to the Restoring Human Movement podcast, where movement experts discuss the latest evidence-based practices to help you and your clients move with mastery. And now, your host, Dr. Sebastian Gonzales. Hey everyone, it's Sebastian, your host with the Restoring Human Movement podcast. Thanks for joining the Movement Movement. This is your first time on the show. Welcome. You missed a lot. Please go back in the archives and check out all that we have to offer. This is around probably episode 250 plus or so. And so we're going to change the format slightly today. This is still intended for lay public, for everyone to really understand a little bit more about their body and just understand that you can improve. You can get better from hip pain and back pain and knee and so on. Actually, all you kind of need is a little bit of guidance to do the right thing and maybe debunk some myths along the way so you don't do the things that are, let's just call them ineffective. Because we've all experienced ineffective treatment and programs and so on.

I'm not going to intend to know everything today. This podcast is mainly just to share the things that I've found to work in our facility in Costa Mesa, California. We're going to cover the topic of hips today. We've covered it a lot in the past. There's a ton of podcasts that we do have where I've interviewed people. I've talked about privately as this one-on-one one will be today. But today we're going to answer some questions. So on our YouTube channel, we have, gosh, I think we have 66,000 followers on YouTube and we publish videos three times a week at the moment. They're on a variety of different conditions as you can imagine. We're going to talk specifically about hips today.

So I'm going to run through some of the questions that we have because there is really good questions in there. But also, to be 100% honest with you, it's hard to answer these questions on YouTube because we can't really give direct guidance to people that we have not really examined. So I thought I might take these questions as kind of answered as a theoretical thing today. And that might be more helpful to everybody collectively. So you figure out what to do with your own body. So, uh, the first question is, is, uh, it was about a video that we talked about hip impingement. So they asked, is it possible to have hip impingement without bony changes?

Uh, short answer is yes. Um, so you can create pinching onto the front part of the hip. Actually, I should probably explain first what hip impingement technically, uh, is because it might give you a little bit more context. Um, usually it's more qualified as a pinching feeling when things actually physically come in contact on the front part of the hip, uh, usually in the groin area. Most people do not have piriformis buttocks or back pain associated with it. Although in an advanced, um, in, in advanced, uh, types of scenarios, they can, because a lot of compensation has occurred. Um, but you don't necessarily need to have bony changes with it. There was an interesting study that was done, uh, quite a few years back. I want to say under 10 years ago, but it was, uh, more than five. Uh, it was a radiology study where it was addressing mainly, they looked at x-rays and they checked to see, there's some signs you can kind of see on x-rays that would in theory see that there would be impingement happening. And they, uh, correlated it with, um, patients, uh, subjective, uh, feelings of the symptoms. And so what they found was that with an anterior pelvic tilt, with the pelvis, uh, kind of dumping forward, uh, almost as if you had a bucket of water as your pelvis, if the water spilled forward, there was a higher probability of impingement symptoms with a certain range of squatting. Let's just say full depth squat. Um, whatever that means to you, let's just pick an arbitrary number, 90 degrees squatting, a pass parallel. So there was a symptom of impingement with an anterior tilt and going down to that depth. Now, if you add a posterior tilt, which is dumping water out the backside, or if we were to coach the squat kind of as a simple fashion of do less, don't work so hard, um, make it sloppy squat, how you shouldn't type of thing, then actually the range improves dramatically. I want to say it was like five or 10 degrees. It was like enough to where basically the person could get to that same depth without having any symptoms whatsoever. Eventually they would get symptoms to go a little lower because it only increased their pain-free range. But the question is, is can you have hip impingement symptoms without bony changes? And the answer is yes. Um, there's obviously things that can be associated with hip impingement symptoms that are bony changes like, uh, cam deformities, which is like an oblong shaped, uh, part of the, uh, femoral head and neck, which just creates a, it's a change in bony architecture.

Um, an interesting thing that they had, um, years ago, again, another radiology study is that they were in, by the way, um, look these up on your own. I don't have the reference to it. I read them and I throw them away most of the time. Although sometimes I include them in articles that we do write, uh, on P2 sports care, search hip impingement. I probably referenced it somewhere along the lines in there. Um, so they were checking to see, um, kind of when people develop these cam deformities or these oblong shaped types of, uh, uh, femurs. And so did it relate to, uh, actual symptoms or is it something that was developed along the line? Um, I want to say there was something to the degree of, it was around the time where growth plates close. So I want to say it was a, I think they studied a bunch of soccer kids. Uh, I don't know how they, uh, got the parents to agree to giving, doing x-rays to kids that don't really need it just for a study, but apparently they did it. I think they did it.

That's how they did it. Um, so anyways, they checked some kids like, you know, say when they're 12 and they checked them when they were 14. And at that point, when the growth plates started to fuse, they developed the cam deformity. And so it's more of thought to be something that's associated with active younger kids or pre-pubescent kids, even teenagers that start to develop this oblong shape as a, um, as an adaptation to their activity level. I'm not saying their activity level is necessarily bad. Um, although we could argue the point that maybe, uh, too much like things like club sports and so might be something that actually would make the, make the bones kind of respond in such fashion.

I don't blame club sports, but, uh, I know that when I was growing up, we had options. We didn't have to do the same sport all the time. We use, it was optional with our one to play baseball in the summer, or you can just go hang out the beach or play a different sport. And, um, now it seems like it's not like that. And it seems like every kid plays a year long, same sport, maybe two sports. In my opinion, it's a little bit nutty. Um, but either way, yeah, you can have impingement symptoms without bony changes. Let's go. That's a good question. Uh, good luck with that. And let's find another question. Another question we have is on hip labral tears. And this was specifically on that video, but, uh, this question would probably be moved across the board with, um, lots of hip and actually, uh, bodily problems and pain and aches and pains, uh, discussion. So the question was, is what sort of activities would you recommend a patient avoiding or recommend they do, uh, if active hip flexion increases pain, should they avoid it? So this person's referencing again, if we're talking about labral pathology, most of the time these people actually, well, I'll say the most common type of labral pathology does not like hip flexion, which is bringing the knee to the chest and it doesn't like the knee crossing midline. And it usually doesn't like, uh, the knee diving into the foot diving out. Um, this, these tests are called, um, scours test. There's Fadir's test, uh, and usually for bears tests, which is not necessarily the same mechanics I just spoke of.

But if you Google all these terms, it'll probably pop up as like a common thing that someone should be doing when they examine your hip. Uh, these are some of the standard orthopedic tests, the hip, there's a lot more that you could do. So usually these tests, what they find is what are the tolerances of your hip? Um, what is your hip like at the moment? What is it not like? Uh, in the same thread, we can probably test out things like active and passive ranges of motion, uh, such as extension, flexion, cross, crossing midline, which is adduction and then abduction, which is kind of out to the side and then kind of internal external rotation. Um, the hip has the possibility to move a lot. It's a ball and socket joint. And so I kind of take the approach of just finding the, finding the mechanics that generally make it worse. And then we just think, huh, if flexion or bringing the knee to the chest actually bothers the hip, wonder what the opposite direction would do. How does that feel? And so usually we'll test that and they're like, that feels fine. So what that would indicate to me is there's, there's a direction it doesn't like in the direction that it does like. Um, usually when we work with people, when our medical team workers, works with people, we, um, try to establish three things on day one. Number one is what, what is a good diagnosis and does it fit the mechanics of what is going on in this exam? If this person had, let's just say if that had an infection or we, if our diagnosis was a hip, um, joint infection, not to say we see those a lot, nor do we treat them, but it only hurt with certain ranges of motion. Those mechanics wouldn't necessarily make sense. Um, it would probably hurt at all times the day. They'd probably have a fever and it wouldn't matter which drink, uh, direction we actually move the person into, or they move themselves. It would hurt all throughout because it's more, uh, like a fire burning in there. Now, if it's something more, a little bit more mechanical, then we're going to find some type of mechanic that makes sense with the diagnosis. So if bringing the hip to full flexion bothers the person and we have a painful clicking and popping, then it wouldn't be uncalled for to say maybe a labral tear or a label pathology of some sort might be in question. Now, remember I said painful clicking and popping, not clicking and popping because we have, uh, dancers come in here where they actually pop their hip a lot. It's just a thing that they do. You can visibly see it on some people.

It doesn't hurt. They actually kind of like it. Um, it gives them some relief and that would be a not painful clicking and popping. There's also differences of like clunking and clicking and popping. They're kind of different. Um, so I usually qualify those, but should this person necessarily avoid flexion of the hip if flexion bothers it? Well, um, there's three things that we address. Again, number one is the diagnosis mechanics and then figure out what first aid or what type of movement might make them feel better. In this case, exposing them to a hip flexor stretch or hip extension might actually make them feel pretty good or it might not. Um, some label tears don't like any movement. Um, some of them like it. Uh, and the second thing is what is this person doing throughout the day that is increasing their problem or making their problem remain because we do know the body just heals itself generally if you just let it do it. And the third thing is, is, is there an exercise that we can, uh, comp compliment, they can compliment the problem to support it, to make it so they don't have to just avoid activity because steps one, step two is basically, here's what you have. Don't do this.

And step two is do, uh, um, or sorry, step one is here's the diagnosis. Uh, here's what you do to re to make it feel better. Step two is don't do that. Cause it'll, it'll pick the scab. Step three is, Hey, let's actually build some building blocks and to be able to do everything again. Um, so if this was someone who really didn't like hip flexion, I'd probably tell them to let's extend the hip a little bit, maybe throughout the week, go on walks, uh, stretch the hip flexor. Uh, second part would be, yeah, there's certain, there's certain activities like hip flexion that let's just not avoid, but let's not seek. Um, the recommendation of walking is going to automatically get them away from sitting more, which is hip flexion. Um, I wouldn't try to stretch it into hip flexion because people do things like pigeon stretch would be out. Things like forward folds would probably be out. Um, uh, crossing the, the legs, uh, as you sit would probably be out. And, um, but I wouldn't make yourself neurotic about it. Just don't seek it and then do other things instead of it for a bit. Uh, basically changing your life just, just for a week. You don't have to avoid it forever. If you sit for work, think about standing. If you don't want to stand in your sitting and you're on a laptop, just work on your belly a little bit. Um, maybe if you're on a conference call, uh, on zoom, cause people do that a lot today. Now just go on a walk during which, or pace your house. There's a lot of different ways to, uh, manipulate, uh, exposure to hip flexion. The third thing I'd probably give them, uh, I'd probably give them something that compliments and deloads the hip flexor, which makes it so the hip flexor doesn't work quite as hard. Um, glute exercises should work very well. Usually ab wall priming exercises work really well. Uh, banded bridges are one choice. Uh, hard style planks is another choice. Uh, keep in mind. It does depend on how it gets coached and how you do it. Um, it's a misconception that people think I have to fight through pain to get rid of pain. Um, no, these exercises should not be uncomfortable at all. It's challenging, but it should not be uncomfortable to the fact that you feel your hip flexor when doing so. So, uh, that was a good question. Um, I hope that helps and let's move on to the next one. Another question, which is a really good one is my left hip clicks. It's painful. Sometimes should I ask for an MRI or MRA? I'm back pain. And if the hip isn't stable as it should be, would it be a, uh, would I be able to play or if the hip isn't as stable as it should be, could it, could it be, would play a huge factor in back pain? No. Uh, so I think let's see, would the hip be unstable, create some back pain is what I'm interpreting. Is it possible my back is compensating for my hips? Um, because I don't have, uh, I don't have scoliosis. Um, maybe, um, I know my hip clicks and, um, it doesn't necessarily, uh, result in pain. Uh, imaging is always helpful. Uh, it's not necessarily needed. And I can strongly, uh, I have a lot of situations where we've worked with clients where things are going really well. They have this kind of thought in their mind of, I think, what if something else is there, you know, what if something else is there that I really need to address that I need to know about? And there's nothing wrong with that.

There's nothing wrong with getting imaging. Um, but it's complimentary information. Uh, as I mentioned in the last thing, uh, about hip flexion is we can, we can sort out most people's hip problems and develop programming around it without really having to do too much imaging. Uh, but usually, so we kind of a saying in the, in the medical profession is you get imaging when you feel the imaging will change your course of action. And so if I'm looking for cancer, I might get a certain type of image or scan to make sure it's not there because if you did have cancer, we would send you to the appropriate person. If you did have a fracture, we'd be looking at a certain type of image to rule out a fracture, but we need to be suspecting a fracture. Um, or if you're not responding to anything that we're doing and things are like I mentioned earlier, like it's kind of like everything hurts. It's always there. Um, there's not a time in the day that it actually feels like even a bit better. It's not activity dependent. Then, and you have a fever. It's like, well then yeah, we should be looking at other complimentary, uh, images, scans, blood work, things like that. Like there's other things to be looking cause they're all complimentary. Normally things like a good, uh, thorough examination and history taking process can help out to screen if you actually need to do any of those things first. But just because people have pain is not a definitive reason to get an, uh, an image done. Now an MRI, it definitely can be helpful to the hip. Um, it's not the standard for things like a labrum if we're talking about labrum. And in that case, there is some, uh, some injection required. Um, to my understanding, it's pretty expensive. Um, uh, I had a colleague that, that went through with it and they said that was the most painful thing they've done. Um, it ended up being a negative image, which made them feel better knowing that it wasn't something they had to do something dramatic to actually change. But, uh, it's all up to you really. If you feel like you want to get those done and you have a team member, a medical, a medical team member that can help you get that image, you can get it. Um, you probably will need a referral for it. Um, but referring someone to an image means you can get the image done. It doesn't mean your insurance will cover it. So we've had people we've worked with where they're like, well, I want to get the image done. I really want it done.

Can you refer me for it? And we do. And then they're like, well, the insurance won't cover it though. It's like, well, you know, it's all in your power. You can pay cash if you want. Like they're not as expensive as you think. Just call around and ask what they're, uh, what they're willing to, if they're willing to work with you. Um, you'd be surprised, uh, how much better you'll mentally feel if you put things into your own control. Um, yeah, the, the, the insurance will do what they're going to do. All right. But this is all under your own power. You can, you can pay for it if you want. Uh, I paid for an MRI cash for my back cause I wanted to know something. Um, so the second part of this question is, uh, I guess it, it depends. Uh, so back pain can come from the hip, but also hip pain can come from the back. Um, we had a couple of cases this last week where they did have back pain. They had back pain and nerve pain when walking and we get, we gave them a hip intervention, which was simple hip flexor stretching repetitively. And they were able to walk around for previously about 30 seconds. And after that two plus minutes and even pace around to have a conversation with us about, um, you know, about what's going on in their life. They didn't really have any problems. So in that case, a hip intervention helped deload the back, which can create the symptoms in the back can create hip symptoms. In this case, it can create things into the groin, which seems like a hip problem, which maybe it is because it rooted from the hip. In this case, it can produce stuff into the gluteal region, but also down into the side of the thigh and sometimes into the shin. And it's important to note that things that are referred down into the thigh and into the shin are probably not pure hip. Um, addressing the hip and mobilizing that might be important and it might be part of the puzzle that we need to solve, but it's not the whole thing.

Anything goes below the knee, especially in a tingly burning, uh, numbness type of fashion. Like it did something coming from the spine probably somehow. Um, now is it the primary cause? We don't know. Usually a good history taking and thorough examination could help imaging maybe, but imaging doesn't stress test the area to figure. I mean, we can just have this person walk and generally see that walking creates pain, but if he rounds his spine and does like a, kind of like a, a walk, like he's walking in a, uh, with a walker, it actually all of his pain goes away. So changing the posture changes his sensation. And so it's load testing and that's not necessarily done in, in an image. Now the other part, uh, or we mentioned that that's where hip pain can create the back, uh, but also back pain can create the hip. Um, I, uh, I alluded to this earlier, but there are parts of the spine, uh, notably the upper lumbar spine, which can actually refer directly into the area where, uh, people have gluteal pain, where they have groin pain. They can have a pseudo or fake sports hernia presentation. They can have adductor tightness. They can have hamstring tightness. Their hip can generally feel stiff. Um, I met a lot of, uh, dancers that feel like they want to pound their hip because it's a deep ache in the upper glute. All this can be spine referred.

It's not always, but it's a high probability of it being. So, um, now not everybody will have back pain associated with hip pain that is referred from the spine. Uh, I just started writing a, uh, a book I've written, I've written a couple of books. So they're somewhere in print copy and somewhere in like e-version that we have on our, on our website. Cause, uh, I want the, I want the power to be able to change them as I learn more, as I want to reword things and improve everything for everybody. So, uh, this one is mainly on hip diagnosis and how to really boil down something like the Dr. Google's big old laundry list that comes out that just confuses everybody.

And so, uh, in this scenario, there's, I usually boil it down to three different types of hip problems. There's internal hip, external hip, or referred to hip. Internal hip is like your labrums, your impingements, your in, um, like deep inside hip architecture stuff, even like bony changes, arthritic changes. Those are internal hip. External hip is the things that most people kind of consider my hip flexor, my hamstring, my glute, my adductors, like, um, things like that. Your syndromes, usually those are external hip. And then there's referred to hip, which the spine can refer to the hip and the hip does not have to actually, the spine does not actually have to hurt if it refers to the hip. A good exam will tell you all this. Um, also organs can refer there. Uh, some people end up, um, finding things like, I think it's, um, uterine polyps and I forget, uh, uterine cyst rather. Um, and there's a bunch of other things. So there, there's a reason to be examined thoroughly with that, but, um, the back in the spine, the rest of the body can, can compensate. The longer you have something, I don't want to say it's impossible to overcome stuff like this. If you've had it for a long time, but the longer you wait, the more the body will start to compensate. Um, and it'll start to ingrain these motor patterns and, um, it will adapt. Uh, we had a gentleman come in the other day that he had longstanding, uh, hip pain on, uh, on the left side of his body. And then once we watched him move and do some exercise, we actually saw that his left musculature on his back actually was way more developed on that side. And so, um, this has been going on for a long time. Um, we know from a bodybuilding experience, probably a lot of us that muscle does not grow overnight. It happens over time. So this is something that happens over time and you just have to reverse engineer things. So, um, I think it's always best practice to address things quickly and early, uh, have a team approach who can help you identify these things, movement compensations. If you do have them, um, just, I know everyone's like you want people listen to the podcast, like you're, um, what's, what's the one with the, the, the biohacks, you know, it's like, Oh, improve your concentration by using this one type of rare, like, uh, fruit from the Amazon. Right. And so everyone's in these body hacks, you know, these biohacking and so on. Um, consider improving your movements and having someone help you identify them. That is the biggest body hack biohack in the whole world, but it actually has a long-term effect too. Um, so the body's one unit, it works together. It's not an isolation. This hip or back is probably going to affect your foot, your knee, your neck, uh, and so on. And in things like your imaging might show things like scoliosis because of that compensation. Um, in that case, the scoliosis might not be a primary problem. It's a secondary problem. So the body's one unit, you know, um, a good program can help you, uh, a good trainer or a good teammate on your medical team can help you identify movement compensations. And then a good program that you just do that, you know, how to do, and you can do it all on your own, but you know how to, you need to know what to do and how to do it and just do it. And then that's the way you reverse engineer this whole process. Good question. Let's get on to another.

Here's another question, which is, uh, I like this one. This one's, uh, it's simple, but I think it, it can help out a lot with understanding, um, why your body's work, uh, functioning how it is. Um, I'm an athlete, uh, and, um, I started having some hip pain when I do stretches, the pain in the area gets better, but when I jump again, it comes back. So what do I do? Um, here's the thing is a lot of times people will get a little bit of, they'll get some misunderstanding of why their body feels okay at rest, but it actually becomes painful again. Once they jump again, let's just say, um, we had a gentleman come in before that he had, he had knee pain, so not too much different than back pain, just different application.

Uh, he took it upon himself to stop running for three months and he felt fine during those three months and he did everything else he was doing, but the only thing that was really bothering, bothering was running. And then three months later he picked up running again and it was exactly the way it felt before. And I know a lot of you have probably had this same experience as well. Uh, I know that I've had it over the course of usually waiting a week where I'm like, ah, my hamstring fit a little tight from baseball. I'll wait a week, not do anything. I'll play again on Sunday and it's there again. Um, it's kind of like this phenomenon like that should have worked. Like why did rest not work? Um, why did stretching not work? I thought it would stick. So, um, there's something called the functional envelope. And so if you guys go through Google and you look up functional envelope, physical therapy, you'll probably find something. Actually, let me, as we're doing this, I'll just write functional envelope, uh, physical therapy. Let's just see what pops up and I'll kind of direct you in the right way. I go to Google images and they'll be like these curves. Um, there's one in particular, it's from researchgate.net.

It says four zones of loading. Um, and so there's, if you click on that, you'll find that there's four basic, um, ranges. There's the zone of sub physiological underload zone of homeostasis zone of super physiological overload in the zone of structural failure. Um, this one's a lot of big words. I know that, um, I'll put it in perspective here. Um, the one at the bottom sub physiological is basically you're not doing enough to do anything. Actually you're getting worse. Probably the homeostasis means happy zone. Super physiological is like you've been challenged, but you nothing broke. Uh, and then there's the failure, which is like tissue disruption, like tears and so on. And so if you go down a little bit in the related images, you'll find another image, which has a similar curve and it has the same line. Yeah. It came from the same study and, or the same paper. And it says, has something called the functional or the envelope of function. And so if you click on that one, it has this, um, uh, graph where there's there's on the left side is load. The right side is frequency. And so it puts in perspective, a couple activities that we might do, you know, and everything under this line is the happy zone. Like everything is fine. It doesn't really hurt to do. Um, so I rested it for three months. I didn't do anything outside this line basically. And then I did something over the line that started to bother me. Uh, you'll see at the bottom left where there's low, low, low frequency is sitting into a chair. That's, that's, uh, I mean, I mean, this is the nicest way. Most of the world is under loading their body. They're not doing enough to be physically prepared, including myself. Um, I think the, um, uh, I think the rough estimation is, uh, uh, for cardiovascular fitness is, uh, 150 hours minimum of some type of, uh, moderate range cardiovascular fitness, like a week. Uh, it's hard to get, you know, three to four days of, of moderate heavy load with resistance training. And, uh, I don't even do all this. I should, but there's a lot of people that sit in their chairs and they're hanging out. They're wondering why they're not getting better. Um, this is why you're deloading your body. And so then there's this, there's all these other activities are under this line, walking 10 kilometers, two hours of basketball, bicycling for 20 minutes, jumping two meters in height. You see each one of these things is different timeframes. Walking 10 kilometers takes a very long time. Two hours of basketball is two hours of basketball. And then there's jumping, which takes like, like seconds, right? Milliseconds probably. And so load is higher with the jump than it is with the walking, but also frequency changes. Everything's still in this happy zone. Everything's good.

But if you start to move out of the happy zone and there's a little bit of a problem, let's use this person, um, uh, as a, although we won't use the hip, we'll use the runner as the example. So my hip hurts when running, I stopped running. So now he's under the level of the, of the line. And then he decides to then go well past the level again, which is going to be running, you know, I think five miles when not running at all. And so he might've been okay running three miles or 3.2 miles, but then he gets 3.3 and he's past the line. And you can't, if you build past the entire line, if you just push through, push through pain, it'll be okay. Right? No, you might hit a zone of failure, which, um, failure is tissue disruption or failure or tears and breaks and so on. Stress fractures are a prime example of this. Um, so there's, uh, when you, when you're rehabbing things or when you're trying to get back into your sport, the best thing to do is not just rest and then assume it will get better. You have to hang out in the zone of homeostasis. So the happy zone for a little bit. And you also have to challenge some of the zone above it, which is not breaking stuff, but challenging your body. And that's what all basically challenging and good rehabilitation, coaching, strength, strength, conditioning is really about. It's moves your line. So your line can move based upon how you challenge your body. If you want to improve with your running, then you don't just start with like going off the couch to running 10 K you gradually increase your mileage. Um, not to the point where you break anything or have a stress fracture or tear a muscle. Like you just get sore and that's okay. Um, and then if you're trying to lift weights to get strong, to be a strong man or a strong woman, you would go the other route.

You'd gradually use like a linear undulating approach to improve your body's ability to lift those weights. Now I'd love to say you can be a jack of all trades. Um, or sorry, you can be a king of all trades, but realistically we're, if you try to do everything, you'll be subpar at everything, which is not a bad thing, but don't expect the world of being like, um, don't expect yourself to be the best runner. If you spend time doing other things too, there's complimentary things that you can do. Um, like weight training can help with running, but it's not necessarily, I mean, running makes you a better runner. Um, uh, within reason, like you can get better as a runner by not running. Um, so anyways, I guess I might've gone a little bit away from the question, but for the most part, stretches can make the areas feel better. Resting can make the areas feel better, but when they start to encroach on that line, um, jumping in this case might be a little bit past that line, then it hurts again. Um, maybe a reasonable way of going about it would be to break down the function of jumping and build it back up again. Um, jumping vertically is, it does require a hinge pattern. It also requires squat pattern. Long jumping requires a little bit more of a hinge pattern, like you're loading the bow and arrow. And so you can regress these movements or regress the full activity of jumping or long jumping. I don't know which one he's doing, uh, into the patterning of it and then load that pattern a little bit and then start to add a little bit more of a ballistic approach to it. Um, something might be easy is like, don't just completely avoid, um, hinging. You might want to add things like deadlifting, kettlebell swings, um, squatting, um, split squatting, like something that will build the lower body a little bit, because if you deload your whole person, uh, then that's going to be a bigger hole to dig yourself out of. Um, also the body is one big unit. Uh, we have had people come in with hip pain that we actually give them, uh, overhead pull downs and overhead presses to help out with. So things like planks and squatting and lunging and, uh, carries and all these things can be very helpful. So think of all things that you can do and you might consider starting to do those. Or if you're worried about it, maybe start to do some, uh, have someone with a, uh, a good coach to actually do it with you.

So, um, I hope the style was helpful to you guys today. Uh, I'll probably do a couple other versions of this. And if you're wondering how you can get your question featured and do it an honest, anonymously on Google, like most people are on YouTube, like most people do subscribe to our channel and you'll get all these videos as they come out. Um, we're going to continue to do a lot of videos over the course of time because we think everyone does seem to like them. Um, keep in mind, all the videos are circumstantial. If we're talking about the worst hip stretch in the world, we're talking about a circumstance where it is the worst hip stretch because the worst hip stretch can actually be helpful for some people with other conditions. So everything does depend. It depends on the circumstances and the mechanics of why your body is reacting the way it is. So if you want to figure out how your body can benefit from certain activities, you should get examined. You should have yourself looked at by a doctor or a qualified medical, uh, qualified medical provider, which does not have to be an MD does not have to be an ortho, but it can be, it can also be, um, uh, like a doctor of physical therapy, a chiropractor, an athletic trainer. Somebody is going to help you figure out the mechanics of what's going on with your body. Um, and there should be a thorough history done.

There should be a thorough examination done and if needed imaging done, not always required. Uh, I hope this was helpful again. I'll see you guys next time. Thanks for being part of the movement.