It's Not Hip to Hurt


Acute hip injuries in golf are rare indeed.  Occasionally a touring pro may have what’s called a “snapping” hip: a painful noise caused by the psoas tendon snapping forcibly across the front of the hip during the twisting motion of the golf swing. But that, too, is not very common.  A much more common entity is the slow, chronic loss of range of motion (ROM) within the hip joint that plays a role in degenerative arthritis of the hip.

The thigh bone connecting to the pelvis makes the hip joint.  Supporting and carrying the daily load of our body as well as whatever abuse we decide to heap on it, the anatomy of here is well suited:  it is surrounded by the biggest ligaments and muscles of the body.  Made to take the stress of locomotion—walking, running, jumping, and, more importantly, landing, this joint is a toughie when it comes to trauma.  Yet the subtle stiffness that begins to alter the ROM of this joint from repetitive stress or the occasional acute trauma can destroy the joint if left unchecked.

Hip joint pain is usually first felt in the groin, deep in the pelvis.  It may even seem to radiate down the inner thigh towards the knee.  The usual complaints of “hip” pain are nearly always the associated symptoms of a lower back problem.  Typically a golfer will come in stating “My hip is killing me. I must have sprained it or something.” But when asked to point to the area of pain, he will point to that area of soft tissue just below the belt line at the top of the buttock.  Invariably, this is a painful trigger point from the lower lumbar area.  A true mechanical hip problem will have a specific loss of ROM and when the barriers of motion are challenged pain is often felt deep in the groin area, front of the hip, or on the outside of the pelvis (side of the hip).

Hip ROM is essential to maintain for the relative health of the foot below it and the low back above not to mention one’s golf swing.  If the hip is allowed to become restricted your body will try to compensate with whatever it has available and usually that is motion from another area: the foot or low back.  A right-handed golfer trying to get over his stiff left hip during his finish will almost always use his low back to do what his hip will not allow.  Unfortunately, the low back will not tolerate this for long and soon a back injury will result. Sometimes the unlucky part is the foot.  If the hip is not allowed to rotate inward fully the foot has the capacity to flatten slightly in an attempt to accommodate this loss of ROM.  This can be a wondrous example of the body taking care of itself or it may end up as a painful heel as ligaments on the bottom of the foot receive a chronic stretch.

As I said the hip is a big joint and when it has problems, they tend to have big consequences.  I would refer the reader to the recent article on hip strengthening and stretching for some self-help advice to help you avoid those “big” consequences.

Ralph Simpson