ON Chiropractic Spring 2016 | Page 6

Patient Care SPINE SPARING HIP E XERCISES The hip is an elegant, complex joint and its function is likely connected to the health of the spine and low back pain (LBP). Chiropractors frequently see patients with hip issues, from basic stiffness and reduced range of motion to acute sports injuries and chronic pain conditions. O ur hips help us accomplish functional tasks every day. From a healthy aging and mobility perspective, people need adequate hip strength and mobility for Hip function should be considered in assessment and management of the following conditions: almost everything they do: ∞∞ Mechanical low back, pelvic and sacroiliac conditions. ∞∞ Activities of daily life including carrying, bending, reaching, hygiene and dressing. ∞∞ Basic mobility including stairs, walking, sitting and getting into and out of a car. ∞∞ Strength tasks including kneeling and squatting. ∞∞ Exercise including cycling and running. ∞∞ Local hip complaints. ∞∞ Knee pathology including arthritis in older patients and functional problems in younger patients. ∞∞ Lower kinetic chain issues and sports injuries. To help patients age with excellent physical capacity, it’s important to address hip function along with general fitness and performance. Any clinician who has observed patients with hip pain getting up from a chair knows that hip pathology affects how a patient uses their lumbar spine. However, current research evidence has not yet clarified the exact nature of the relationship between hip pathology and LBP. For more information on the current state of the research on this relationship, members are advised to consult the OCA’s Webinar on Demand, Spine Sparing Strategies, with Dr. Shawn Thistle. After reviewing the evidence, Dr. Thistle offers three guiding assumptions he uses in his practice: 1. A limitation in a specific hip function (e.g. flexibility) is more likely to be related to a patient’s back pain if the patient regularly relies on that particular aspect of hip function. All patients are unique! 2. Using manual therapy and home care to address that specific hip function may alleviate or prevent LBP. 3. When a patient has limited mobility in the hips, they compensate by using their spine for functional tasks such as getting into and out of a vehicle. Helping patients to improve strength, range of motion and stability in the hips can “spare the spine” from this added stress. 6 SPRING 2016