Are you Suffering from Hip pain At night? These four structures could be the cause of your disrupted sleep.

If you are suffering from hip pain at night, it can be 1.) Worrying 2.) frustrating and 3.) Confusing.
How can you have pain when you are not moving? Have I injured myself and not noticed it? Is it something serious? should I see a consultant?

These are all general questions, but the truth is the answer can be very simple and the treatment even simpler.

What does hip pain at night feel like?
Hip pain at rest feels like a deep ache travelling down your leg, into your butt or groin. It does not refer past your knee. Pain referred past your knee can be related to SCIATICA PAIN( insert Link). The pain will get worse if you remain in that position. That is why the same pain may come when you are sitting in a deep chair/couch or driving long distances.

What causes hip pain at night?

The Hip/pelvis area is a very complex structure that requires to be mobile and robust at the same time. Most cases of hip pain at night are caused by tight muscles that either need strengthening or stretching or both. The muscles and tissue at the front of the hip are the most commonly “tight area”. This because modern society has a relatively sedentary lifestyle if we work in an office or travel a lot for work. We tend to sit a lot more. Long periods of sitting leads to tight muscles at the front of your hip, namely the Illiacus, Psoas Major, TFL, and Rectus Femoris. Concurrently, we have weaker muscles at the back of the hip, namely the gluteal muscles and deep hip rotators.

There are also powerful ligaments that keep the hip joint strong, but these are rarely injured or cause significant pain at night.

Osteoarthritis
These are the degenerative changes that occur in joints, which results in a loss of cartilage. Cartilage is like a shocker absorber in your hip, so it’s designed to take a lot of abuse over the years. Unfortunately, all that mobile and strength can become unbalanced as we get older and are less active. Muscle imbalances cause the mechanics of your hip to change and are thought to speed up the rate at which osteoarthritis advances. Before we go any further, please note that every person over the age of 40 will have some form of osteoarthritis in their body. ITs has been deemed a natural part of ageing. So don’t worry if you have seen this term on your MRI. A come People with OA usually have mobility issues where their hips feel stuck get achy on long times walking or standing.

Tendonitis
Tendons are what attach muscles to bones. They have a natural elastic property to them, and there may function to absorb and release energy. Are the hip this is maybe focused around walking, running and changing direction if we are playing sport. Over time, if we become less active, these tendons tend to become weak and frayed, resulting in their inability to absorb forces as we walk. If they cannot absorb the force, then the knee, hip or lower back subsequently takes up their job. This, in turn, can result in injuries further up or down the kinetic chain.

The main tendons that cause pain at night are the GLuteal tendons. IF your glutes have become weak over time or you have gained weight, then they may have to work harder to move your frame. Once they become tired and frayed, they can become painful to touch; hence lying on your side will cause pain as you are compressing the tendon.

Note: Tendons are remarkably robust structures capable of absorbing forces 9-12 times bodyweight. If you weigh 100kg, that’s 500kg it can tolerate. This is why for tendon issues, heavy resistance training is superior to bodyweight exercises and should be done under the supervision of a trained professional who has the experience of resolving hip pain through strength training.

Bursitis.
Bursae are tiny fluid-filled sacs that lie between tendons in your body. There may role is to reduced friction between tendons and muscles. Bursitis can become inflamed if you have a weakness around that area, spend a long time of pressure on the bursae and or have done a long walk that your body may not have been used to causes the muscles and tendons to fatigue and rub off the bursae more than usual. This type of pain is usually very sharp in nature and is not only limited to nighttime pain.

How can I get rid of my hip pain at night?

There are three main points to focus on here
1.) Reduced the inflammation in the painful structure – OA TENDON BURSAE
2.) Stretch the tight structures in your body
3.) Strengthen up weaker muscles
4.) Condition the muscles

Reduced Inflamtion
The easiest way to reduced inflammation is abstaining from the activity that is causing the inflammation. If you are sore after 20 mins walking, don’t go and do 3 hours hike at the weekend. It’s never a good idea. Next, take some anti-inflammatories, ask in your local pharmacy to see ones that would suit you best.

Stretches for hip pain at night
Finally, do some light exercises like stretching or strengthening. This doesn’t have to be specific, but focusing on areas that are typically neglected, like the front of your hips, quads, glutes, and upper back, is an excellent place to start.

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Strengthening Exercises for Hip pain at night

As mentioned previously, tendons like to be supported with high resistance. If you have been completing bodyweight exercises for a tenon injury, then, unfortunately, this is not the correct method to rehab your injured based on the latest scientific evidence we have available to us.

Finally, get moving. Once that injury feels better, you need to get out and condition those muscles. This sounds harder than it is. Fi, you are a walker. It could be as simple as doing a fast walk for 10 mins- almost running, walk slowly for 3 mins and repeat. If you are a running, starting off with 60m runs at a fast pace, full recovery between reps.

The idea is to expose the injury to multiple speed. Your body is brilliant and will get used to moving at the same speed and actually can lead to damage if you do the same exercise at the same speed week in week out.

This Article was written by Diarmuid Hegarty, Clinical Director ReSync Physiotherapy, MICP MSc Physio, MSc Sports Med, NSCA. Our team are here to answer any questions or queries you may have about your pain/injury. We offer Free Consultation for people who are unsure if physiotherapy is right for them.

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