Simply put, the lateral pelvic tilt is a condition causing one side of your hip to appear higher or lower when compared to the normal hip position.Medicine identifies these two conditions as:
Hip hiking – where, on one side, hip is raised above the neutral position and
Hip dropping – where the hip drops lower than neutral position
In today’s article, we will be talking about proper muscular biomechanics, lateral pelvic tilt self-diagnosis, most common conditions leading to it and best exercises to correct it.
Proper Muscular Biomechanics
A proper relationship between muscular length and tension is one of the core foundations of proper body biomechanics. When this relationship is disrupted – when a muscle is tight and his antagonist (“a muscle that opposes the action of another” – Source:TheFreeDictionary) becomes weak – a postural abnormality may occur.
As you might already know, our pelvis involves a number of different muscles which allow movement in all directions – anterior, posterior and lateral (front, back and to the side). If the relationship between any of these muscles is disrupted, it may lead to pelvic tilting, mild low back pain, or a more intense, piercing pain felt in the lower back and down the affected leg.
Lateral Pelvic Tilt Assessment
Most of the time we recommend seeing your doctor for a correct diagnosis, but pelvic tilt is a condition you could easily diagnose yourself, at home. All you need is a mirror, a good set of eyes and knowing where your iliac crest is located. Once you’ve located the iliac crests on either side, facing the mirror stand as evenly as possible and try to determine if they appear level.
So what is iliac crest and how do we find it?
The iliac crest is a bony ridge stretching across from the anterior superior iliac spine to the posterior superior iliac spine. It can be easily felt below the oblique muscle on the side of the torso. You can just slide your hands up and down this region until you hit this bony ridge. The image below will also help pinpoint it:
Lateral pelvic tilt can also be diagnosed indirectly in patients with spastic gait. A spastic gait is a condition where the foot becomes stiff, gluteus medius and tensor fasciae latae become weaken and the sufferer is forced to shift his entire trunk when swinging their leg forward. Moving like this will cause muscle imbalance and cause the pelvis to tilt.
Why Lateral Pelvic Tilting Is Bad For You?
Of course, we all know that pelvic tilting is bad since it will disrupt the muscle balance in our body, cause posture problems and lower back pain. But exactly happens to the muscles?
When the hip is raised above its natural position (in hip hiking), quadratus lumborum muscle becomes tight. Quadratus lumborum is a muscle that connects vertebrae to the iliac crest, so when you think about it, it makes perfect sense that tension in this muscle will raise the hip.
Now, to in order to compensate hip hiking, our body will create hip adduction (“adduction is a movement towards the mid-line of the body” – Source: IvyRose), so adductor muscles will become tight as well. Consequently, adductor muscle antagonists (abductors, namely gluteus medius), will become lengthened and possibly even weaker.
On the other hand, when the hip drops, chances are quadratus lumborum muscle becomes weaker and lengthened and gluteus medius muscle becomes tight. This then leads to weakness in adductor muscles.
Patients with lateral pelvic tilt may also be subject to:
Sacroiliac joint pain
Treatment And CorrectionExercises For Lateral Pelvic Tilting
Correcting the pelvic tilt may seem easy but the most important thing that needs to be done prior exercises is to pinpoint its exact cause (and access the damage that has already been done). This is the main reason we recommend first seeing your physician, then start devising a self-treatment plan.
The majority of people will “catch” lateral pelvic tilt in its early stages, where correcting it will be relatively simple. Mild cases usually require only posture and walking mechanics correction.
This is, of course, dead simple but dead effective; most of the time we don’t even pay attention to the way we walk and the way we position our spine when sitting or standing. So, what you need to be doing is practice standing in front of your mirror and trying to distribute your weight evenly across the both sides of your body, while keeping your pelvis in neutral position (correct dropping and hiking).
More Severe Cases
Even the more severe cases should pay attention to their posture and walking mechanics… Unfortunately, their condition has progressed more, caused more damage, so these simple corrections are just not enough. These cases also require stretching and strengthening exercises.
Just to freshen up, hip hiking is caused by tense quadratus lumborum, hip flexors, and hip adductors. So what we need to do is stretch QL, hip flexors, and lower back; and strengthen the hip abductors.
Dropped hip is caused by weakened QL and hip flexors, where abductors are tight and adductors are weak as well. Here we need to strengthen hip flexor and adductor muscles while aiming for stretching abductors and tensor fasciae latae.
Diaphragm pain may not be as common as some other health conditions but, in most cases, it can be very unpleasant and long-lasting. Looking at the most popular health forums, you can come across numerous cases of people complaining about pain in the thoracic diaphragm region lasting for months, sometimes even years!
It is our desire to help these people (and you) understand your body better, learn more about the diaphragm and the best way to deal with pain in this region.
To avoid any confusion, I must point out that today we will be talking about thoracic diaphragm exclusively; there are other “diaphragms” in the human body (such as urogenital or pelvic) but we won`t be covering them in this article.
Thoracic diaphragm is a dome-shaped sheet of muscles which separates the the thoracic from the abdominal cavity 1. The thoracic cavity, or chest cavity, is a chamber enclosed by the ribs, sternum and spine, which contains major respiratory and circulatory organs (lungs and heart) 2; and the abdominal cavity is the space between abdominal muscles and the spine, containing a number of vital internal organs (stomach, liver, pancreas, intestines etc.) 3.
Its name comes from Greek diaphragma meaning partition or a barrier, so it literally means the muscle that divides thorax from the abdomen 4.
We already said that this is a sheet of muscles, and it is divided into three groups (based on the muscle fiber origins):
Costal – from the inner surfaces of lower six ribs and their cartilages and
Lumbar – from the lumbar vertebrae by two pillars called crura.
Since the diaphragm is strategically positioned between thoracic and abdominal cavity, it is pierced in a number of places to allow various structures to pass from one to the other cavity. We won`t be going through all of them, but we must mention the larger ones:
Aortic hiatus (hiatus – Latin meaning opening/gap5) – located at the back of the diaphragm (you can see it on the image above), through which passes the aorta (main artery of the human body), azygos vein and the thoracic duct (largest vessel of the lymphatic system)
Esophageal hiatus – situated in front of the aortic hiatus through which esophagus (foodpipe) passes
Vena caval foramen (foramen – Latin meaning opening as well ) – for caval vein (one of the largest veins in the human body)
Diaphragm is the main respiratory muscle. When we inhale, it drops down and increases the volume of thoracic cavity, which creates suction that draws the air into our lungs. When we exhale, the diaphragm relaxes and recoils back to its original position, and the air is forced out.
Diaphragm Pain Causes
You have to be aware that diagnosing the exact cause of chest or upper abdomen pain yourself, is not something I would recommend. Usually, my first recommendation is to visit your doctor and see what is going on, but it is my duty and pleasure to help you educate yourself when it comes to your own body.
Painful Inhalation and Exhalation
There is some confusion when it comes to diaphragm pain and breathing. If you experience pain on a full inhale, it is more likely caused by problems with transversus abdominis muscle (muscles on the side of the abdominal wall); and if you feel pain on a full exhale, it is likely related to the diaphragm 6.
Pain can also be felt when coughing or sneezing. Shortness of breath may also indicate problems with diaphragm.
Patients with diaphragm spasm usually complain about pain in the area below the sternum and just below the ribs on either side of the abdomen 7. They may also complain of chest pain, shortness of breath and inability to get a full breath.
Pain release requires diaphragm stretching which occurs at the end of a forced exhalation. Forced exhalation may be accomplished by using the power of the abdominal muscles, hand pressure on the abdomen or bending the body forward as you exhale. Most corrective measures involve changes in posture and breathing exercises.
It is important to note that there were cases where the diaphragm went into spasm due to an intense emotional stress. Once the stress was gone, so was the spasm.
Pain During Exercise
Intense, vigorous exercise without warm-up can cause pain on the side of the thorax, around the lower border of the rib cage. This pain is usually relieved when person is resting and it intensifies by continuing exercising.
And the best way to prevent this type of pain is to do a proper warm-up and stretching prior to exercise.
Hiatal hernia is a condition where the upper portion of the stomach protrudes upwards, into the thoracic cavity, through the opening on the diaphragm called esophageal hiatus (we mentioned it above). It is relatively common in older population (of people over 60 years of age), but can present itself in younger adults due to:
Frequent heavy lifting
Most common symptoms are chest pain, difficulty swallowing, coughing or frequent hiccups.
Home treatment usually involves changes in the lifestyle: losing weight, improving posture, exercising or changing your diet. Surgery is rarely needed but it will bring relief in case of an emergency.
Pain During Pregnancy
Shortness of breath is normal in pregnancy and should not be a cause for concern. As the baby grows and the uterus expands, diaphragm may rise up to 1 1/2 inches and decrease your lung capacity 8. When this happens (better yet, before it happens), you should consult your doctor and ask for some exercises for improving your breathing and posture.
However, if you start experiencing pain in this area, consult a medical professional.
This is a more severe injury and it is usually associated with blunt trauma (in motor-vehicle accidents) where there is a tear . Not all accidents will cause thin injury though, frequency varies from 0.8-8% 9, and it may sometimes be overlooked.
The injury will not heal on its own so the surgery is needed.
The easiest way to describe strawberry legs is to think of them as dark spots on the skin, commonly caused by hair removal. These visible dark spots can appear on every skin type, but they are most noticeable on tanned skin and in women of color.
Obviously, they are not harmful and aren’t linked to any health problems, but they may have a devastating visual effect; taking one quick glance at those prominent dark pores on your legs can ruin your confidence, mood or a date night!
But don’t worry, we are here to help! Our goal is to help you get rid of strawberry legs fast, using natural, homemade remedies and recipes.
Before we go on, though, you need to learn to distinguish strawberry legs from a common shaving rash.
Strawberry Legs VS A Shaving Rash
The correct medical term for strawberry legs is an open comedo. Comedo1 (plural: comedones) is a technical term for a clogged hair follicle in the skin. There are two types of comedones:
Open – an open comedo is a hair folicle that is open to the air which causes oxydization and black color (blackhead)
Closed – closed comedo is closed by the skin so the oydization does not happen and the color remains white(whiteheads)
Pores usually get clogged due to bacteria, oil, or dead skin cells buildup (or a mix of the three). Another common cause are ingrown hairs, which are succeptible to irritation, inflammation and clogging.
A shaving rash however, is just a short-lasting skin irritation caused by an aggressive shaving or a dull blade.
It is best to address shaving rash, also called razor burn, before it even occurs, by employing these prevention tips:
Use light strokes – applying too much pressure is almost guaranteed to case irritation
Swap dull blades – a dull blade will discomfort,
tugs and pulls during shaving and lead to irritation
Limit your restrokes – it is etimated that as much as 60% of shaving constitutes of restrokes! Reducing the number of restrokes will reduce the stress to your skin
Medical Definition Of A Hair Follicle
We’ve referenced a hair follicle2 a number of times in the previous text but failed to give a proper explanation of this skin structure.
A hair follicle is a sack from which hair grows (derived from a latin ford follis: bag). A sebaceous (oil) gland opens up into this sack and secretes oils which lubricate our skin.
A healthy hair follicle produces about six inches (15cm) of hair growth per year.
What Causes Strawberry Legs?
By far, the most common (and the most dangerous) cause of these dark spots on the skin is a condition called Folliculitis.
Folliculitis – Causes, Types And Home Treatment
Folliculitis3 is an inflammation in one of more hair follicles. It is a common skin problem and caused by:
Or a fungal infection
How Do I Spot Folliculitis?
A common early sign of this condition is small red bumps on the skin or, in some rare cases, white-headed pimples. These pimples and bumps are around the hair and, if not treated properly, might develop into scabs or itchy crust.
Other, more severe symptoms are clusters of puss-filled of blisters, burning or tender skin, and large swollen bumps on the skin.
The condition is not dangerous in itself, but you can make your life worse by scratching it. Excessive scratching will almost certainly lead to an infection, which may lead to permanent hair loss. You might think that a permanent hair loss might be a good thing (you won’t have to shave as much) but hair is connected to the touch receptors in our skin and may serve as a protective warning device.
There are two main types of hair folliculitis: superficial and deep. Superficial Folliculitis
Superficial folliculitis affects only a part of the hair follicle. Its common forms are:
Hot tub folliculitis – also called pseudomonas folliculitis, is caused by pseudomonas bacteria. This bacteria can be found in many places but is most common in hot tubs and pools where chlorine and pH leves are not properly regulated. Exposure to this bacteria causes round, itchy bumps.
Bacterial folliculitis – is caused by staph bacteria. Staphylococcus bacteria resides on our skin all the time,
but they only cause infection when they penetrate it(when we cut ourself for example). BF will cause white, pus-filled, icthy bumps
Razor bumps – this is just a common skin irritation caused by ingrown hairs. It is most prominent on the face,
neck and in the bikini area.
Pityrosporum folliculitis – this type is caused by a yeast infection and results in chronic, itchy pustules.
Deep folliculitis is a bit more dangerous and its most common formes are:
Sycosis barbae – this type is associated with “first time” shaving and it is benign
Gram-negative – gram-negative folloclitis is a deep infection caused by staph bacteria
Boils – painful, pus-filled boils around the hair follicle indicate that a serious infection is raiging. It needs to be addressed immediatelly before it causes major damage
Sosinopilic folliculitis – this type only affects people with AIDS/HIV. Its exact cause is still unknown, one thing we do know is that these itchy bumps may make the skin darker as they heal
Shaving is the most common cause of strawberry legs as it leads to ingrown hair.
Most cut hairs will grow back through the skin once you cut them; while some may start developing underneath it. This occurrence is more common in individuals with thick hair, as opposed to ones with thin, fine hair.
Since the hair starts growing into the skin, our body refers to it as a “foreign object,” and our immune system responds accordingly by “attacking it.”
This is when the symptoms start to appear – itching, burning, swelling, and white bumps.
In some cases, the skin around the follicle may become slightly darker, leading to strawberry skin appearance.
Properly moisturized skin is a healthy skin. What happens in dry summer months (as well as those cold, windy ones) is that your skin dries out.
Dried out skin loses its ability to shed dead cells effectively, so they start building up. This buildup will, in turn, hinder skin shedding even more and cause even more significant problems(might also lead to an infection).
The solution? Using a proper moisturizer will usually do the trick.
Our age-old archnemesis – acne! Acne is so common and widespread that most of us had them at least at some point in their lives(some still do).
Acne commonly occurs in puberty as this is the time when oil production kicks into high gear. Though they are not dangerous, they can leave nasty scars… on your skin as well as on your self-esteem.
Oil glands are to blame here as they will clog your pores and cause dead skin cells and dirt buildup. Though the pores are clogged, they remain opened, come in contact with air and oxidize, which results in hyperpigmentation(darker skin).
How Do You Get Rid Of Strawberry Legs
Finally, we get to the section you’ve all been waiting for – how to get rid of these dark spots! The crucial thing to remember here is clearing up your pores.
So, in the following paragraphs, we’ll be covering some of the most effective ways you can unclog your pores, keep your skin clean and get rid of strawberry legs.
Efoliate With Baking Soda
Wash your legs with warm water and pat them dry using a cotton towel
Grab a bowl and add 2 tablespoons of baking soda and some water
Mix to form a paste
Apply the paste and rub in circular motions for 2-3 minutes over the affected area
If you run out of paste just add more baking soda
Once you are done rubbing, wash the debris off with warm water and pat your legs dry
Apply toner to moisturize and seal off the pores
Baking soda is one of the best, low-cost scrubbing agents you can use since it will soften the sebum, open up your pores, scrub the debris, but do it gently. It won’t damage or irritate your skin but will do a proper job of cleaning it!
Cucumber And Sugar Body Scrub
Grab a blender and add 2 cups of white sugar, 11/2 cup of cucumber, 1/2 cup of coconut oil
Blend 30-60 seconds, pour into a glass jar and put into a refridgerator
After one hour, grab your jar and apply your scrub to the problematic area
Rub for 2-3 minutes and then move on to the next area
After you are done wash it away with hot water and pat your legs dry
Apply a toner
Cucumber is a fantastic moisturizer, so it won’t dry your skin as you exfoliate. Natural vegetable oils found in it will also lighten your skin and detoxify and improve your complexion.
DIY Green Tea Scrub For Strawberry Legs
Wash your legs with warm water and pat dry
Grab a bowl and add contents of 4 green tea bags, 11/2 of white sugar and 1/2 of coconut oil
Mix it into a paste
Apply to your skin in circular motions for 2 minutes
Wash it off and pat yourself dry
In addition to drinking green tea, you can reap its benefits by applying it to the skin. Studies have shown that it protects the skin from harmful effects of the sun, acts as antioxidant and even has anti-inflammatory properties.
Using An Epilator Instead Of Shaving
Of course, you don’t need me to tell you that using an epilator is painful, lasts longer, and may cause skin irritation initially.
If we compare it to shaving, it doesn’t stand a chance! Or does it?
Though shaving is quicker and less painful, it comes with a few noticeable drawbacks – the hair grows back faster and thicker, leave you with a stubby look, the possibility of cutting yourself and, of course, causing ingrown hair and strawberry legs!
Though using an epilator will hurt at first, most users agree that the pain tolerance increases over time and it hurts way less. So, once you get over that initial hurdle, you can reap some of the benefits that come with using it:
The hair will grow slower and be thinner
Skin will look and feel smoother
Less ingrown hair
Decreased probability for strawberry legs
Aloe Vera Sugar Scrub
Mix 2 tablespoons of aloe vera, 2 tablespoons of sugar and 1 tablespoon of lemon juice
Mix into a paste
Apply and rub for at least 1 minute over the problematic area
After you are done, rinse it off and pat yourself dry
Aloe vera is an amazing plant as it fights acne, cleanses your skin, has anti-inflammatory properties, and nourishes your skin.
And as for lemon juice, it will scrub excess dirt and grime from your skin, exfoliate but also make your skin lighter. Lemon is rich in vitamin C and citric acid which may, over time, make your skin appear brighter.
No, we didn’t switch to talking about headaches. Actually, salicylic acid, a derivative of acetylsalicylic acid (aspirin), has been used for centuries (dating as far back as 5th century BC) to remove excess skin oil and dead skin cell buildup.
It will also clear up redness, swelling, repair your damaged hair follicles, and lessen the effects of a skin infection.
Sea Salt Scrub
Making a sea salt scrub is easy and simple, as long as you buy sea salt and coconut oil.
All you need is one cup of sea salt and a half a cup of oil, and you are good to go. Mix if for a few minutes and rub it on your skin in circular motions.
Make sure you buy fine sea salt as coarse salt is too abrasive.
Alpha And Beta Hydroxy Acid
Both alpha and beta hydroxy acids are used in skincare industry to exfoliate the skin.
The only difference between the two is that AHA is water soluble while BHA is only soluble in oils.
Though they are becoming increasingly popular, no definitive scientific studies are proving their effectiveness.
How To Prevent Strawberry Legs?
When it comes to strawberry legs (as with many other skin conditions), it is better to work on preventing it then addressing it after it has already happened.
Since the main reason, you get ingrown hairs, stubs, and strawberry legs is shaving, we are going to offer you some tips to make it as smooth as possible.
We’ll start with the razor. Make sure it’s:
Clean – many bacteria can reside on the razor without you even knowing it. A single use can result in whole colonies of bacteria, so using a disposable razor is a sound option.
If you don’t want to have to buy a new razor everytime you shave,
you can clean the one you have after use. All you need to do is rinse it under hot water and after it’s fully dry, submerge it in alcohol for a few seconds
Sharp – a dull blade will tug and pull on your hair and cause irritation, so make sure the blade is sharp before you commit to shaving
Before you even start shaving, you should try exfoliating your legs, keeping the skin on your legs clean and healthy will ensure a smoother shave.
And after you are done shaving, you should try washing your legs in cold water, without soap(as it may irritate the skin). After you pat your legs dry, apply some gentle aftershave and put on something cozy until your skin goes back to normal.
Sternum popping, collar bone cracking, or joint cracking in general is not considered harmful; and if you go see your doctor about it, he/she will probably tell you not to worry.
This is a natural occurrence and, though we are still unsure why it happens, we are fairly certain it does not pose any threat to your joint health (kinda weird we can make this claim when we don`t know the exact cause of it, don you think?).
Anyways, today we are here to talk about cracking in one specific area of our body – sternum. Before we go into the actual causes of joint popping, I think we should talk a little about the anatomy of the breastbone.
Sternum is a flat bone located at the front of your chest. It consists of three parts: manubrium (upper part of the sternum), the body (mid section) and xiphoid process (pointy lower part of the sternum). One of its main functions is to protect the delicate structures located behind it and, at the same time, build up the chest (thorax).
As you can see on the image below, edges of the breastbone are quire jagged… this is because it articulates with both clavicle bones and cartilages of the first seven ribs. And this is where that clicking noise takes place. It is usually in the sternoclavicular joint (joint between the collarbone and sternum) or in any of the numerous sternocostal joints (joints between the ribs and the sternum).
So Why Do These Joints Pop?
Sternum popping, and joint popping in general, usually happens spontaneously, on its own… of course, there are exception – like popping your back for instance. I, sometimes, like to pop my back after sitting at my computer for a long time. Other people like cracking their knuckles.
One thing is for sure, though, we still don`t fully understand exact causes and mechanisms which lead to joint popping. I know it sounds crazy, but its true! But, we can make some educated guesses:
Ligaments and tendons snapping – when we move our joints, other structures within the joint move as well, such as tendons and ligaments. Some researchers believe that these cracking noises are caused by these ligaments and tendons snapping into their original place
Gasses – no, not the ones that pop in mind first; I am talking about gas bubbles that get released from joint fluid as we move
Rough, uneven surfaces – this is especially common in arthritis sufferers where popping and cracking noise is caused by uneven edges of the bone. Of course, this is very painful and not common in healthy individuals
Partial dislocations, bones popping out of place etc
Sternum Popping When Stretching
I don`t know about you, but I notice these cracking noises in my breastbone only when I`m stretching, sometime I hear a pop when I take a really deep breath.
Once again, this is completely normal, especially if you are stretching yourself after longer period of inactivity (in the morning, for instance). But if you start experiencing pain, tenderness of soreness in the breastbone area, you should talk to your doctor.
Sternoclavicular Cracking When Doing Dips
I already touched this topic in one of my previous articles (Pain Around The Collarbone Area – Clavicle Pain). Doing dips is incredibly difficult (for most people), it`s an advanced exercise and it has to be done with extreme caution… especially if you are just a beginner, like me.
I tried doing dips several months ago and, when I finished my set, I was struck by an intense, sharp pain in area around my collarbone. I haven`t experienced cracking, but some of my friends did. So, what I did in this situation?
Well, at first I stopped doing them altogether… But, as the time went by, I started getting back to them but I only do 3,4 reps; no more because I know (fear) I will experience that same pain again and injure myself.
What advice I can give you? My first advice would be to find someone who knows what he`s doing. It doesn`t have to be a personal trainer, but make sure you find someone familiar with these types of exercises to show you the correct way of doing dips. And if the pain persists, consider visiting your doctor.
Most Common Causes Of Sternum Popping and Cracking
We still don`t know what mechanisms lead to joint popping but that doesn`t mean we can`t list some of it`s most common causes:
Physical injuries – sternum bruising and light injuries are common in some sports (like basketball, soccer, football etc.) and, even though they will heal quickly, they can cause these popping sounds. More severe traumas can also cause them – high speed collisions where you slam your chest against the steering wheel, for example
Muscle spasms -if the spasm is strong enough, it can cause partial dislocation of the ribs, as we mentioned above
Strenuous activity – any strenuous activity which puts additional pressure to the chest, can cause sternum popping. Activities such as weight lifting, doing dips and even push ups
Costochondritis – an inflammation of the cartilage of the ribs. This is a relatively harmless condition and it will usually go away on its own, without any treatment; but the sternum can be painful and tender to touch
Tietze syndrome – this is also an inflammation of the cartilage of the ribs but it differentiates from costochondritis because cartilage is usually swollen
Arthritis – arthritis can cause joint degeneration, rough and uneven surfaces which can cause clicking, popping and cracking noises when they rub against each other. The pain may vary depending on the severity of the degeneration, but it can be very painful
Can You Treat Breastbone Popping – When To Go See A Doctor?
If you are a healthy individual, and you experience breast bone joint popping from time to time, there is really no need to worry. This is normal and it happens to all of us, so there is really no need to “heal” it. In some cases it will go away on its own, and in others it may stuck with you for years.
But if you start experiencing pain, swelling, tenderness or a general feeling of discomfort, you should visit your doctor and see if there is some underlying condition which is causing these symptoms. It is usually nothing serious, but it is worth checking it out just for the peace of mind.
Image 1 – Source: Gray H. Anatomy of the human body, page 120
Radiocarpal or wrist joint is one of the most complex joints in our body. It is build up of distal (lower) sections of the two forearm bones and another 7 bones of the hand.
These bones are linked with numerous ligaments (which we will cover in the next section) which can get damaged through wear and tear that comes with age, but injury-induced torn ligament in wrist is more common.
Anatomy – Bones, Joints and Ligaments of the Wrist
If you look at most anatomy text books, you will see that wrist joint is referred to as the joint between lower end of the radius and upper surface of three carpal ( carpus – a group of bones connecting hand with forearm) bones – navicular (scaphoid), lunate and triquetrum (triangular) 1; as you can see on the image below:
But when we talk about the wrist in “layman`s terms”, we usually imply joints between the radius and ulna, and joints between two rows of carpal bones. For this reason we are going to cover all these joints now:
Distal Radioulnar Joint
This is a joint between distal ends of the ulna and radius, connected by two ligaments – anterior (front) and posterior (back) radioulnar ligaments. Movement in this joint is fairly limited and it consists of the radius rotating around the head of the ulna. When the radius rotates forward, result is a movement called pronation (thumb is closer to the body) and supination (thumb away from the body).
Radiocarpal Joint – Wrist Joint
This is the joint we mentioned above – between distal radius and scaphoid, lunate and triangular bones. The joint is strengthened by many ligaments, which is why torn ligament in wrist is such a common injury. Those ligaments are:
Ulnar Collateral and
Movements this joint permits are: flexion, extension, abduction and adduction. You can check out the short video below for the demonstration of these movements:
This is a group of joints which we can divide into three subgroups:
Joints between the top three bones of the carpus – secured with a set of three ligaments
Joints between bottom four bones of the carpus – also secured with a set of three ligaments and
Joints between the top and the bottom row of bones – secured with 4 ligaments
I know that many of you reading this article, are not doctors or medical students and you might think all this anatomy is redundant, but I wanted to help you fully grasp the complexity of the wrist joint. There are so many different structures in this confined space, so an injury can cause a lot of damage, of course, tear one (or more) wrist ligaments.
Most Common Causes Of Torn Ligament In Wrist
The most common cause of injury, or in our case a torn ligament in wrist, is physical trauma. Two of the most common traumas resulting in a ligament tear are:
Falling onto your outstretched hand – if the force is substantial this can be a serious injury, causing strains, sprains, ligament tears but also break bones
Bracing yourself on the dashboard before a car collision – this is usually just a natural instinct, extending your arms and bracing on the dashboard in order to stop your body from going forward
Repetitive stress – most sport activities involve some sort of repetitive motion. In basketball, for example, during a jump shot a player is required to flex his joint (to propel the ball forward and give it a backward rotation); and in tennis, players are constantly flexing and extending their wrist joint, depending on the type of shot they choose. These repetitive movements can weaken the ligaments, put a lot of strain onto them and, eventually, cause tears
Aging – aging is, of course, a natural process our body goes through, and there is nothing we can do about it. Ligaments problems in, healthy adults, will usually start around the age of 40
Arthritis – arthritis is not so much a cause of torn ligaments in wrist, more a collateral damage. When ligaments become weaker bones start to move abnormally, the wear and tear becomes more intense and bone and joint damage intensifies, resulting in pain, at first, and eventually arthritis
Weaken ligaments may go undetected for some time, because they will present with no symptoms. But, as the time goes by, the damage can add up and result in unstable joints, pain, limited range of motion and complete or partial ligament tears.
How To Diagnose A Torn Ligament Yourself?
To summarize it into one word – don`t! There is a common misconception in people… they think that you can read a few articles online and become an expert. If that were the case, there would be no need for higher education… The truth is that nothing can replace a well trained expert`s eye, backed up with years of experience, not to mention MRIs and X rays. This is why I always advise people to talk to their doctor, if they experience pain, swelling or any other problem with their wrist.
What will the doctor ask you?
No need to worry about it, you probably already know the all the answers you doctor will need. Most common questions are:
When did your symptoms started?
How did the injury occur?
Is the pain becoming more intense?
Have you tried to treat it yourself?
Do you think you have a torn ligament in wrist?
Next comes the physical examination, and I have to warn you that it may hurt a bit. Your doctor will try to access the severity of the injury, move your wrist to see if there are any problems with the range of motion, how are bones aligned and to pinpoint the exact location of the pain.
What Medical Tests Can You Expect?
Doctors will usually order an X ray of your wrist – to see whether any bone is broken, and MRI – to see what is the condition of the ligaments and other soft tissues around the joint; they can also do blood tests or an EMG to measure the electrical activity of the muscles.
In some rare cases, doctor may even require an arthroscopy. This is a procedure where a tiny camera is inserted into the wrist joint to show the surgeon exactly which ligament is damaged/torn, and can also assist during the surgery itself, to grant a better view of the ligaments that are being repaired.
Most Common Symptoms Of Ligament Injury In Wrist
Of course, there is no one specific symptom to confirm a torn ligament in wrist, but there are symptoms which will point us in that direction. They are:
Initial localized pain and swelling
Ecchymosis – this is a hematoma, commonly called a bruise, larger than one cm (0,39 in) in diameter. Discoloration and bruising will last a few days, but will eventually subside on its own
The pain that does not go away – after that initial intense pain is gone, patients might experience pain which is not as intense but it last for a long time (several weeks). Patients might also feel the pain which intensifies with movement, or becomes more intense on its own as the time goes by. If you experience this type of pain, you should go see a doctor
Joint instability – joint instability will become more noticeable after that initial pain period, when you start using your wrist and hand more. If the injury was severe enough, it might have damaged the ligaments to the extent where they are not able to secure wrist joint and bones properly. The bones may slide incorrectly, pop out of place (clicking and snapping noises may appear) and start to grind against each other
This grinding can lead to arthritis of the wrist. This is a severe condition where the pain can appear during an activity (involving this joint), but it can also intensify after the activity itself, and cause the joints to become stiff.
Doctors usually say that accurate diagnosis is the key in efficient treatment, which is 100% true! Why? Well, most people don`t really like going to their doctor. They tend to diagnose themselves and assume injury is not severe: “It`s just a sprain, the ligament is not torn.” Then they rest for a few days (until the pain goes away) and resume with their daily activities. They only visit their doctor after several months, when they start noticing something is not right.
As for the treatment, it can be non-surgical or surgical.
Non-surgical treatment is usually reserved for patients with partial wrist ligament tear. It involves:
Splints or a cast to immobilize the joint and allow the ligament to fully heal (up to six weeks)
After the ligament is fully healed, patient will usually require physical therapy to regain the range of motion and strength within the muscles and joints.
Surgical treatment is for patients where the ligament is completely torn; it may also be required if the bones are not aligned properly. It is vital that the surgery (if it is required) gets done as soon as possible, before scar tissue forms and bones fall out of their place.
There are several surgical procedures that can be done and surgeon will usually choose the best one based on your current situation.
Bone pinning is a procedure where the surgeon will insert a metal pin to hold the bones in place, until the ligament is fully healed. This procedure is good for partial torn ligament in wrist, but it needs to be done within couple weeks after the injury, before the scar tissue starts to develop.
Ligament Repair/Reconstruction Surgery
This surgery is usually performed after six or more months after the injury occurred. The goal of this surgery is to identify the torn tendon and insert a tendon graft (a tendon taken from another place) in its place.
Recovery Time After Surgery
Recovery time will depend on the type of surgery that was performed, but patients are usually able to use their hand within the first couple days after the surgery. After two weeks stitches are removed and patients are advised on which exercises to perform and in an effort to regain full mobility.
(1912.) Gray H. Radiocarpal Articulation, Anatomy of the human body, page 327
Image 1 – source: Gray H. Anatomy of the human body, page 327
We often take our hip joint for granted; it is massive, and it bears a lot of our body weight, allowing us to walk, move around, stand, sit down and get up. But, just like any other joint in our body, it is susceptible to wear and tear.
As the years go by, structures of the hip joint suffer more and more damage until one day you try to get up and feel a sudden, sharp pain. This intense pain is usually brief; it appears after we’ve been sitting for extended periods of time, and it goes away after walking.
Another important point you need to take when talking about this short-term hip pain is that it can lead to osteoarthritis, so it is vital that you take it seriously.
Before we go ahead and jump to the causes of this condition, we’d like to take a moment to talk a bit about hip anatomy.
The Anatomy Of The Hip
The hip joint is where the thigh bone (femur) connects to the pelvis. Believe it or not, the hip joint is second most mobile joint in the human body (second only to shoulder joint) because of the specific way it is built.
We call this type of joint a ball-and-socket joint because the ball-like top of the thigh bone (femur head) fits into the cup-like area on the pelvis (acetabulum).
But, because it carries such a heavy load (our entire upper body) it is designed for stability, rather than a range of motion.
The capsule of this joint is sturdy and thick, locked in place by robust ligaments and muscles.
Why Do You Have Hip Pain When Sitting?
It is important to stress out that hip pain is not normal! Some people acknowledge it as an integral part of aging process, but this is not the case – any time the pain is present, it means something is wrong.
The good(bad) thing about hip pain is that it will not go unnoticed. The hip joint allows us to move around, sit, get up or stand, so if there is a problem with cartilage, tendons, ligaments, or bones, it will manifest itself as sharp radiating pain, stiffness in the joint, or referred pain felt in the groin area, down the inner thigh. Interestingly enough, lower back can cause the pain to radiate to the hip.
So what is causing this pain when sitting that goes away after walking? Here are some of the causes:
Hip impingement syndrome
Hip Impingement Syndrome
Also called femoroacetabular impingement, it occurs when acetabular labrum(a ring of cartilage surrounding the hip joint – Source: Medicinenet1) is damaged. The damage may be caused by a deformity, wear and tear damage, or by a mechanical injury.
Many HIS sufferers are those individuals that spend most of their day in the seated position. When we assume this position, there is typically enough space between femur head and acetabulum to allow full range of motion.
But if there is an anatomical anomaly present they can bump into each other, limit the range of motion and cause pain. Common causes of these anatomical anomalies are:
Shorter femoral neck
Enlarged acetabular surface
Increased depth of acetabulum etc.
But even people with no anatomical anomalies might suffer from hip impingement if they increase their flexibility to the extreme. This is why a lot of athletes also suffer from this condition – football, hockey, and baseball players for example.
Diagnosing Hip Impingement Syndrome
The syndrome can be relatively easily diagnosed based on your description of the symptoms and physical examination. Other common symptoms include:
Groin pain associated with physical activity
Painful clicking in the joint
Reduced range of motion
In addition, your doctor will probably order imaging tests, just to make sure. These include:
A CT scan
How To Treat It?
Nonsurgical treatment for hip pain when sitting will involve changing your routine – avoiding activities which cause pain, in combination with physical therapy and medication.
Surgical treatment usually steps in when physical therapy is not enough to relieve pain. In this case, arthroscopic surgery is required, where the surgeon will make small incisions, insert a small camera (called arthroscope) to try and pinpoint the anomaly and address/remove it.
Keep in mind that it is still unknown whether the surgery can prevent or even delay osteoarthritis, there is still some research to be done concerning this issue.
Stiffness2 can grab hold of every joint of our body; it is not only limited to the hip. In most cases, this is just a short-term condition brought up by a mechanical injury, such as a hip fracture, dislocation, or tight hip flexor muscles.
On the other hand, it can also be a part of a long-term, chronic medical condition. Some of the most common conditions are:
Osteo and Rheumatoid arthritis – osteoarthritis is a chronic condition where cartilage(protective tissue at the end of the bone) starts to deteriorate, and the bones start rubbing against each other. Rheumatoid arthritis, on the other hand, is an autoimmune disease(a condition where your immune system mistakenly attacks your own body) that damages joint tissue
Tendinitis – tendons are thick cords of tissue that join muscles to the bones. If for some reason, they become inflamed or irritated, a person will develop a condition called tendinitis
Ankylosing spondylitis – AS is a type of arthritis primarily affecting your spine, leading to pain, and disability
Lyme disease – this is an infectious disease caused by a bacteria called Borrelia burgdorferi, transmitted by an infected tick. The disease advances in three separate stages with a different set of progressing symptoms. A localized rash characterizes the first stage; chills, fever, fatigue, and sore throat characterize the second one while the third one may lead to severe headaches, brain disorders and arthritis
Symptoms And Diagnosis
The main symptom is, of course, a stiff joint, but you will also notice localized pain, limited range of motion and hear a clicking sound as you move.
A physical exam is usually enough for a correct diagnosis, but your doctor might need some additional information such as a clear list of symptoms, existing medical conditions, injuries, etc.
X-ray and MRI are usually not needed to make the right diagnosis, but they can be used to pinpoint the location of the problem or rule out other, unrelated conditions.
Treating A Stiff Hip
Treatment will depend on the underlying cause. In most cases of hip stiffness, a doctor will advise his patient to adopt some light stretching exercises to release tension within the muscles, walk, and rest when the pain appears.
Arthritis, on the other hand, is not a curable medical disease, so appropriate medication is prescribed to help patients manage the condition and reduce the pain.
Hip or trochanteric bursitis is an inflammation of the trochanteric bursa on the outside of the hip joint.
Bursa3 is a small, fluid filled sack situated in places in tissue where friction would commonly occur. So, its main role is a protective one.
Trochanteric bursa is located on the outside of the hip joint, where the pelvic bone meets the top of the thigh bone. When this bursa gets inflamed, the patient will experience some of the following symptoms:
Inability to lie on the affected side
Pain when getting up
Pain when remain seated for longer
There are numerous ways of addressing the inflamed hip bursa, depending on the severity of the condition. In its early stages, doctors usually prescribe physical therapy, ice, and painkillers to help reduce the swelling and pain. This is why you might feel the pain going away after walking.
Doctors will treat more severe cases with injections and bursa draining; if that doesn’t help, they might even use surgery as a last resort.
Arthritis4 is a term we use for the conditions affecting out joints and the surrounding tissue. Early signs of arthritis are swelling in the joints, pain, and stiffness; over time, the disease will progress and cause severe joint damage.
Here are the six most common types of arthritis:
Juvenile arthritis – a type of athritis affecting children
Infectious arthritis – arthritis as a result of an infection within the joint
Psoriatic arthritis – psoriasis is a skin disease causing patches of thick, red, itchy skin. Some patient suffering from psoriasis can also develop a type of arthritis we know as psoriatic
OA is severe, degenerative disease (most common in hip, knees, spine and small joints of the hand) that breaks down the cartilage in the joints.
It is more prevalent in older individuals, people that are obese and often come as a result of a direct injury.
OA is usually diagnosed using a combination of physical exams, medical imaging technology, and blood tests. And as for the treatment, the doctor will often prescribe topical creams, physical therapy and exercise and, in more severe cases, operation or even a complete joint replacement (hip replacement surgery).
Autoimmune diseases5 occur when there is a malfunction in our immune system. Usually, our immune system protects us from diseases and infection, but in some cases, it can produce antibodies that attack healthy cells and tissues within our own body!
This is precisely what happens in RA patients. Unlike OA, RA can affect even your eyes, mouth and lungs; it is not strictly a “joint disease.”
Noone still knows what exactly causes RA, but the good news is we can slow down the progress of the disease with medication and lifestyle changes.
Gout is also a common type of arthritis occurring when there is an increased uric acid build up in the body. It causes intense pain, stiffness, swelling, and increased the temperature in the joints.
Uric acid6 is a substance resulting from the breakdown of purines7, commonly found in meat products.
Usually, uric acid gets dissolved in our blood and passed through the kidneys out of our body in urine. Sometimes though, this uric acid can build up within the body in a needle-like crystal form. When these formations accumulate within the joint, they can cause tremendous pain.
Gout will first “go after” your big toe, but it can also spread to ankles, knees, wrist, fingers, and elbows.
Piriformis muscle is a flat, pyramid-shaped muscle located in the pelvic region. Its primary functions are to rotate the thig outward, abduct it(move away from the midline of the body), and to hold the acetabular head in place.
A gap at the lower border of the muscle allows for the neurovascular structures to pass(along with the sciatic nerve). This gap can become tight and put pressure the passing nerves, causing piriformis syndrome.
Some of the main causes of this condition are:
A blow to the region
Tightness in the muscle
Sitting for long
Various sport activities
Penetrating wounds etc.
We refer to sciatica as a symptom of one or more problems with the sciatic nerve.