Julie Pitois LMT, CAMTC
Okay. Yeah, we’re talking about the hips again. 

Mike Julian LMT, CAMTC

Not Just Where The Femur Meets The Acetabulum 

Julie Pitois LMT, CAMTC
Last week, if you guys were with us last week, we talked about hip pain and what he had pain actually was. 

Remember, went by about like why we have hip pain and what’s going on with it as far as like posture is concerned. 

Remember the hip pain is not just the ball and socket joint, right there. A lot more to the hips than just where the femur meets into the acetabulum. 

Mike Julian LMT, CAMTC
Yeah. The whole thing is you might be getting hip pain in the hip, but where’s it coming from? That’s the big fat. 

Julie Pitois LMT, CAMTC
Let’s go slowly down so you can actually see . Okay. The hip is the largest ball and socket joint in the body, for sure, but maybe in the world. 

It’s the ball is over the head of the femur. It fits into the socket called the acetabulum right into the pelvis. Scully’s got a nice one here. He’s trying to show you. This is what actually, it allows us to kind of walk and move, right? 

You’ve got this big femur, your thigh, that’s your thighbone. What it does is it moves forward. It moves back, it moves out and move in. It rotates in it, rotates out, okay, there’s a lot of movement going on into this hip. 

What we’re working with is most people will find that they have pain in this area, but is it really, truly, always coming from your hips? Now we discussed last week where it could be potentially coming from the actual hip capsule. 

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Julie Pitois LMT, CAMTC
Like I just said a couple of seconds ago, there’s this big pelvis that fits into this hip that we get to contend with as well. Right? 

So the hip joint is formed. Wounds are I’m sorry. A joint is where two bones are formed is where two bones meet, sorry, it’s something in my Bible. There’s varying amounts of movement within them, right? 

Pain may be related to structures that are involved in the function, in support of the joint. There are several joints within this pelvic region. You have your hip joints, you have your pubic synthesis, which is in the front of the pelvis. 

That’s actually where the two big bones of the pelvis come through. And it’s right down into the middle. It’s your pubic bone, your pubic synthesis. You’ve got your sacred iliac joints into the back. That’s where your ilium are on the side. 

Julie Pitois LMT, CAMTC
You’ve got your sacrum that comes down in the middle. The joint is where the SA the ilium and the sacrum meet. So those are your sacroiliac joints. 

There’s your sacred Cox and GL joint down here where your sacrum and your Coxix hit at the bottom of your tailbone. This is like the tailbone. 

This is like where people fall and that this breaks or bends, and there’s a bad ski accident waiting to happen right there when you pop your joint back in here. Hello to all of you out there. I see you. 

Mike Julian LMT, CAMTC

Julie Pitois LMT, CAMTC
Let’s go over why these are so important to the hip function and hip pain. The pubic synthesis right here, let me move Scully. 

This guy right down here, not trying to be inappropriate, but this is what it looks like here. It’s the joint where each half of the pelvis joins at the front of the body, right? The word synthesis is a means where two bones are closely joined. 

That’s the whole point of synthesis and the joint is a flat or a small plane joint right in here. This is the joint also where women, when they’re having babies, it expands and opens up for childbirth so that we can actually get the kid out of the shoot because it’s important. 

The kid would get caught in there. That would be a whole nother tissue talk. 

Mike Julian LMT, CAMTC

Julie Pitois LMT, CAMTC
Exciting. Yeah, this disc that sits right in between here, right? 

What this does is this allows for movement, but it also, if we think about it, when we’re walking the bones in the pelvic area, actually move . 

You have very little movement, but there is supposed to be some movement down in here because as we’re walking and let’s say, Scully’s having a good walk and let’s say his walk is a little off shot because he has. 

Mike Julian LMT, CAMTC
A civil cut on the trail. 

Julie Pitois LMT, CAMTC
Something like a blister, whatever. As he’s kind of moving around or moving the pelvis actually moves forward and backwards . 

It moves forward and backwards and it blew it. It’s kind of an undulation because as the body moves, it has to compensate for the weight distribution that it’s given. 

As he steps down and goes into it, the pelvis drives down this pelvis drives back not a ton, but because we have to have some kind of movement into this pelvis to keep us movable beads, right? 

Really small movements, everything is rotating over the joint at the hips. Pain that’s related to the pubic synthesis is most commonly associated with injury or excess strain due to like either a major trauma. 

You have a fall, or you do the support when you’re not meaning to do the splits. Have you ever done the splits when you didn’t mean to hurts? 

The Hips and The Hormone Relaxin

Julie Pitois LMT, CAMTC
If you get too much stretchiness in the joint during pregnancy, remember there is this hormone that gets released called relaxin. 

For women, it allows the joints to become very loose so that we can actually create movement for babies. Right. That relaxing actually stays up to six months after childbirth. 

We may have given the baby, but then, or had birth, given birth to the baby, to me, one of those Wednesdays. These guys actually stay fairly loose. The ligaments stay pretty unstructured. 

They have to, they have to wait for that hormone to get out of the system. In doing that, it creates way more movement into the, but then we thought possible at this point. Right. Right. 

Also it depends on what if you’re a female, it depends on what kind of birth did you have? Did you have a breech baby? Did you have a seat? 

Julie Pitois LMT, CAMTC
You know, did you have a C-section? Did you have a vacuum delivery? Did, were there forceps being used? 

Like how much trauma was going on in there when you were giving birth, that’s going to play a huge role in hip pain. Crazy. 

We don’t think about it as much, but this guy plays a big role in how the hips actually work, because it will misalign the way the pelvis sits. 

If the pelvis sitting right, the hips, aren’t going to work that well, does that make sense, guys? Hopefully it does. 

Also not only just the ligament, but all of these gigantic muscles that we have coming into the hips, we have these giant glute muscles that fire off and extend the hip and laterally rotate. 

We have muscles that come into the front of the quadricep. We have muscles that are the hamstrings that extend the leg and bend the knee. 

Imbalances In The Hips And Body

Julie Pitois LMT, CAMTC
The quadricep what’s is the knee flexes the knee and extends the knee and flexes the hip. We have all these giant muscles that come into it. 

All of the repetitive use can create in balance all of the muscles of the adductors, the inner thighs that are attached right up in here. If you have too much of one thing and I had enough of another it’s crazy in imbalance. 

Right? Right. Think about your sports that involve kicking soccer, football for punting. What else? Rugby is a big sport because you’re doing a lot of running and you’re doing some kind of kicking. 

What are, I guess, well, run bay. I don’t know, but let’s say repetitive movement, repetitive movement, high speed, track and field. If you’re doing hurdles, if you’re doing any kind of a sprint, you’re going to have one side that’s more imbalanced than the other. 

Julie Pitois LMT, CAMTC
That’s going to lead up into potential hip pain based around this pubic synthesis. It’s most commonly experienced right into the groin area and or directly wrote over the joint. 

So you’ll have pain here. You’ll have diffuse pain coming out over here. You want to make sure that you are see, there is a lot of kicking and rugby. I do. 

I was right. You can actually address the area of the pubic synthesis, lot of people don’t think about this because they think groin well growing part of the hips guys, I mean, you got to use a hip to get to the groin and the grind of hips. I mean, it’s kind of part of it. 

You want to make sure that you are looking at all different factors that come into play with this big hip joint. That would be one area of the hip. 

Look To The Opposite Hip To Find The Source Of The Problem

Mike Julian LMT, CAMTC
Well, often it’s the opposite hip. That’s actually giving you the trouble staying hidden while pain is hitting the opposite side of that. 

Julie Pitois LMT, CAMTC
Right. Well, and now only, but let’s say that the pelvis is moving either way more or one side is just not moving and then it’s forcing movement on the other side. 

What’s what you’re feeling is you’re feeling pressure into here into groin pain. It might be actually coming from the front of your pubic bone. I mean, and it goes into the hips. 

People will think automatically that it’s could be hip joint and hip capsule coming into groin. It could be the opposite way. That’s something to think about right there. 

The other side, if we pull Mr. Scholarly around, is that sacroiliac joint, that S I, and Scully’s doing a really good job of showing you what an imbalanced SI joint looks like. 

Because if you notice, he’s kind of listing to the left side, which is actually how a lot of people stand. 

The Sacroiliac Joint

Julie Pitois LMT, CAMTC
He’s got a cool little scoliotic effect into his vertebrae, but as his pelvis is sitting this it’s offset. If the pelvis isn’t balanced, then all of the muscles upstairs and all of the muscles downstairs are going to be pulling at different angles, causing more pressure into this area. 

Right? SF sacroiliac, it’s sometimes referred to as your SSI joint. That’s what a lot of people will, it’s SSI, sacroiliac, where the sacrum meets up and is attached to the ileum. 

They meet up, remember it’s the joint is where they lay together. Does that make sense? I hope so. Okay. Come down into the tailbone, which is the coccsyx. These joints, these SSI joints, they’re designed for stability, very little capable movement capability, very little. 

They, again, go up and down as we’re seeing up and down and they go forward and back for poor Scully. 

Julie Pitois LMT, CAMTC
Just, it’s more like an undulation is really what it is. It’s taking the impact of the body up here and down here and distributing it is really what’s happening to it, right? 

We want the SSI joints to move. What we don’t want is the SSI joints to move to a point where this becomes an issue and there’s pain associated with it, right? 

These are also surrounded by some of the strongest ligaments in the body because they have to be so think about, let’s say Scully’s been like this for a long time. 

Cause he has, but the ligaments that are attached into here that attach to the sacrum, to the ileum and the ileum over into the lumbar area, there’s a lot of different ligaments. 

I’m not going to go into all of them right now, but what happens is there’s a stress that’s applied now, ligaments, their job is to stabilize their, their CROs, that their fibers are sitting like this, like a basket weave and they’re pulling so that they can be pulled from all different angles and create stable stabilization. 

Mike Julian LMT, CAMTC

Julie Pitois LMT, CAMTC
Let, so let’s say poor Scully has been sitting like this for a long period of time. 

His ligaments can only do this for so long before they start to loosen and loosen and become overstretched. 

If they’re overstretched, they’re actually going to be providing pain to the area because they can’t do their job, which is to stabilize this giant pelvis. Does that make sense? Hopefully it does. 

You’re getting me back into my teaching mode because I say, does that make sense? Every two seconds, my bum, my bad. What this whole pelvis is between all of the muscle structures that are pulling at it from all different areas. 

All they provide stability so that the joint structure can transfer the pressure of all of the large forces that are going between the body and the legs, because there’s a constant movement between the body and the legs all the time. 

Julie Pitois LMT, CAMTC
Let’s think walking, running, jumping, think about when we’re actually moving, what all is has to transfer, just walking alone. You’re basically taking all of the weight of your body from one side and you’re transferring it to the other, 

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Mike Julian LMT, CAMTC
Just distributing forces, right? From one place to another, all of a sudden, 

Julie Pitois LMT, CAMTC
Right? Some of the pain that’s associated with this SSI joint is a low back pain from the back into the butt, into the hip. 

This is your hip joint guys. This isn’t just back, but people will feel it into their back. Now this is most commonly developed in pregnancy or childbirth for women because your belly is so big because the relaxin is in here because the pelvis is now expanding for childbirth. 

It doesn’t set you up for stability, stability, and our strength in a feel good place afterwards, right? Because you have no stomach muscles they’ve been expanded for like nine months or so this also may occur after like a major trauma. 

If you fall, yeah. You fall onto one leg. You fall down, you trip over a curb, like all sorts of stuff. You get yanked by a dog. If you’re walking a dog. 

Mike Julian LMT, CAMTC

Julie Pitois LMT, CAMTC
Also over time, it can occur as well. You can have repetitive movement, repetitive forces and boom, boom. 

That’s going to give you joint pain. This pain will then come here. It’ll come up. It’ll go down. It’ll go into your butt. It can potentially go into the nerve and irritate the nerve. It’ll run down the back, run a leg.

A lot of it, here’s the thing with SSI. The one indicator that happens majority of the time with SSI, joint is from sitting to standing is brutal. Once you’re standing, you can deal, but it’s going from sitting to standing. 

That’s like, Ooh. And, or trying to lay down, laying down when your pelvis gets flat. If it’s not flat, it’s not going to get flat. Everything’s going to be irritated going from sitting to standing. 

If the pelvis is like this, you’re trying to Level off a pelvis that isn’t level, and it’s going to go up, right? 

Hip Joint Pain Coming From SSI Joint

Julie Pitois LMT, CAMTC
The structure of the sacroiliac joint makes it a very stable joint. 

Julie Pitois LMT, CAMTC
Remember they are attached. This instability comes back here. You may be having hip joint pain that is coming from your SSI joint. 

Then it’s coming into your hip capsule. It’s into the pubic bone and to the pubic synthesis, it could be all of these different things. And that could be creating hip pain. 

Hip pain starts into here, goes down into the leg or comes into the front. This is your hip. It could be from all three areas, 

Mike Julian LMT, CAMTC
Not so many. It could be from one area. That’s creating all the imbalance everywhere else. Right? If what I consider the structure is, if you don’t Google, it can say you’re struggling. 

Julie Pitois LMT, CAMTC
Getting any more education, 

Mike Julian LMT, CAMTC
It just point one area since it’s all interconnected in such an intimate way, just pulling one area is going to affect everywhere else throughout their whole body. Not just the one structure, right? 

Julie Pitois LMT, CAMTC
Here’s the other thing, too. If anybody out there has ever had any clicking or popping going on in their hips, 

Mike Julian LMT, CAMTC
I do popping and locking. Is that the same thing? Yeah. It’s not, 

Julie Pitois LMT, CAMTC
Well, no popping and lock you. Won’t be scary. Don’t have, don’t do popping and logging. 

If you have any clicking or popping in your hips, a lot of times that is the tendon that’s popping and snapping because the way of the leg is not in alignment with the actual hip joint. 

It could because all this is off that it’s going to give you some clicking and popping in there as long as there’s no pain in it, you’re pretty much okay. We, you to guide, check with the doctor, but there’s something going on. 

Cause it’s telling you something, but it could just be more of a tendency to, yeah. Pain in pain related to the sacroiliac joints or the SSI joints is most commonly up in the upper buttocks. 

Reason region is more up here. We all had it into a point tenderness pain right into the back. 

Julie Pitois LMT, CAMTC
A lot of times it’ll go right into the upper butt. A lot of times people will think if the disc issue, it’s gotta be a disc. 

It’s gotta be dead. Well, the dysentery affected because they’re in the front and they’re going to be affected with anything that’s offset in here. 

Mike Julian LMT, CAMTC
It’s creating our attention all the way up, 

Julie Pitois LMT, CAMTC
Right? But it’s not necessarily a disc issue. It’s a positional issue of the body and the bones and what’s happening is the hip pain is creating. 

Or the imbalance is creating a hip pain all throughout the front and the back of your body. If that makes any sense to you. Hopefully it does. The other thing too is we have this coccsyx back here, right? 

So this is like your tailbone. This little guy back here gets broken a lot and bent a lot. It’s, it’s actually mobile. It’s like the last remnants of we have of our tail when we had a tail way back when like a couple of years ago, not in the eighties, but like further. 

What’ll happen is have you ever missed your chair and fallen on your butt? Have you ever gone skiing and fallen on your butt? Have you ever gone skateboarding fallen on your butt? 

Julie Pitois LMT, CAMTC
Have you ever fallen on your butt? If you fall on your butt, what will happen is a lot of times this thing could potentially break off or more than that, is it all actually move and go up and in. 

It’s that pain where you have to sit on a donut because everything is so painful back there. This is actually there they’re fuse joints, but their joints. What’ll happen is they’ll go up and in, and then we’ll give you lower, but pain and back pain, still part of the hip area. 

Because you have this, that’s now bent. Yes, you can actually get that thing straightened. It’s a very intimate process and it’s very painful process. You’re going to have to find a specialist that actually does that. They’re out there though. 

So this can be done. If you are having chronic pain down in your seated area in the Cox six and the tailbone, it could because you’ve taken a fall and this thing has moved up. 

Julie Pitois LMT, CAMTC
What did, again, that does, is it throws all of this off. Everything about your hip joint is now off. There’s a lot of things that go on, unfortunately. 

So you could be over flexible. You can be under flexible people who tend to be overweight. Severely overweight, have a lot of issue in this area too, because of imbalance. 

With the weight of the pressure, into the hip joint, with the way of pressure into the offsetting, into the pelvis, into when you’re sitting into this c********r area, that could be a problem as well. How do we, how do we deal with this though? 

Mike Julian LMT, CAMTC
First off, the first thing is to assess and address what is really causing the pain that you’re experiencing, figure out where that’s coming from. Because if we could target that, we can clear a lot of problems out of the hip. 

Julie Pitois LMT, CAMTC
The other thing to you guys is when you’re looking at the actual hip, you have to see where are your imbalances like look at Scully and how offset he is. 

Most likely he’s got what’s called an upslope, which means that this side is a little too tight. Like the muscles in here might be a little too tight looking at to his QL, looking this, oh, his leg just fell right off, 

Mike Julian LMT, CAMTC
Coming off legs, 

Julie Pitois LMT, CAMTC
His poor guy, his internal and external rotators, domino holes. They might be a little too tight from rotating or sitting too much and kind of sitting in slouching over to the other side. 

What it’ll do is it’ll increase, it’s called an up slip and it will actually take your pelvis and it’ll move it upright. All of the muscles on the other side will do their best to compensate to make that better. 

What it’ll do is it’ll throw an imbalance into the joint and remember muscles move joints. Okay. 

Sitting At A Desk All Day Can Contribute To Hip Pain

Mike Julian LMT, CAMTC
Absolutely. Yeah. The next thing I look at is, okay, those were the structural problems. Why did those structural problems occur? What’s going on? What’s going on? 

Posturally it’s, you’re repeating over and over again, sitting at a desk, something you’re doing throughout the day and many hours a day, that’s creating this problem cause we can correct it, but how do we get it to stay and not come back?


Julie Pitois LMT, CAMTC
Right. With all of the sitting, the one thing I will say that end with pregnancy, because we brought that up today is weak pelvic floor muscles. 

Yes. These deep pelvic floor, the pelvic floor is right in here. Ladies and gentlemen, it’s deep. One of the biggest ones is the big transversus abdominis, which actually is part of your abdominal muscle structure. 

But it doesn’t contract. Like we would contract the bicep the way it shortens is it drives in on itself like a corset. Yeah. Everything contracts and pulls in and supports all of this deep structure. 

Remember the pelvis, what its job is in the hips are to take the impact of the ground below us and to deal with all this moving stuff above us. 

We need to have a structure of these deep, intrinsic muscles down in here to do the small movements that support the upper body to the lower body. 

Julie Pitois LMT, CAMTC
Yes. If we have had been in childbirth and we are expanded and we have a lot of relaxing so that the joints aren’t really as stabilized as we want them to be. 

If we are doing a sitting job and we’re sitting on our butts all the time, remember last time we said, if you’re sitting your P your femur is sitting up like this, right? Because out, and so that’s how you’re sitting and then your hands are here. 

Most of the time your body and your whole head is sitting over here, you’re in a collapsed state and this is not going to be tight More majority of people when they’re sitting, aren’t thinking like pulling my belly. 

What’ll happen is this’ll just get collapsed on and get forgotten about. When you stand up this now can’t support the load. That’s now applied to it with all of the movement that we’re giving it. 

Julie Pitois LMT, CAMTC
That is a big or guy stuck. Poor guy got stuck in. That’s a big part of it too. We have to think about all of the different aspects that go into the hip joint. 

The hip joint is never just the hip joint. If you are having hip pain, if you are having butt pain, if you having front of the hip pain, if you’re having groin pain, think about all of the areas that it might jump into and think about why. 

If you think about the why you’ll be able to address it and you might be able to get rid of it pretty quickly. Yeah. So, so really a lot of it is the fact that we are not balanced. 

That’s the only way I can think about it. We’re not, we’re not, I’m not mentally balanced today for sure, but the, all of the stability and all of the postural stuff. 

Julie Pitois LMT, CAMTC
Once we are stronger in certain areas, once we have worked this deep pelvic floor, if you are listening to me right now, take a deep breath and on your exhale, I want you to blow it out through your teeth like this, as hard as you can. 

What you’re going to feel is you’re going to feel a little inkling of an activation down here and that, because the transverse abdominis, that’s how it gets activated is through a sharp exhale. It has to be a forced exhale. 

What that’s going to do is it’s going to lock up everything in here. If you can’t figure out how to contract it, because you can’t do crunches, don’t help that transversus abdominis, you want to do a deep, forced exhale and all that strong exhale. 

You’re going to actually feel everything tightened up and lock. And I would. 

Mike Julian LMT, CAMTC
Suggest pulling your belly button in just before you can do that. Exhale, it’ll help guide that inward rather than pushing out that. 

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Julie Pitois LMT, CAMTC
Yeah. That can help support your structure so that if you are having any of this pain, we can locate it easily or use layer two more easily. 

Yeah. It’s one of those days. Anyway, I hope that helped. I hope that helped with you guys. I hope that gave you a, some kind of an idea that it’s not just because you’re feeling it in the hip, that it could be in all different factors of the pelvis. 

Mike Julian LMT, CAMTC
I’m going to go get my hips examined. You. 

Julie Pitois LMT, CAMTC
Should, you should. So it could be muscle. It could be joint. It could be ligament. It’s definitely going to be posture because posture is the sum of all of those parts. 

If you are using muscle joint, nerve ligament, the posture gets pulled in all different directions, structure yourself, and you’ll find that your pain will go away. 

Hopefully that helps you guys. I hope you guys have a great rest of your week and we will see you next week. We’re going to be talking about the knee. 

Mike Julian LMT, CAMTC
Do amazing things. Yes. 

Julie Pitois LMT, CAMTC
All right. Bye guys.