Tuesday, November 25, 2008

My Hips Don't Lie

Today's blog post is about hips.

I know... you think you know 'the hips'. Often curvy, located between the thigh bone and the back bone. (Oh, those bones, those bones, those crazy skeleton bones.)

But when patients come in complaining of hip pain, it often becomes obvious that one of us didn't pass Anatomy 101. "My hip hurts", you say, pointing to your waist or lower back. "Fix my hip" you insist.

The picture to the left was found by Googling 'hip pain', though I'd refer to that area as the low back, the upper glutes, or even the 'iliac crest' if I thought you'd be impressed by that sort of thing. True hip joint pain will present in the front near the groin, as demonstrated by the picture to the right. Note that these are my favourite patients, the ones who present with their bones visible through their clothes and the problem highlighted in bright red. Makes for an easy diagnosis.

Just so we are clear: the hip joint proper refers to the connection between the femur (leg bone) inserting into the pelvis. So in fact, the thigh bone connects to the pelvic bone, and I don't really know what the hip bone is. It is a fascinating joint, the hip (to me anyway... though my favourite joint is the shoulder. Fun!), influenced by a host of muscles like the iliopsoas and the gluteals. It is a stable ball and socket joint, which sacrifices mobility for stability. This means that it is strong enough to hold up your hefty 'hips', Beyonce, but just mobile enough to let you walk, and rarely mobile enough to do the splits or the cancan.

I've had some of my own hip pain lately, thanks to a certain fetus who shall remain nameless (Especially if it is a girl, seriously, we can't agree on a name. Suggestions welcome...). This is a common pregnancy complaint, hip pain, due to pressure from the growing baby directly on the pelvic joints as well as muscular compensation around the area. In my case, the baby was positioned diagonally, the head pushing against the inside of one side of my pelvis.

Funny thing, it felt just like someone was pushing my pelvis apart from the inside.

My relief came in the form of massage, pelvic adjustments, and the baby committing to a more head down position. A complete cure for my particular condition apparently involves becoming a parent. Fortunately, most hip pain problems are much simpler to treat. Hip pain from arthritis is often managed with a combination of massage and modalities such as ultrasound, as well as nutritional supplements like glucosamine. Hip pain in runners is commonly due to iliotibial tightness and can be relieved by releasing that muscle. Hip pain may also be due to bursitis, a local inflammation that responds to ice and rest.

Tragically, hip pain is often misdiagnosed due to simple anatomical confusion. (Tragically Hip pain is entirely different, often due to pain in little bones, but can be fully completely treated.*) The important thing is to really understand the origin of your 'hip' pain, and treat it accordingly.

So, Shakira, your hips may not lie, but they sure are misleading. Work that into a catchy tune.

*I'm so sorry for this... so very sorry.

Wednesday, November 19, 2008

Baby Brain

I've been trying to get a blog post up for the last week.  I've got many started, covering fascinating and sure-to-be popular topics such as: 'Anatomically Relevant Idioms!', and 'Hip Hip Hooray... not.  When Hip Pain Strikes', and the much anticipated 'Mind Over Uterus: Using Hypnosis to Manage Childbirth'.  Of course these are all working titles only, but I'm sure I've whetted your literary and chiropractic appetites.  
The problem?  I can't finish a damn thing.  This is not writer's block - I've got plenty to say!  I just can't find the words.  I'm... a little slow lately.  With words.  And stuff. Like on any given day I usually have at least one article of clothing on backwards.  Fortunately (or not, as it were) it is usually a garment not visible to the public.  I recently washed the television remote control along with the duvet cover, not noticing until halfway through the dry cycle (45 minutes of CLUNK CLUNK CLUNK didn't tip me off!).  I know I've done other dimwitted things, but they've seemed to have slipped my mind.  My sieve-like mind.  

It took me a while to catch on.  Perhaps I needed more sleep?  A case of premature senility? Maybe too much zinc in my diet... or would that be not enough?  Why was I so obtuse (thank you thesaurus.com)?  

Baby Brain.  

To be perfectly frank, I had always doubted the veracity (is that the right word?) of this condition.  I felt it was an excuse that the, let's be honest here, more simple moms-to-be used to make up for their... uh... shortcomings.  Surely a braniac like myself would only thrive during pregnancy.  I'd spend the 9 months reading up on child-rearing philosophies while mastering sign language to teach to my genetically gifted infant, and maybe finish that book on Jung that I'd started.  

Well.  Mea Culpa (does that make sense?  Latin is not a strong subject right now either...).  My bad.  Apparently, you're with stupid.  I've got a bad case of baby brain.  My blood stream has been rerouted to the womb.  

So, loyal readers, forgive me if there is greater space between posts, for there seems to be greater space between my ears.  I've got a bunch of really, really good stuff started... but these days the only thing I seem to be able to finish is a meal.

Tuesday, November 11, 2008

I Remember

Remembrance Day.

As a child November 11th was about fuzzy plastic poppy pins (and wearing them in your mouth as funny lips), reciting "In Flanders Fields" and listening to a trumpet sound. And something about soldiers.

I never really felt much on this day, but this year seems more momentous. Maybe my own life-changing events are causing me to reflect. Perhaps the recent political election and renewed sense of hope from down south are affecting me. I just find myself thinking a lot this remembrance day, hoping that soon, the concept of war will be so far from our day to day life that it will become harder and harder to relate to. That we will need Remembrance Day more than ever, because otherwise, we will have forgotten that some people are not free.

Until then, I remember.