Read on: danhwilliams.com

Read time: 2.5 minutes

I will get to Academy footballers!
And how they help explain hip pain. 

The paper sits open on my laptop..
BUT before I get to how a Cam shaped hip forms..
 
Something interesting happened last week.
While I was sat operating like this..

And thinking about running mammals helped me
..understand what was going on.
 

Let me explain..

I got this (small) spike of hip pain..

As I've written about a fair bit:
I'm a hip surgeon who gets hip pain
And as I wrote about in newsletter #50..
 
While training for the Great North Run
(all spring + summer long)

My right hip => ZERO pain
  (not even a twinge)

I've kept running the magic 25 miles /week
  (more soon about that magic number)
..while I decide upon my next target.
 
And kept my bodyweight
TO THE KILOGRAM
..in the right place.
 
((Aside from one small blip.. baked goods, as ever, to blame!))

👉 Bodyweight
👉 Activity
👉 Measurement

All ticked off and working well.. and NO pain.


So WHY last week?
 
Well, as part of our family’s life adventure
..we’re living in magical Somerset.

While I do chunks of work
..in magical Cornwall.
 
Over half term the kids go to the beach
And I do some joint replacements.
 
And this time that included
A run of partial knee replacements.
Not that unusual.. but this time we had 6 in row.
 

Why did that matter?

Well, the penny dropped writing last week’s Newsletter.
And this particular line..
 
‘Most running mammals do NOT need a large range of hip movement’
 
Now, I’m fairly sure I fit the bill of a ‘running ape’
One of the 1 in 5 male humans with..
A Cam-shaped Hip.
 
And I think my hip stays largely settled.. 
So long as I don’t use a ‘large range of hip movement’

I need to channel my inner woolly rhinoceros, polar bear and horse.
 
I stand up to do a TOTAL knee replacement.
And my hip is fine.

Standing (+ moving about) is good for our hips (and back).
 
BUT I sit down to do a PARTIAL knee replacement.

Some detail..
The patient’s knee sits in a holder
Dangling over the edge of the operating table.
 
I'm sat down (key info)..
The knee rests at my eye level..
I can see all I need through a small incision.

AND I control the patient's foot (+ leg) between my own knees.
Too much detail perhaps(!)

BUT that detail it turns out, DOES matter.
 
To hold the patient’s foot between my knees..
I push my own knees together.
 
With my own right hip in flexion
I twist my own right hip inward..

Flexion + internal rotation like this..
  (white arrow)

I repeatedly impinge my right hip.
  (red arrow)

WOW!

The penny dropped..
I need to think about my own leg position.

I plan to do many more PARTIAL knee replacements.
They're great operations, that really help people.

SO, I'll need to change my own position.
Do I need to stand up?!
 
I’ll let you know..
 
Anyhow, the message for this week..

We should listen to our mammalian ancestors
If we are ‘running apes’, we need to pay close attention to our hip movement.

Are there positions in your everyday life that cause your hip pain?

Analysing academy footballers.
Helps us understand how a cam shape hip forms.
That story is coming up.. (thanks for waiting)

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