Dear Doctors: I got diagnosed with a strained tendon in my hip after a soccer game. I thought it was healing OK, but now when I try to make fast movements, like a quick step forward, my leg feels slow and heavy. It's like walking through deep water. What is happening? Is it going to go away?
Dear Reader: The sensations you have described are actually a well-known part of the healing process from a soft tissue injury in the hip, which includes the muscles, ligaments and tendons. When any of these tissues is injured, it is possible for the nervous system to inhibit movements that it perceives as potentially damaging. In your case, you tried for a forward thrust of the leg in order to step quickly. Instead, you got a slower, more measured movement. That's the "walking through water" sensation you described. It occurred because the brain modified your "move fast" command in order to protect the injured area.
Let's begin with the hip, which is a ball-and-socket joint. That means the rounded head of the thigh bone, or femur, fits into a cuplike hollow in the hip. This ingenious structure allows the hips to bear the weight of the torso while also giving the legs and pelvis an impressive range of motion. Muscles, ligaments and tendons -- the soft tissues -- anchor the hip joint. They provide power, stability and flexibility. They also send information to the brain about changes in the hip's movement and location. This is a concept known as proprioception. It's complex, subtle and (nerd alert!) fascinating. And it's at the heart of that "walking through water" feeling you have described.
When you injure your hip, sensory receptors in the soft tissues can also be affected. This can result in confused or faulty information about the hip's position and movement -- that's proprioception -- being sent to the brain. Rather than risk further injury, the brain begins to modulate movement. The good news is that, with time, normal movement typically does return. How long this will take depends on the extent of the original injury, successful healing and the demands that are put on the hips and legs.
Physical therapy can also play an important role in recovery speed. For this type of injury, the focus is on balance, strength and dynamic stability. That's a fancy way of saying the ability to maintain your balance while your body is in motion. Exercises include single-leg stances for balance, performed in a variety of positions. In more advanced work, balance exercises may take place on an unstable surface, which targets stabilizing muscles around the hip. Step-ups onto a low box and minisquats help build strength. Increasingly challenging ball catches are used to improve coordination and reaction time.
Improvements to strength and proprioception allow the brain to once again trust the information it receives. This lets the nervous system gradually back off from its protective response. And with those protective "walking-in-water" inhibitions eased, normal speed and freedom of movement can finally return.
(Send your questions to [email protected], or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)
