19 yrs old, 6 years of hip problems.

[Quickstart]

I will preface this post with the following disclaimer: This is only an educated guess based solely on your reported symptoms, and is no way a definitive diagnosis.

With that out of the way, it sounds like you may have Janda's distal crossed syndrome. I will try to explain this as best I can.

Hypermobility is a significant factor for the development of musculoskeletal injury and postural dysfunction. When joints move more than they should it puts exaggerated stresses on other joints, ligaments, muscles and tendons when they try to hold 'normal' alignment'. The picture below highlights posture commonly found in hypermobile individuals.



You might be able to see that there is an increased arch in the small of the back with the hip bones jutting forward. Essentially what you are doing is not using the muscles around your pelvis and lower back to keep you in alignment. You are hanging off the ligaments of your lower back, hips and knees to keep you upright. While this is an effective way of keeping you upright, it will cause problems to the strength and length of your muscles. Because your pelvis is tilted forwards, the muscles that run across the front, and where you are getting your pain (Iliacus and Psoas) get tight. See below for these muscles.



You also get tight across the muscles in the small of the back, and weak in the abdominals and gluteals (because you are not using them to stand/sit properly). This posture also puts stress on the joints and ligaments of the spine, which may explain your numbness/tingling in the feet. The tightness in your Iliopsoas (Iliacus + Psoas) is most likely causing the majority of your symptoms, but the other factors can contribute too.

You need to start a stretching programme for your tight muscles, strengthening for your weak muscles (ie pilates and gluteal exercises) and postural correction (which could include taping, exercise or bracing). Your physio could also try some manual techniques to aid you to help you lengthen these muscles and guide you through a progressive core-stability program.

If none of these treatment options work then another option could be getting more comprehensive diagnostic imaging, like an MRI or ultrasound, done to clear any other abnormalities. But, again, without a comprehensive assessment this is merely postulating.

[Eleanor]

I cant thank you enough. Even if that isn't what I have at least I know a little more about my body. I do jut my hips forwards when I stand and my knees are always pushed back. I never knew bad posture could end up so badly :s

I will definately start some sort of excersise regime and slowly build up my strength.

Thank you so much for the images too. The physio did mention the muscles but couldn't explain them as thoroughly as the images and I could never remember their names.

So, excersise is the way forward. Thank you for clearing this up for me.

(once again, I understand this is just speculative, but it does seem to make a lot of sense to me)

Oh, and are the clicky hips part of this, or or do they click because of something else?

[Quickstart]

The hip clicking can technically be explained by this particular problem. When that muscle gets tight, the tendon is more prone to flicking quickly over one of the bony bits at the front of the pelvis. This frequently causes pain and can cause a sensation of something moving in the front of the hip.

There are other causes of the clicking hip of course.

One is the iliotibial band (ITB) that causes snapping on the outside of the hip. The last is that there is something disrupting the internal mechanics of the hip -- like a piece of bone, cartilage or something else. If the exercise programme does not work, then I would advocate a CT/MRI to just clear something like that.

Hope you find some relief from this.

Cheers,
Quickstart