Hi, I’m just wondering if there’s any special concerns when training with hip dysplasia in one hip? I am 19 years old, male, and have hip dysplasia in my left hip and 60-degree thoracic scoliosis with a smaller 30-degree lumbar curve. About 2 years ago I was doing lots of running, and injured my hip getting out of the car. That’s when we got an x-ray and found the dysplasia, the doctor said “they had seen worse” but didn’t tell me exactly how bad the dysplasia was, I’m pretty sure it’s mild from comparing it to others online. Also asked if it was a labral tear and they said “probably not” based off moving my leg around, and “there’s no way to know unless we get an mri”.
Since my injury and until very recently, I’ve had to walk with a hand on my hip, to kind of massage certain painful spots that crop up when I’m walking, usually in the front of my hip but sometimes in the side and back as well. The pain happens when I’m pushing off the ground with my left leg behind my body, at the back of my stride, so I guess I’ve cut that part of the stride a little short to avoid that. I always walk 4 miles a day. From what I can remember, both internally and externally rotating my hip as far as I can causes pain, but I don’t even try to do that so I don’t know if that’s still the case. Lots of functional movements, getting out of cars/into cars, lowering my leg after it’s lifted, etc were painful over the last 2 years, but I’ve tried to do less “babying” of my hip recently (and this has helped certain movements become less painful). For example, I’ve been pushing myself to walk without my hand on my hip, and it’s mostly working well, sometimes I still need to massage a painful spot but overall I’m now able to walk without supporting my hip with my hand or massaging my hip. Also, I started doing hanging leg raises a few weeks ago and that’s helped me get into/out of cars easier. But I still can’t run without lots of pain, which I’m okay with because I don’t know if running is the best thing anyway with hip dysplasia. But I would like to get stronger, and I also read this guy’s story on reddit, where he had mild and painful hip dysplasia, started weightlifting, and felt way better with everything, so I just want to know if that can be the case for me too. Is there anything someone with hip dysplasia needs to avoid, and what exercises sound like they might be good to start with with my kind of pain and issue. I really hope I don’t need to get that PAO surgery for the dysplasia, it just seems excessive to me and I think it’d be awesome if my tissues could find a way to adapt, get stronger and pain-free even though they feel more stress than an average hip.
Also curious about scoliosis, I’ve heard about Lamar Gant, my curve is a little smaller than his is, much less outwardly apparent because I have a lower curve that balances it out and don’t have as much muscle development as he did to “outline” my spine like that. But I’m not 100% sure what the consensus is about lifting with scoliosis and if there’s anything I need to be more careful with, since my case isn’t mild/moderate but a rather large curve that I could get operated on for, but I elected not to since it’s still way too small to affect my lungs/heart. I was told I didn’t have any limitations by my doctor and I’ve been told weight training would be fine, even beneficial, for my back, I’m just uncertain because a physical therapist 4 years ago told me there were many things wrong with my form, in part from the scoliosis, and that I should avoid lifting, sports, and bodyweight exercises and all the stuff I was doing back then until I could do them properly.
What led me to that therapist 4 years ago (when I was 15), was that I was always tweaking my shoulder, not so much during lifting but especially during sports like basketball, table tennis, anything that required me to use my arm with quick/fast movements. But sometimes during lifting I tweaked it as well, especially with the military press, that would occasionally give me lots of neck pain and shoulder pain for a couple days (is this because I have to bend my back backwards in order to get my arms vertical, because they don’t go all the way on their own?). Sometimes heavy bicep curls would hurt my shoulder, I feel like I use my shoulder a little when I do bicep curls so when I go heavy with them it hurts the shoulder.
Oh, and initially just my right, but now both shoulders pop most times I move my arms above parallel, I imagine this could be from basically avoiding every upper body exercise except bicep curls for the last 4 years, but they popped even when I was exercising a lot, just not as much as they do now. The other thing that led me to that therapist was that, when playing soccer or really doing any sport, I tended to arch my back a lot and sometimes I tweaked it when making a sudden movement. I always arched my back during split squats (but it wasn’t arching on every rep, it arched and stayed arched at the start and stayed arched throughout if that matters), split squats were one of my favorite exercises but it turned out I was doing them wrong by having anterior pelvic tilt and arched back during it, not sure if that’s actually wrong or not now that I’m reading some articles on your site. It should also be noted that I only worked out with dumbbells or bodyweight exercises my entire life. Should also be noted that I wasn’t sleeping too well that summer when things really started to hurt/get injured, but I did experience much more minor tweaks (in the shoulders specifically) the previous years too so it can’t be 100% because of the sleep issue, can it? Admittedly my nutrition might not have been great either back then, I might have been in a calorie deficit, but I think I was eating enough protein (I always aimed for 1 gram per pound of bodyweight). The last symptom that led me to therapy 4 years ago was elbow pain during push-ups and overhead tricep presses with a dumbbell. It happened gradually, but my tricep would click, especially my right tricep, and then there would be a rep where it’d just get really painful. Right at the middle of where the tricep meets the elbow, not on the inside or outside of the elbow.
The form problems diagnosed were: anterior pelvic tilt, too much arching of my back, weak core muscles, inactive serratus muscles and inability to raise my arms (especially the one on the side of my spinal curve) completely overhead, overusing my upper traps, rolling my right shoulder forward (a tendency that comes from my rotated ribcage), not hinging from the hips enough during squats. 4 years ago I worked on all this stuff with that therapist but didn’t really get anywhere. It was insanely hard for me to activate my serratus properly and not use my upper traps to lift my arm, it was really hard for me to hinge at the hips properly without falling backwards, and I never got rid of the elbow thing. I was able to strengthen core muscles though.
From what I’ve been reading on your website, most of these issues don’t really matter in terms of pain for most people, but why did I present with all these issues and pain? Are any of them relevant biological factors in my pain, do they matter when the person has a severe scoliosis and hip dysplasia, or are they irrelevant to my pain? I’ve read bad posture/form isn’t a big deal in regular people, but what if it’s forced/structurally bad posture and form from the way my spine is? Is it a problem that my scoliosis forces my right shoulder to roll forward and internally rotate, does this increase my risk of injury? I see a lot about rounding the back during a squat not being as big of a problem as people thought for a long time, but is it a problem if I arch my back when I squat? Is it a problem if my right shoulder rolls forward/shrugs at the top of a pull-up? When I do a bench press, there’s just no room for me to have my shoulder in normal position because of my “hump” from scoliosis, the only position it can be in is internal rotation and forwardly shifted if that makes sense, is that a problem?
I guess my overall dilemma is, to what extent are scoliosis and hip dysplasia relevant biological factors in my pain, or would I have these same issues without those conditions, and whether there’s anything I should avoid with those conditions, and whether that first therapist was right about avoiding all lifting/exercise without proper form. I want to know if there’s any program or lifts I should start with given my symptoms, if dumbbells would be okay to use for exercises. And if you had any suggestions for the various other form issues and stuff I brought up above that’d be great too. I’d love to hear your thoughts on this stuff, thanks so much in advance!