Throughout the year, and often over holidays and festive breaks, many people spend much of their time sitting at work or for social functions, or travelling long distances by car, plane or train. This may play havoc with hip pain. Here, we discuss some simple strategies to reduce hip pain sitting, when socialising and travelling.

Key Strategy 1 for hip pain relief in sitting: Watch your hip angle

Sustaining your hips in a position where they are bent more than 90°, may cause pain aggravation of:

1. conditions within the hip joint ( Osteoarthritis, labral tear, Femoroacetabular Impingement Syndrome), of the muscles and tendons around the hip and pelvis (Gluteal tendinopathy, trochanteric bursitis, Greater Trochanteric Pain Syndrome, proximal hamstring tendinopathy),
2. the nerves that run through the buttock (Deep Gluteal Syndrome, Hip-Related Sciatica, Piriformis Syndrome).

You can reduce this angle in a number of ways to help reduce your hip pain sitting:

• Avoid choosing low chairs or lounges/sofas
• Tilt your seatbase forward just a little if possible, to bring the hips a little higher than your knees
• Use a wedge cushion
• Recline your seatback slightly

Key Strategy 2 for hip pain relief in sitting: Reduce Compression

For those with pain over the sitting bones (ischial tuberosities), which may be associated with proximal hamstring tendinopathy¹ or ischiogluteal bursitis, the aim is to relieve the pressure over these bones in sitting. Often a pressure relief cushion (made from foam with an egg carton pattern) is very effective at reducing the compression across these structures when sitting. Or just start with some sort of pillow to increase the softness of the surface on which you are sitting. For some people, this isn’t enough and you may need to purchase a piece of thick medium density foam and cut out a couple of holes for the sitting bones. Sounds weird but works well!

For those with pain over the bones at the sides of the hips, usually associated with gluteal tendinopathy or trochanteric bursitis³, bucket-type seats in vehicles that wrap around the sides on the hips and thighs, may exert some pressure there. This can become uncomfortable after prolonged sitting. This discomfort can be eased by lifting your hips higher, so that you elevate yourself away from the edges of the seat. For example, use a wedge cushion or fill in the middle of the seat with a folded towel, creating a flat surface with no pressure from the raised edges of the seat.

For those that suffer with coccydynia, pain related to the tip of the tailbone, direct pressure of the coccyx on the seat can become painful. Coccyx cushions are available with an area cut-out to remove pressure from the coccyx². If you run out of time to find a pillow before your travel, use the general principles of removing pressure from the tailbone, even with a folded towel lengthwise under each thigh and buttock, to lift the tailbone away from the seat.

Pressure relieving cushion

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Wedge (angled) cushion

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Coccyx cushion

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Key Strategy 3 for hip pain relief in sitting: Move Frequently

Just remember, MOTION IS LOTION for your body. Moving has lots of benefits for your body but in this situation will help relieve sitting pain. If you are stuck in a seat, try to move within that seat:

• slowly rock your pelvis forward and backward, gently arching and bending your lower back within a comfortable range
• move your legs – those aeroplane exercises are really good for you – pump your ankles up and down, alternately lift each foot and straight the knee as far as you can within the space
• squeeze and relax the gluteal muscles of the buttock – this helps ease the pressure on your bottom and stimulates blood flow through the area.

Even better, wherever possible, get up & move. If you are travelling in a plane or train, get up regularly and take a short walk up the aisle. If you are travelling in a car, make a point of stopping every hour at a minimum. Yes, we’re all in a hurry to get to our events but in the long run stopping for a short break each hour will mean you reach your destination in a much better state. Avoiding driver fatigue also reduces the chance of motor vehicle accidents, so drive safe and stay comfortable this holiday period.

If you are sitting at a social event, find an excuse to get up and walk or suggest to the person you’re talking to that you continue your conversation while talking a stroll – chances are they are sick of sitting too!

Your Hip Pain Professional Can:

Hip Pain Professionals:

• Will ensure you have the correct diagnosis of your condition and therefore ensure you purchase the best cushion for your individual requirements
• Will educate you on what movements may be best for you to apply regularly, reducing your symptoms.  
• Will help you come up with strategies where the above is not giving you enough relief.

References 

1. Nasser A (2018) Proximal hamstring tendinopathy: a systematic review of interventions. JSAMS, Volume 21, Supplement 1, Pages S96–S97

2. Lirette et al (2014) Coccydynia: An Overview of the Anatomy, Etiology, and Treatment of Coccyx Pain. Ochsner J. 14(1): 84–87.

3. Grimaldi et al (2019) Gluteal Tendinopathy: Integrating Pathomechanics and Clinical Features in Its Management JOSPT. 45 (11): 910-922