Question
Hello Doctor Scott F. Gillman my name is Paul.
7 years ago I suffered I chronic lumbar disc herniation when I was 22 years old, I think it was caused by bad posture while standing and sitting and it was triggered even more after cutting a tree with an ax.
I spent over 8 months with this terrible pain, I had an extreme inflammation of my sciatic nerve, I couldn't walk, stand and worse lift my left leg in a 90 degree angle. I did my respective M.R.I, and treatments such as physical therapy with compressors, swimming, and respective postures while laying down and sitting. I never operated my lumbar (thank goodness) and luckily I am considerably better now. But the only problem that still remains and it worries me is that my joints between my leg femur and hip produces a loud popping sound that really scares me a lot, it is produced when I lift my leg with my knee  bent (like marching action)and lay it down, there it produces a loud "DOK" audible sound in which it doesn't produce pain but it worries me, because it's like a sensation that something worse can happen. Recently I also experience frequently low back pains when I do abdominal exercise to maintain fit, and it is very sensible to in what type of surface I lay myself to bed. In the mornings I need to make stretching movements to establish my flexibility in my daily routines.
Please doctor, I respectfully request in what treatments should I perform or do to nullify that audible sound that I mentioned and also what causes it in my joints or what is happening?, and what can I do to reduce my back pains especially when I do abdominal exercise (crunch method).
I'm looking forward for your response.
Thank you Dr. Scott Gillman.

Answer
Hi Paul,

The "DOK" sound likely is coming from a tendon that is sliding over a bone in the inner hip.  It also can be coming from your pelvic bone at the sacro-iliac joint.   I don't know if there are any chiropractors in Equador, but a well-skilled doctor of chiropractic can evaluate and treat this.  For some people, there are bone spur in and around the hip that the tendon gets caught against, and that causes the "DOK" or snapping sensation.  Sometimes a cortisone injection near the tendon can help, and an orthopedic physician can do this.   As for your back pain: STOP doing abdominal crunches!!!  Instead, learn to just tighten your abdominal muscles.  Imagine that you have to brace your stomach muscles to take a punch (e.g. like a boxer).  This simple maneuver, abdominal bracing, can help your back.   But flexing your lower back, e.g. bending forward into flexion, or laying on your back and flexing into an abdominal crunch places a lot of force on the discs.   Bending repetitively into flexion is bad.  Take professional golfers, for example.  When they bend repetitively to retrieve the golf ball, they do not flex forward.   Instead, they put the club against the turf, and then they bend while holding the club with one hand, reaching for the ball with the other hand, and swinging their leg up in the air.   This enables them to pivot at the hip and not flex their lower back.  This spares their discs!  You can visit this web site: www.coreessentials.biz  and look at the exercise called "1-leg dead lift." This is in Template-1 #7.  Also try Template-2, #1,3,5 and 8;  Template-5 #2,3; Template-6, #7;  Just do these.  No ab' crunces.   Also, see if you can find a doctor of chiropractic in your country.  

'Hope this was helpful.

Dr. G