What could be causing your hip pain
Pain in the hip can have major repercussions on mobility, agility and your ability to function in general. It is a common problem, and can be confusing because there are many causes. It is important to make an accurate diagnosis of the cause of your symptoms so that appropriate treatment can be directed at the underlying problem.
If you have hip pain, some of the most common causes include:
Arthritis is among the most frequent causes of hip pain, and there are many treatment options available. It is generally towards middle age that symptoms become apparent, but can also occur in the younger age group. It is not just a matter of waiting for the inevitable hip replacement as Physiotherapy can help with education, strengthening, improving flexibility, and importantly looking at contributing and co existing factors. Unloading and activity modification advice, gait reeducation and a strengthening program for the gluteals are needed as well. We can advise you or get you started on a suitable hydrotherapy program with reduced weight bearing. A video walking analysis can help with imbalances and gait abnormalities that can be identified and corrected.
It is often in conjunction with tendinopathy. Trochanteric Bursitis diagnosis is an extremely common problem indicating inflammation of the bursa over the outer side of the hip joint. However it is almost always necessary to treat the bursa by adequately addressing the tendon and muscle weakness that contribute. Otherwise it is only a short term solution. Beware of stretching as this usually aggravates this condition but a graduated tendon loading program is a must. Gait re education and important postural considerations are vital to the recovery of this disabling condition.
Frequently encountered, tendonitis around the hip is associated with gluteus medius and minimus overuse and weakness. This debilitating condition is helped with unloading the painful structures, improving flexibility and a gradual tendon loading and muscle strengthening programme. Not only is this commonly found in our middle aged ladies resuming a fitness programme but also occurs in our much younger athletes and sports people who join bootcamps or start intensive physical training - too much too soon !
Labral Tear. The labrum is the cartilage that surrounds the hip joint. Hip labral tears are being recognised as a cause of pain and catching sensations in the joint. A labral tear can occur traumatically in sports that require sudden changes of direction and twisting movements. They may also occur during running or due to direct trauma such as a fall, heavy landing or motor vehicle accident. Occasionally, patients may develop this condition over time through gradual wear and tear associated with overuse. Physiotherapy treatment is vital to hasten the healing process and ensure an optimal outcome in all patients with a labral tear, even if they should progress to surgery, pre - hab for strengthening hip and leg muscles is vital to a speedy recovery.
Lumbar spine referral
Many back and spine problems can cause symptoms around the buttocks and hip. Common problems that refer pain to the hip region are discs and the sacro iliac joint. Many patients mistakenly believe they have a tricky hip for many years when the initial issue is actually their back. Accurate assessment by a physiotherapist will help identify when this is a presenting component of the painful hip.
Snapping Hip Syndrome
Snapping hip syndrome is a word used to describe three distinct hip problems. The first is when the Iliotibial band snaps over the outside of the thigh. The second occurs when the deep hip flexor snaps over the front of the hip joint. Finally, tears of the cartilage, or labrum, around the hip socket can cause a snapping sensation. Stretching and mobilizing tight structures in conjunction with stabilizing and strengthening is required.
Muscle strains/ imbalances
Strains of the muscles around the hip and pelvis can cause pain and spasm. More common are the groin, piriformis, deep buttock muscles, and hamstring strains. Asymmetry around the pelvis can be addressed with muscle energy techniques. Piriformis syndrome is sometimes caused through protection or dysfunction of the adjacent SIJ or hip joints, weakness of your deep hip stability muscles and over pronating feet. Our physiotherapists can treat these structures and dysfunctions.
Stress fractures of the hip are most commonly in athletes who participate in high-impact sports, such as long distance runners. A typical clinical feature of a stress fracture is a history of exercise-related localized pain that increases with activity and either abates with rest or persists at a lower level. If training continues, the pain progressively worsens and is brought on with less intense activity. The mainstay of treatment is avoiding the impact activities, then resuming graduated activity when evidence of healing is present.
Osteitis Pubis is an overuse injury characterized by tissue damage and inflammation to the pelvis at the site where the two pubic bones join (pubic symphysis), resulting in groin pain. This typically occurs due to repetitive running, kicking or change of direction activities. It can also develop due to excessive abdominal muscle contraction (such as during repetitive sit ups) or following inadequate rehabilitation of other injuries, such as adductor tendinopathy.
A thorough subjective and objective examination from our physiotherapists is usually sufficient to diagnose the cause of hip & groin pain. However investigations such as an X-ray, ultrasound, MRI, CT scan or bone scan are often required to confirm diagnosis and rule out other less common injuries. Our close liaison with our adjacent doctors can make this a smooth process if required.
Physiotherapy treatment is vital to hasten the healing process, ensure an optimal outcome and reduce the likelihood of recurrence.
Treatment may comprise:
- soft tissue massage
- electrotherapy (e.g. ultrasound)
- dry needling
- joint mobilization
- the use of crutches
- ice or heat treatment
- exercises to improve strength, flexibility and core stability
- correction of abnormal biomechanics (e.g. the use of orthotics)
- anti-inflammatory advice
- activity modification advice
- a gradual return to activity / sport program
- taping to assist with unloading the painful structures
- graduated tendon loading program
- heat moulded orthotics for feet
- video gait analysis on our Hindmarsh Gym treadmill.
Our highly skilled physiotherapists have a special interest in hip pain and joint injury. Traditionally, most hip joint conditions have often been treated with only short-term aims ie.g. cortisone injections or painkillers. The thorough assessment of WHY your hip pain developed is an integral part of our physiotherapy management.
We strongly believe that if you don't correct why you are vulnerable to hip injury then it is only a matter of time before your hip pain returns.