Hip Injuries
Hip Pain & Injury Treatment
Hip injuries and knee pain are very common and can have many causes:
- traumatic (eg sports injury)
- wear & tear (eg arthrosis)
- muscle weakness
- muscle tightness
- overuse
- biomechanical dysfunction
Therefore it is essential to make a correct diagnosis of the underlying cause in order to provide appropriate treatment for an optimal recovery. Injuries may affect muscles, ligaments, meniscus, cartilage or bones. Most commonly the pain is localized around the injured area and can be felt during activity, after activity or constantly. Many injuries can be treated conservatively with physiotherapy. However, with more severe injuries surgery may be necessary. In this case the patient will need post-surgical rehabilitation.
Common Hip Injuries:
-
Groin strain
Groin strains happen in most cases during sporting activities and daily activities. The cause is either overuse or excessive load to the muscle (sprinting or jumping). The severity and symptoms of a muscle strain depends on the degree of stretching or tearing of the muscle.
- Grade I strain: This is a mild strain and only some muscle fibres have been damaged. Healing occurs within 2-3 weeks.
- Grade II strain: This is a moderate strain with more extensive damage to muscle fibres, but the muscle is not completely ruptured. Healing occurs within 3-6 weeks.
- Grade III strain: This is a severe injury with a complete rupture of muscle fibres. The healing period can be up to three months and may in severe cases require surgery.
Physiotherapy optimizes the healing process. Exercise therapy, including stretching, strengthening, and stability exercises helps to restore full function of the muscle.
-
Labral tear
The hip or acetabular labrum is a ridge of cartilage that runs around the rim of your hip joint socket. Its purpose is to stabilise the hip socket. The labrum can tear from its attachment, causing pain, clicking, or catching. The most common causes are falls or sporting injuries that force the hip into extreme positions. Repetitive movements in sports like football, golf, running, or cycling can also damage it. Common contributing factors to these issues include degenerative changes of the labrum or poor biomechanics.
In the acute stage of a labral tear physiotherapy is aimed at reducing pain and inflammatory signs. At a later stage exercise therapy including strengthening and stretching exercises becomes a vital part of the therapy to restore full function of the hip.
A percentage of hip labral tears will require surgery to stop the pain and clicking. The procedure should also improve the hip joint integrity, which reduce future degeneration associated with labral tears.
-
Osteoarthritis
Hip osteoarthritis is a degenerative condition where the articular cartilage of your hip joint gradually wears away, exposing the underlying bone. As the arthritis progresses, bony spurs also develop in and around your hip joint in response to the change in load distribution and biomechanics. Common causes are age, overweight, excessive loading sports, previous hip injuries and genetics. Although this is a chronic condition you can have acute episodes as well. The cause for this is overloading during sport, daily activities and even work. The symptoms are pain and stiffness in the hip, clicking or grating and decreased strength of the lower limb muscles. During an acute episode, physiotherapy helps reduce pain, alleviate inflammation, and regain flexibility.
During non-acute episodes it is very important to do regular exercises in order to optimize strength, stability and flexibility. This will help to maintain your hip’s function and to avoid surgery. Your physiotherapist will tailor a trainings program for your specific needs.
In advanced stages of osteoarthritis pain might become chronic even with regular exercises. In this case hip replacement is the last resort of help (please see below for more information on hip replacement)
-
Hip replacement
In a total hip replacement (also called total hip arthroplasty), the damaged bone and cartilage is removed and replaced with prosthetic components. To find out more on hip replacement, please click here.
-
Bursitis
Hip bursitis is a painful condition at the site of the hip. The bursa is small jelly like sack positioned between the hip bone and soft tissues, acting as cushions to help reduce friction. With repetitive activities like running or cycling the bursa can become inflamed. In the early stage pain is usually felt only during activities, but with progressing intensity pain may be felt also after activities or at rest.
Physiotherapy aims to reduce pain and inflammation signs including modalities, massage and stretching. In the later stage exercise therapy focuses on strengthening the muscles surrounding the hip to restore full function and to prevent reoccurrence.