Hip Pain Treatment
Femoral acetabular impingement
What is it?
FAI a condition where a bony outgrowth occurs on one or more of the bones affecting the hip joint. This causes the joint to become incongruent, causing some abrasion and pain during different ranges of motion.
How does it present?
Typically end of range movements, especially extension and medial rotation will aggravate symptoms, however this varies depending on the type of impingement and location of the abnormality.
Why has it happened?
Bone spurs can develop over time surrounding joints. With the hip it’s classified into two different types, a deformity to head of the femur (effectively the “ball” of the joint) known as a cam type, or a deformity of socket referred to as pincer type impingement.
How can we help?
Providing guidance to strengthen the muscles that support the hip joint can help alleviate symptoms and provide greater stability. Lifestyle and homecare advice can also help prevent aggravation to existing symptoms. Sometimes, surgery may be considered to remove the bony outgrowth.
Trochanteric bursitis
What is it?
the femur (thigh bone) has 2 bony prominences at the proximal (upper end) of the bone referred to as the greater and lesser trochanter. These areas serve as attachment sites for body’s ligaments and tendons. The greater trochanter has a bursa (synovial fluid filled sac) that aids smooth movement of the hip joint and its tissues. These bursae are found throughout the out body and can become inflamed.
How does it present?
Often, sitting with the affected leg crossed will elicit symptoms. This is due to a pressure increased on the greater trochanter. You might also notice pain when getting up from sitting and laying on the affected side also causes aggravation.
Why has it happened?
This is a common injury amongst runners, often due to running on tracks without banking, or incorrect gait where the toes are crossing the midline repetitively. Genu Valgum (knees naturally falling more “inward” on standing” can also predispose the trochanter to an increase in pressure. Bursitis can occur in a sedentary person however also, direct rubbing, friction or impact can cause this to arise.
How can we help?
We would examine your hip, knee, foot and ankle mechanics. It’s important to understand how these structures work together as well as independently. It may then be possible to recognise and help correct any imbalances.
Osteoarthritis
What is it?
As we age, we naturally present with degenerative changes. This thinning of the joint cartilage can lead to pain and inflammation called arthritis. The degree of symptoms varies widely on the individual, with some people exhibiting no pain at all and others with a considerable drop to their quality of life. As a weight bearing joint, the hip is prone to arthritis than other areas.
How does it present?
Often stiffness and pain during certain movements. You may notice is worse in the winter, this is due to cartilage having a poor blood supply, and warmer temperatures assisting its healing.
Why has it happened?
Everyone’s joints degenerate with age to an extent. Fortunately, the condition is very manageable and active steps can be taken to help prevent and slow down it’s progression.
How can we help?
Advise on strengthening the hips supportive musculature, life style and home advice can help. Hand on treatment can keep the joint mobilised, and correct other areas that might be placing excessive pressure on the hip.
Adductor Strain
What is it?
A common condition amongst athletes, the adductor strain, commonly referred to as “groin strain” can often become chronic leading to greater frustration. It is a strain to the muscles that span from the inside of the knee/thigh up into your pelvis/groin. Theses muscles act to bring your thighs together and help to stabilise the pelvis during movement.
How does it present?
Often, pain felt in the groin that worsens with activity is typical. In more severe cases, you may notice some swelling or bruising. The adductor can also strain at the distal (knee) end, but this is less common.
Why has it happened?
This is often caused by trauma, an overstretch into abduction or extension from the hip. Strains might keep reoccurring if not properly rested and rehabilitated. Often, the adductors can be come too tight if the abdominals are weak, as they have to work increasingly hard to stabilise the pelvis.
How can we help?
Orthopaedic assessment could help determine why the adductors keep straining. It could be due to other areas becoming too tight/dysfunctional that could be mobilised/released through techniques such as: massage, medical acupuncture, and manipulation etc.