Are Your Hips Bothering You?

Causes, Symptoms, and PT Treatments for People Living with Hip Pain

There are a variety of diagnoses that can be the cause of your hip pain. It can come from wear and tear, overuse, bone injuries, and many more causes. The way your hip pain presents will depend on what exactly is going on. This article will break down the causes, symptoms, and treatments you can expect during a physical therapy treatment.

Let’s take a look at what the hip joint is and what it does:

The hip is a ball and socket joint which is able to move in many directions. These include flexion and extension, internal and external rotation, as well as abduction and adduction. While this joint is one of the largest in the human body, it is subject to damage and overuse. Hip pain is commonly the result of a muscular issue (muscles & tendons) or a skeletal issue (bones).

Many diagnoses that are discussed in this article are the result of a movement disorder. When the joint mechanics are not functioning ideally, it eventually leads to microtrauma and pain. What separates a good PT from a great PT is that a great PT will address pathomechanics (the way you move) in order to fix the anatomy that is dysfunctioning. Some treatments to help correct movement disorders include:

Joint mobilizations
Therapeutic exercises to target specific muscles and increase stability
Stretching to lengthen or reduce tone in specific muscles
Education on posture and positioning in order to facilitate the healing process

Physical therapists don’t treat “hips”, they treat movement disorders! However, it is helpful to know the diagnosis caused by this. Below we will briefly discuss the most common disorders of the hip, as well as some treatments one may expect from a physical therapy session.

Osteoarthritis (OA) : This is the loss of cartilage in the joint which may lead to pain and loss of function. OA is found in up to 25% of adults ages 55+. It can be caused by genetics, trauma, obesity, as well as poor biomechanics. OA usually presents as achy or sharp pain that increases with activity in the buttock, groin, thigh, or knee. It may become stiff with inactivity, especially first thing in the morning. When hip OA progresses to a certain degree, surgery may be indicated. Physical therapy is a great way to manage hip OA in order to prevent or prolong the need for surgery. When you come in for an appointment your PT will guide you through exercises and stretches as well as education on posture and positioning.

Hip Impingement: Abnormal friction between the ball and socket causing damage to the hip joint or the structures that get caught in between. A hip impingement may be accompanied by pain in the groin after walking or prolonged sitting. Pain may also be felt in the low back, SI joint, buttock, or side of the hip. Continued friction without treatment can cause further damage to the musculature as well as the labrum. Activities like running and cycling, and even light stretching should be avoided when a labral tear is suspected. Your PT will guide you through the proper exercises that should be performed. Some of these may include mini squats, glute bridges, and clams.

Labral Tear: A tear along the ring of cartilage located on the outside rim of the hip joint. A tear may be the result of the joint being stressed in a rotated position. It is common for the pain to be sharp with a clicking, catching, or locking sensation. The pain is mainly in the groin but can also be in the buttock region. There are tests that a physical therapist can do to determine whether or not they suspect a labral tear. During your treatment you can expect low-intensity exercises that activate muscles of the hip and core such as monster walks and dead bugs. With this diagnosis, it is key to stay active with exercises that do not cause pain.

Muscle Strain: A pulled muscle can result from a trauma such as a fall, sudden twist, or a pulling muscle or tendon. It can also result from poor biomechanics, overloaded muscles that can no longer compensate for weak primary muscles, or muscles that are fatigued and not working well. A muscle strain may lead to swelling, bruising, soreness, stiffness, and limited range of motion. When you come in to heal a pulled muscle a PT will treat the cause first, which can be a muscle imbalance or poor biomechanics. Then they will promote healing through education to avoid certain motions based on your stage of healing. Finally, they will address pain through the use of modalities such as ice, ultrasound, or electric stimulation.

Tendinopathy: This is when the tendon of a muscle becomes irritated and becomes damaged. Tendinopathy is most commonly due to overuse, beginning a new exercise program, or increasing a level of exercise too quickly. The tendon is not accustomed to the new level of demand and this new input may cause damage. If you have a tendinopathy you may see warmth and redness, swelling near the tendon, or feel some tenderness. You may also notice a loss of strength in the affected area. Some treatments that you may expect during a physical therapy session will include cross friction massage to increase blood flow to the area or eccentric exercises, depending on the stage of damage.

Bursitis: Bursitis is the inflammation of a bursa, which is tissue that prevents friction between two surfaces. It is a vague diagnosis usually caused by repetitive movement or prolonged or excessive pressure. Bursitis usually feels a lot like tendinopathy and is best treated by getting to the root of the movement disorder causing it, as determined by your PT.

Peripheral Nerve Entrapment: This is the impingement of a nerve as it passes through certain structures. Symptoms of a nerve entrapment vary greatly depending on the nerve that is affected. These are some of the most common symptoms: radiating pain, numbness and tingling, a burning sensation, and weakness. Some treatments for this may include soft tissue therapy around the nerve, strengthening of certain muscles to decrease compression and taping in order to take pressure off of the nerve. Good recovery is achieved with the vast majority of patients, however the amount of time it takes to treat varies.

A physical therapist at Evolve can help you get on the road to healing your hip pain. Our therapists do not just treat symptoms, but we get to the root of the cause. We strive to enable our patients to live pain free, and prevent the recurrence of related issues. Click here to find out more information about physical therapy for hips

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About Evolve Physical Therapy in Brooklyn-

Brooklyn's Premier Holistic Physical Therapy Clinics-
There’s physical therapy, there’s training, and then there’s EVOLVE.

We use the science of biomechanics merged with fitness to help our patients get better and stay better! First we evaluate, then we heal, then we strengthen our clients so they can reach their goals, feel better, and live happier lives. We do so by utilizing a range of core techniques and specialized treatments to reduce pain, improve mobility, enhance physical strength and deal with the underlying issues, not just the pain itself.

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1-718-258-3300
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Are Your Hips Bothering You?