HIP INJURY GETTING IN YOUR WAY?
Physical Therapy for the Hip
HIP PAIN AND INJURY GETTING IN YOUR WAY?
The hip joint is a ball and socket joint where the top of the femur meets the pelvis. The mechanics of this joint allow for a great deal of movement of the leg but requires the appropriate balance between mobility and stability to reduce likelihood of injuries. True hip joint pain is felt deep in the groin area but many other conditions involving muscles, tendons or nerves surrounding the hip may be felt above, below and to the side of this area.
WHAT HIP CONDITIONS CAN A PHYSICAL THERAPIST TREAT?
Bursitis: Bursa are small sacks of fluid that act as cushions over a bony area. The most common area for bursitis in the hip is on the greater trochanter of the hip on the outside of the upper leg. Bursa can become inflamed or irritated with repetitive friction usually caused by activities such as long distance walking on uneven surfaces or on uneven legs, running up hills or even by a direct trauma such as falling on the hip. Bursitis can cause pain and irritation when lying on the hip, lifting the leg, climbing stairs or walking. Physical therapy can help reduce inflammation and pain and address contributing factors such as muscle weakness, leg length discrepancies or movement pattern errors to resolve symptoms and limit recurrence.
Labral Tear: An injury to the band of cartilage that lines the outside of the hip joint is called a labral tear. A tear in this area can occur from a trauma such as a fall or car accident but is more often the result of repetitive stress and strain during activities such as deep squatting, cutting and twisting. It is more likely to occur in the presence of bony abnormalities in the hip joint (hip impingement). Typical symptoms include dull pain felt deep in the groin that can be sharp with low squatting, clicking or catching of the hip with movement, pain and stiffness that is worse after prolonged sitting or walking and stiffness or muscle weakness. This cartilaginous ring is not capable of healing on its own so some people may opt for surgery. Others can achieve a satisfactory level of symptom reduction and return to activity with physical therapy to optimize muscle strength and length and address movement patterns.
Osteoarthritis: Arthritis can occur in any joint. In the hip, osteoarthritis refers to breakdown of the cartilage that covers the femoral head (ball of the hip) and lines the acetabulum (socket of the pelvis) and a loss of synovial fluid that lubricates the joint. This results in rubbing of bony surfaces together causing pain and stiffness. In severe cases a total hip arthroplasty (replacement) may be performed by a surgeon. While physical therapists cannot reverse the OA itself, arthrtitis physical therapy has proven an effective treatment modality for arthritis. Restoration of optimal joint movement, addressing biomechanics and movement pattern inefficiencies, maximizing muscle strength and education on possible activity modifications are all helpful.
Muscle Strain: Muscles are made up of bundles of muscle fibers aligned in specific patterns. When these fibers contract they shorten the muscle and pull on the bones they attach to creating movement and strength. At either end of these fibers is a strong band of tissue called the tendon which connects the fibers to the bone. When overstretched, overused or contracted against a sudden load, a muscle strain can occur as muscle fibers or the musculotendinous junction are torn or injured.
Grade I strain (mild): very few muscle fibers are injured. Pain typically occurs the next day but no swelling or bruising is observed. Pain may be felt when the affected muscle is strongly contracted or stretched at its end range.
Grade II strain (moderate): many (but not all) fibers are injured resulting in stiffness, loss of flexibility and loss of strength. Pain is felt both during contraction of the muscle and stretching. Swelling and bruising over the injured area is common.
Grade III strain (severe): all fibers of the muscle are completely torn or the muscle belly has detached from it’s tendon. Severe pain is often felt upon injury and heavy swelling and bruising will develop. Range of motion may be either significantly reduced due to pain or excessive because the muscle is no longer limiting it. This muscle will generally be unable to produce any force due to the severe disruption in the fibers
Peripheral Nerve Entrapment: This condition refers to compression of a nerve as it passes through structures around the hip. Depending on the location and severity you may experience radiating pain or burning sensation, numbness or tingling or muscle weakness. Manual therapy techniques such as soft tissue mobilization or stretching may help reduce compression. Taping to offload the area may also help. Your physical therapist may also prescribe strengthening exercises to ensure surrounding musculature can support the affected area while minimizing compression.
Tendinopathy: Tendons are the thick, fibrous bands or cords that attach muscle fibers to bones. Pain felt outside of a joint at the end of a muscle which is exacerbated by movement may be tendinopathy. The most common cause of inflammation and irritation in the tendon is repetitive overuse. Often biomechanical or movement errors, muscle strength and length asymmetries or insufficiencies are an underlying cause. Pain is usually described as a dull ache that can interfere with your activities. Tenderness, mild swelling and general weakness may also be present. Patellar tendinopathy, achilles tendinopathy and hip flexor tendinopathy are examples of tendon irritation that may occur in the leg.
LET US HELP YOU GET ON THE ROAD TO HEALING
While a physical therapist cannot repair the labrum or reverse osteoarthritic changes in the joint, physical therapy is an excellent treatment option for acute and chronic hip pain and injuries. Your body was meant to move and whether you are looking for help rehabilitating after surgery or conservative treatment for discomfort that is keeping you from participating in home, work or recreational activities, physical therapy should be at the top of your list. Through a thorough assessment and evaluation, a physical therapist at Evolve can get to the root of your problem and develop a plan of care that will not only treat your symptoms but enable you to stay active for as long as you like by preventing the recurrence of related issues.
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About EvolveNY-
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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