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
- 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 strains happen in most cases during sport 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.
The hip or acetabular labrum is a ridge of cartilage that runs around the rim of your hip joint socket. Its purpose is to make the hip socket deeper and more stable. The labrum can be torn from its attachment and cause pain, clicking or catching. The most common causes are falls or sporting injuries when the hip is forced into extreme positions. It can also be damaged by repetitive movements in sport activities like football, golf, running or cycling. Common contributing factors for these causes are 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.
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 to reduce pain, inflammation signs 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 click for more information on hip replacement)
Hip replacement, or hip arthroplasty, is a surgical procedure to replace the weight-bearing surfaces of the hip joint to relieve pain and disability. It is most commonly performed for osteoarthritis (wear & tear of the cartilage). That’s why this procedure is mostly seen among the elderly population. In general, the surgery consists of replacing the diseased or damaged joint surfaces of the hip with metal and plastic components shaped to allow continued motion of the hip. The rehabilitation takes 6-12 months depending on the recovery process. After successful completion of the rehabilitation the patient can participate in life without many restrictions. Sport activities have to be adjusted and the hip might not be able to fully bend.
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.