Hip Injuries

Hip injuries or pain is a common condition that plagues many athletes, especially runners. However, determining the causative factor is often challenging because of its complex integration of movements with other structures such as pelvis, sacroilliac joint and lumbar spine. Hence, a special assessment tool is required to analyze hip dysfunction to make a correct diagnosis in order to provide appropriate treatment.

The common hip injuries include:

Groin Strain

Groin strain is common in most sporting activities either caused by overuse or excessive loading of the muscle, usually hip adductor muscle group.  The symptoms include, groin pain and tenderness, pain on a stretch of your groin muscles and pain during groin muscle contraction (thigh squeeze).

At MoveFree Physio, the main focus of physiotherapy is to reduce pain and to restore normal muscle strength and flexibility. Early physiotherapy intervention is usually warranted to prevent further worsening of the condition.

Labral Tear

The hip labral tear is an injury to the labrum, the soft tissue that runs around the rim of the hip joint socket (acetabulum). Its primary function is to make the hip joint socket deeper and more stable. The labrum can be torn from its attachment due to a fall or sporting injuries when your hip is forced into extreme positions. The common symptoms include groin pain, “clicking” or “catching” in the hip socket during movements.

In the acute stage, physiotherapy is focused towards pain management and inflammation reduction. In the later stage, restoring joint range of motion, increasing strength & flexibility of muscles, biomechanical abnormalities will be addressed. In severe causes, surgery may be required.

Trochanteric Bursitis

Trochanteric bursitis is the inflammation of the small fluid-filled sac called bursa at the outside point of the hip known as the greater trochanter. This condition is caused by repeated compression of the bursa resulting in inflammation and pain. It is usually associated with gluteus medius weakness. The common symptoms include, pain over the side of the hip bone when sleeping on the affected side, cross leg sitting, running, cycling, climbing stairs, and prolonged walking.

In acute phase of bursitis, physiotherapy is aimed at reducing pain and inflammation. At a later stage individualized exercise program targeting muscle strength, stability and flexibility is warranted. Sport specific rehabilitation is required for athletes to return back to sport. Shock wave therapy is also useful in aiding the recovery.

Hip Osteoarthritis

Osteoarthritis Hip is a degenerative type of hip joint disease which happens while the bone-cartilage is worn off. There are two main types of OA hip which is primary and secondary. Primary OA Hip is caused by general degeneration of the hip joint, due to aging, overweight or over usage of the hip joints. Secondary OA Hip could happen after a trauma, injury or acute inflammation of the joints which leads to an early degeneration of it. The patients commonly suffer from stiffness, pain on the groin, buttock or down to the knee especially while walking, sitting on the floor or prolonged sitting on the chair.

Clinical classification criteria (from Altman, R, et al.) for the hip osteoarthritis, include:

  • Hip internal (inward) rotation > 15 degrees with pain, morning stiffness < 60 minutes, and age > 50 years, or
  • Hip internal (inward) rotation < 15 degrees, and hip flexion < 155 degrees

In early OA hip, physiotherapy is an excellent choice of treatment where the therapist work on your hip strength and flexibility to enhance quality of life. Since osteoarthritis hip is a chronic and progressive disease, in certain individuals the condition may get worse over a period of time until the point where the person may lose their walking ability. Surgery is the permanent solution to resume walking and other functional mobility to improve quality of life. The overall rehabilitation goals in OA are to maintain range of motion, strength, and endurance, and assist independence in activities of daily living (ADLs).