Hip pain is very common in all age groups. The hip joint and it’s integration with your pelvis, SIJ and lumbar spine (lower back) make it a complex region to correctly analyse and assess any dysfunction.
The Older Hip
The older population are more vulnerable to age-related hip issues such as hip arthritis, trochanteric bursitis and GTPS (Greater Trochanteric Pain Syndrome). Functional limitations could include simply walking, sit to stand, single leg standing, stairs or even sleeping in severe cases.
Hip pain can also be associated with reduced balance so a thorough balance assessment may be required to predict a falls risk. Your Physio may give you fall prevention exercises to address any individual deficits. They may even advise you to use a walking assistance device such as a walking stick, crutches or a walking frame.
The Sporting Hip
Younger sports-related hip issues may come on after prolonged running, jumping or landing activities. Specific sporting hip conditions can be discussed thoroughly with Mend Physio.
Groin pain is one of the most common symptoms associated with hip joint pathologies such as hip osteoarthritis and hip labral injury. There are also many other causes of groin pain that need to be excluded by a health professional.
Only after a thorough hip assessment will your hip pain be effectively rehabilitated to relieve your current hip pain and joint dysfunction, plus prevent the return of any future hip pain.
Hip Pain Assessment
The successful treatment of your hip pain requires a thorough and accurate assessment of your:
- Entire lower limb (foot, ankle, knee, hip, groin)
- Lumbar spine
- Pelvis and SIJ function and alignment
- Deep hip muscle control and activation patterns
- Middle and superficial hip muscle control, strength and function
- Deep abdominal, core and pelvic floor muscle control
- Upper thigh muscle length and strength (e.g. quadriceps, adductors, hamstrings, and ITB)
- Neural tissue extensibility e.g. sciatic and femoral nerve
- Hip joint biomechanics.
Your assessment should include a functional assessment of your knee, foot and ankle joints, plus your thigh and calf muscles. They all contribute to your hip function. Hip pain is often related to your whole lower limb biomechanics and function.
Hip Pain Causes
Hip Joint Pain, Lateral Hip Pain, Adductor-related Groin Pain, Pubic-related Groin Pain, Inguinal-related Groin Pain, Iliopsoas-related Groin Pain and other muscle-related Pain.
There are also Systemic diseases such as Rheumatoid Arthritis, Fibromyalgia and Osteoporosis. Referred Sources such as Sacroiliac Joint Pain (SLJ), Sciatica, Lower Back Pain and a Pinched Nerve.
Hip Pain Treatment
Hip joint conditions are often treated with short-term cures, such as cortisone injections or painkillers. This is inadequate, especially for recurring hip pain.
A thorough analysis of why you are having hip pain is important to solve the problem, to prevent recurrence and improve your performance, especially on the sports field.
Hip pain education should also include teaching you about activity modification, individualised exercises, weight-loss advice (if required), and methods to unload any arthritic joints. We recommend a thorough hip assessment so your hip treatment can progress quickly and get you pain-free sooner.
Trochanteric bursitis is the most common bursitis of the hip. It is also a common cause of Greater Trochanteric Pain Syndrome.
Trochanteric bursitis is inflammation of the bursa (a small, cushioning sac located where tendons pass over areas of bone around the joints), which lies over the prominent bone on the side of your hip (femur).
The superficial trochanteric bursa is located over the greater trochanter. This is the most commonly inflamed bursa. A deep trochanteric bursa lies deeper and can become inflamed in more severe cases.
Trochanteric Bursitis Symptoms?
One or more of the following symptoms may be experienced:
- Pain and swelling occurring on the side of the hip
- Referred pain that travels down the outside thigh and may continue down to the knee
- Pain when sleeping on your side; especially the affected hip
- Pain upon getting up from a deep chair or after prolonged sitting (eg. in a car)
- Pain when climbing stairs
- Pain in sitting with the legs crossed
- Increased pain when walking, cycling or standing for long periods of time
Causes of Trochanteric Bursitis?
The trochanteric bursa may be inflamed by a group of muscles or tendons rubbing over the bursa and causing friction against the thigh bone. This injury can occur traumatically from a fall or a sport-related impact contusion.
It can also be a case of gradual onset via a repetitive trauma to the bursa from such activities as running (with poor muscles control or technique), walking into fatigue, or cycling, especially when the bicycle seat is too high.
It is also a secondary injury associated with chronic conditions such as:
- Scoliosis – curvature of the spine
- Unequal leg length
- Weak hip muscles
- Osteoarthritis (degenerative joint disease) of the hips or lower back
- Calcium deposition in the gluteal tendons that run over the bursa
- Rheumatoid arthritis.
A traumatic injury such as a car accident or fall can also cause bursitis. Acute compression of your bursa causes an inflammatory healing reaction that results in swelling within the bursa, or bursitis. Once the bursa is inflamed, normal movements and activities can become painful from either the pain-sensitive chemical reaction within the bursa or the swollen bursa can provide additional frictional forces in the subsequent movements.
Mend Physio can provide you with an assessment based on your medical history and a physical examination of your hip, pelvis and back.
For specific advice regarding your hip pain, ask Mend Physio