Hip Pain can come on suddenly or slowly and due to a variety of reasons. The symptoms can be debilitating if not properly controlled and diagnosed. The following paragraphs will discuss some anatomy of the hip as well as potential causes of pain and what to do when it strikes.
Anatomy
The hip is a very large joint, and is known as a “ball a socket” joint. The “ball” is made up of the head of the femur, and the “socket” is referring to the concave surface of the pelvis known as the acetabulum. It is held together by many tendons, ligaments, cartilage, and muscle. Tendons serve as connection points between muscles and bone. Ligaments are thick structures which connect bone to bone and support alignment of the joint. Cartilage serves as a cushioning surface for the joint and provides force absorption. Muscles play key roles in the stabilization and function of the hip joint and provide a base for the rest of the lower extremity.
Down to the Source of Hip Pain
Now that you have more familiarity with some of the tissues that comprise the hip joint, it is easy to see that there are many things that could go wrong and cause pain to the hip and surrounding areas.
Arthritis
Arthritis occurs when the bones that make up the joint are exposed & touching which causes swelling and inflammation of a joint. It is the single most common cause of hip replacement surgery in the U.S. Some symptoms that may present with hip arthritis may include; stiffness, clicking, weakness, and pain in the joint especially in weight bearing positions.
Impingement of the Hip Joint
The hip joint can become impinged when the “ball and socket” do not fit together properly for whatever reason. This causes the joint to rub together uncomfortably and pinch surrounding structures, like the cartilage. This can cause stiffness in the hip and eventually lead to arthritis. Some common symptoms may also be; reduced range of motion, clicking or catching sensations, and in more extreme cases, limping or difficulty lifting the involved leg.
Muscle Tendinitis
Tendinitis refers to a tendon that is swollen and inflamed, and can be painful during activities like walking, running, and jumping. These injuries typically arise from overuse, and commonly affect the hip flexor, or psoas muscle in the front of the hip, glutes, which are located in the back of the hip joint, or the iliotibial band which is located more laterally. Some symptoms you may experience could be stiffness, tenderness to the area, and increased pain with use.
Cartilage Injury
This type of condition is often preceded by impingement of the hip. The cartilage gets pinched in between the joint space and can cause tearing or fraying leading to painful sensations through the hip, and is typically constant, even at rest, but will worsen with standing and walking. Locking and clicking as well as limited range of motion are common symptoms experienced by these patients.
How to Diagnose Hip Pain
There are a variety of steps taken to properly diagnose an injury. Often, the first line questioning, when the physical therapist asks about the injury, your history, & your symptoms, is where the physical therapist (PT) gets the best insight into what they think is going on & informs the next part of the eval; the physical examination. The PT will test range of motion, strength, tenderness and more to help get to a conclusion about pain causation. Usually this exam will help rule out potential diagnoses and narrow down the problem or come to a specific solution.
Other diagnostic tools that may be needed include imaging, like CT scans, MRI, or X-ray. These can be very helpful to take a closer look into the internal anatomy to determine any possible abnormalities that may lead to the source of your pain. Another option for diagnosing, will be lab testing. Blood can be drawn to check for foreign bodies that may indicate certain types of systemic issues or infection.
How to Prevent Hip Pain
Hip pain and injury can be prevented by implementing a couple simple strategies. The first, is to maintain an active and healthy lifestyle. You do not have to be a bodybuilder or marathoner, but maintaining an active lifestyle with a variety of modes of exercise helps reduce the risk of injury and other diseases that could predispose the body to injury at the hip.
This could look like walking the dog, joining a pilates studio, meeting with your local run club, making an intramural sports team, and more. Another part of maintaining a healthy lifestyle includes a balanced diet and minimizing things like added sugar which can lead to inflammation like arthritis or diabetes.
The second would be performing adequate warm up and cool down to work outs or any physical activity. This helps make sure your body is prepared to support and produce the load and forces necessary in the work out, and that proper recovery can be achieved. Lastly, maintaining strength around the hip to support the mechanics and function of the joint can be key in injury prevention.
Short Term Management of Hip Pain
In the short term, appropriate management may include some reduction of activity or resting, massage, and/or chiropractics. Ice may also help with acute inflammation and provide some pain relief by reducing sensitivity to the area, especially after activity. While rest is important after an injury, there is benefit in gentle mobility and range of motion of the joint to prevent stiffness and work out swelling. Using the joint or affected area in light graded activity will also assist in reduction of muscle loss and weakness, which could perpetuate the issue if it gets out of hand.
Long Term Management of Hip Pain
If you, or someone you know, is struggling with lingering or new hip pain, it would be beneficial to get professional help from a skilled physical therapist. Inside Track Physical Therapy and Wellness specializes in diagnosing and treating hip injuries, by utilizing a thorough physical examination to determine impairment and causes of pain, using hands on tools to reduce pain levels, and prescribing individualized and specific exercise to reduce risk of reinjury, as well as provide advice and counseling on healthy lifestyle and diet modifications if appropriate.
Hip pain can seem mysterious and be discouraging, but with help and guidance of a Doctor of Physical Therapy, you can get back to what you enjoy and reduce risk of future flare ups and injury. If you think PT might be helpful for you to prevent the need for unnecessary rest, medication, or surgery, sign up to talk to a PT from Inside Track here so we can help you get the inside track on your rehab!
