Hip pain

The hip joint is a true ball and socket joint which by its design allows a large range of motion but at the same time is extremely stable. It shares many muscles and nerves with the low back and with the knee.

The hip is obviously a major weight bearing joint and as such is subject to great impacts often many times body weight. In order to offer some protection from this it has a thick layer of cartilage covering the bone ends and some extremely meaty muscles! These contract and so shock absorb, moments before the foot hits the ground.

Symptoms

Symptoms can arise from:

  • the bones
  • the many ligaments that support the joint
  • the tendons of the very powerful muscles that insert close to the hip
  • small sacs of fluid called bursae which cushion or alter the pull of some tendons

The most common problems seen at the hip are:

Osteoarthritis

This is largely due to normal wear and tear on the joint and so typically doesn't affect those of us under the age of 50. However there are some poor unfortunate souls who do suffer prematurely. Sometimes this is due to a congenital problem sometimes due to previous injuries and sometimes due to an inherited tendency to develope early arthritis. The symptoms normally include some or all of the following:- groin &/or thigh and knee pain, a rolling walk, pain on standing or walking that is quickly relieved on sitting, difficulty lifting the leg onto the bed or out of the car and stiff & weak when trying to move the leg out sideways or backwards.

Treatment varies depending how severe the condition is. In the early stages some pain killers and well prescribed exercise to both maintain mobility and strength will often be very successful in "buying" some more time. When things have progresssed so that walking is markedly curtailed and/or the pain is considerable the only solution is to have the joint replaced. This is a very successful operation and after it the majority of people should be able to return to a completely normal lifstyle. Unfortunately many do not get adequate guidance on the necessary exercises to do both before and after the operation.

Developing and maintaining muscle strength is of fundamental importance if a normal gait is to be regained. These exercises need to be continued for up to 18 months post op. Your physiotherapist should give you a list of progressive exercises to do. If he/she doesn't, hassle them!

Groin strain

This is a pull of some tendons that insert in or close to the groin. It is a common sportsman's injury and is not restricted to footballers. Mostly it involves tearing some of the fibres within the tendon. Tendon is the point of attachment of muscle to bone. It is tough, fibrous and has a poor blood supply. This means it heals relatively slowly. The recommended treatment for a pulled/inflamed tendon is rest. This is difficult to do in the groin because even if you don't put any weight on the leg the particular muscle involved are still contracting.

Mild strains will settle by themselves in 7-10 days, more severe or repeated strains would improve more rapidly with physiotherapy and some anti inflammatory tablets. If it is a repetitive injury then the biomechanics of the lower limb and back need to be examined more thoroughly by an experienced physiotherapist as there is a likelihood of a muscle imbalance problem having developed

Trochanteric bursitis

This is an inflammation of small sacs of fluid that exist under the tendons of the powerful buttock muscles as they insert into the top of the femur(thigh). They cushion these tendons and help to give them a better angle of pull. They can become inflamed with overuse or unfamiliar use of the hip. For example doing a sudden bout of hill walking when previously having a very sedentary life or when getting back on ones feet after a prolonged illness.

Treatment may involve anti inflammatory tablets, injection and/or physiotherapy. The pain is normally felt over the side of the hip and is extremely sore when palpated. It is made worse by lying on that hip and doing a lot of weight bearing

Fractures

Fractures of the femur are normally treated with pins and plates or sometimes a new hip is automatically put in, depending on the site of the break and the age of the person concerned. Physiotherapy to strengthen the buttock and thigh muscles is extremely important if as full a recovery as possible is to be reached.

Read about more common conditions, or contact us to find out how we can help.