Hip is the largest joint in our body and is a major weight bearing joint. They have a major role in supporting the weight of the head, trunk and upper extremities. Hip joint is formed between the round head of thigh bone called femur and the cup-like cavity of pelvis called acetabulum. Both joint surfaces are covered by a lubricating layer of strong articular cartilage. There is a protective layer of connective tissues around called the ‘joint capsule’ and five major ligaments to stabilise.
Pain in the hip can arise from structures in and around the hip joint.
- Arthritis: The most common wear and tear condition is the Osteoarthritis of the hip. Other pathologies like Rheumatoid Arthritis or Hip Necrosis may aslo cause arthritic changes. Degeneration also occurs when the hip joint is immobilised or hypo mobilised after a fracture or surgery.
- Ankylosing Spondylitis: This is a genetic condition leading to inflammatory arthritis of the hip.
- Muscle Strains: Pain may arise from injury or inflammation of hip or groin muscles like psoas and harmstrings.
- Tendinitis: Inflammation of tendons surrounding the joint.
- Referred Pain: Problems related with herniated discs and Sciatica also causes a referred pain around the hip
- Snapping Hip Syndrome: When the Ilio tibial band, deep hip flexor muscles, or labrum tears or snaps it causes a snapping sensation.
- Overuse Syndrome: Overuse or trauma results in various conditions like tendonitis, muscle pull and bursitis. Irritation of nerve causes pain through the hip radiating down the leg.
- Fracture: Fracture of the femur or acetabulum due to direct injury or osteoporosis
- Bursitis: Inflammation of bursa (sac of fluid) on the outer side of the hip
- Hip Surgery: Muscle weakness and pain can occur after hip surgery and can persist without appropriate rehabilitation.
- Pain is usually experienced in the groin and thigh regions
- Radiation of pain along the thigh
- Swelling around the joint
- Stiffness around the joint
- Progressive pain with prolonged or in acute stages even short weight bearing
- Difficulty in rising up from the chair, climbing the stairs, squatting
- Limping, gait
- Impaired balance and lack of postural control
- Pain when lying on the hip
Patients may take medical treatment for relief of pain. Physiotherapy aims to assist with pain relief and muscle strengthening or re-education. Your physiotherapist will select the appropriate modalities for your condition from the list below.
Short Wave Diathermy: This is administered to relieve pain and to improve bloody supply (vascularization).
Lumbar Traction/Spinal Decompression Therapy: If the pain is referred from lumbar spine, traction is helpful. The distraction force reduces the pain and increases the joint mobility.
Interferential Therapy: Interferential current stimulates the peripheral sensory and muscle nerve fibres to reduce pain and inflammation.
Ultrasound Therapy: Helps to reduce localised pain and swelling by increasing micro-circulation
Laser Therapy: The low level laser therapy helps in pain management.
Exercise Therapy: A strengthening program can improve overall range of motion and postural control. This may include exercises for the abdominal muscles as well as the Hip, Back and Knee joints.
Postural Training: Learning to keep joints in the best positions for weight bearing to reduce stress on the joints.
Galt Training: To improve weight bearing control and balance
- If you have hip pain or arthritis, avoid high impact or jarring activities like football and racquet games
- Breast stroke when swimming
- Avoid jumping and running
- Avoid repeated bending and direct pressure on the hip
- Do not sleep on the affected side
- Gym equipment like cross trainers and steppers should be avoided
- Excessive stair climbing to be reduced
- Avoid static position for too long and stretch in between.