The hip is a ball and socket joint involving the articulation between the thigh bone and pelvis. The hip joint is surrounded by many strong ligaments and muscles which aid in stabilising and controlling the movement and mobility of the joint. Since the hip is responsible for aiding in everyday movements such as walking, running, and stair climbing, pain can be noticeable and limit these activities for those busy individuals running around the Sydney CBD.
Hip Pain can be caused by varying factors:
Arthritis aka “joint inflammation” of the hip is common in the older adults and can be caused by conditions including osteoarthritis and rheumatoid arthritis. Progressive arthritis eventually leads to pain, swelling and inflammation of the hip joint due to wear and tear of the articulating cartilage which functions as a shock absorber for the joint. Pain may be felt deep in the hip with the potential to radiate to the surrounding muscle structures or lower back. The severity of the arthritis can be determined by X-rays, physical examination of the hip, history of the hip injury and the amount of pain. Note, however, that X-rays can show significant arthritic changes in people who may not have that much pain. The converse is also true; people can have mild arthritic change on the X-ray but have quite severe pain. It appears that those who have developed or acquired good hip mechanics, strength and elasticity are the one who have very little or no pain. Read below in treatment section.
A labral tear of the Hip involves the soft elastic ridge of cartilage which lines the rim of the articulating pelvic surface in the hip joint. The major function of the labrum is to deepen the hip joint socket and also to increase the stability in such an overused joint. Through varying causes, the labrum can undergo a tear which may present as no pain, or gradually lead to pain, clicking or catching. Labral pain is usually felt deep in the hip or may radiate to nearby muscle structures and the lower back.
Bursitis – A bursa is a small, fluid-filled sac which functions as a gliding surface to reduce friction of the muscles and tendons from rubbing against the bone in close proximity during repetitive activities. Inflammation of the bursas surrounding the hip joint is known as a hip bursitis. Inflammation may arise from mechanical irritation or through repetitive wear and tear with association to other hip conditions. This, with other shoulder issues can be subsequent to many years of poor posture.
Muscle or Ligament Strain/Sprain – Repetitive movements of the hip through varying activities can place a vast amount of strain on the supporting muscles, tendons and ligaments. When these structures become overused and inflamed, pain may arise and vary depending on the severity of the tissue damage and the connective tissue structure involved.
Sometimes the hip or the labrum may be so damaged that surgical intervention may be warranted. However, most people who present to us with hip pain do very well quite quickly and do not progress to surgery. In the case of advanced arthritis some may have surgery delayed for many years if they receive treatment and rehabilitation and are compliant with the exercises.
Like most joints in the body, if the supportive musculature structures have strength and the soft tissue muscles, ligaments and tendons have enough elasticity then an injured or inflamed degenerated joint will improve.
The George St Chiropractic team use a lot of deep tissue massage, functional active-style release and mobilisations techniques to restore the elasticity and improve the integrity of the hip. We teach strengthening exercises to achieve the joint stability and we teach a home-based set of exercises to maintain this. Often there may be co-existing issue with the spine, pelvis and foot and if so we address this at the same time if necessary.