Physiotherapy for Hip and Groin Injuries
Hip Osteoarthritis (OA)
Hip OA is a joint disease that usually happens gradually over time affecting the integrity of the joint cartilage. Decreased hip muscle strength also provides less shock absorption capabilities, increasing the amount of hip joint compression with weight bearing. Muscular weakness and the resultant instability can lead to further hip joint deterioration if not addressed. A diagnosis of hip OA does NOT mean that you will need a total hip replacement. Specific strengthening exercises, gait education, correction of poor biomechanics, activity modification and lifestyle advice all play a big part in reducing symptoms and improving function for patients with hip OA.
Hip Flexor Strain
Injury of the hip flexor muscles typically occurs with sudden movements like sprinting, kicking or changing direction. Hip flexor strains can range from mild to very severe. This presents as localised pain and tenderness at the front of the hip, pain with stretching the front of the hip and difficulty lifting the thigh (especially against resistance) however symptoms depend on the extent of the injury.
A ‘groin strain’ refers to an injury to the adductor muscles (located on the inner side of the thigh). Injury typically occurs in sports that involve sudden changes in direction. This presents with localised pain and tenderness on the inside of the thigh and pain with bringing your legs together (especially with resistance). In severe cases, walking may be difficult. Recurrent adductor muscle strains are common usually due to either; inadequate rehabilitation, resuming sport too early or not resolving other associated problems.
This refers to damage to the cartilage lining of the hip joint. This usually presents as a ‘deep’ ache to the groin, although it may also be associated with clicking and catching sensations. Pain is usually worsened with weight-bearing and twisting activities.
Gluteus medius tendinopathy
The gluteus medius is the primary stabilising muscle of the hip/pelvic region. When walking or running, the gluteus medius muscle acts to prevent the pelvis tilting to the opposite side when weight is transferred onto one leg. Weakness and dysfunction of this muscle allows for excessive pelvic movement which can lead to degeneration of its tendon, known as a tendinopathy. Acute tears, repetitive strain, or friction of the gluteus muscle against the greater trochanter are all causes of gluteus medius tendinopathy. This condition is often misdiagnosed as trochanteric bursitis and often these two conditions co-exist.
Hip bursitis is one of the most common causes of hip pain and is most likely to affect middle-aged and older adults rather than young athletes. Hip bursitis is more common in females then males. Bursitis occurs when the bursa becomes inflamed or irritated. When the bursae are swollen the area around them becomes very tender and painful.
Hip fractures are most common in people over 65 years of age, particularly seen in women with osteoporosis. In younger people, hip fractures are less common and are usually the result of a serious incident such as a motor vehicle accident.
Femoroacetabular Impingement (FAI)
FAI is a condition in which abnormal bone growth on the femur (upper leg bone) and/ or the acetabulum (the socket part of the hip joint) repetitively contact each other. This repetitive rubbing causes damage to the articular cartilage and the labrum.
Dislocation occurs when the ‘ball’ of the hip joint slips out of the ‘socket’. This is rare and usually takes a strong force for example from a motor vehicle accident or serious fall.
Hip and groin pain can also originate from other sources, for example the lumbar spine or sacroiliac joint. Your physiotherapist will perform a thorough assessment of the surrounding areas to identify the direct source of the pain.
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