The hip joint, medically referred to as the acetabulofemoral joint, is the joint between the femur (leg bone) and acetabulum (socket of the hip bone) of the pelvis. The primary function of the hip is to support the weight of the body in both static (standing) and dynamic (walking or running) postures. Because of its close proximity to the pelvis and back, often hip pain is related to lower back pain (see the lower back section of the website).
Injury to the hip can occur from trauma (fracture, labral tear), overuse (tendonitis, bursitis), decreased flexibility/muscle tightness, and prolonged stress (obesity, athletics, poor posture).
Treatment of the hip will be based on your primary problem and will include:
- A pain relief program and patient education on the hip (including its anatomy, risk factors for pain, and ways to manage pain in the short term at home)
- Assessment of other joints/driving factors (leg length, gait, pelvic alignment, etc)
- Postural assessment and education
- Development of a home treatment program to speed recovery
- Manual therapy (massage and hands-on stretching) to normalize range of motion and muscle tone
- Exercise to improve movement and strength
Some common conditions of the hip:Arthritis: describes the degenerative condition where cartilage within the joint breaks down leading to less cushion and more friction in the joint. Arthritis of the hip is fairly common and typically affects people beginning in middle age. In severe cases, a total hip replacement (THA – see below) may be recommended by your surgeon. While arthritis is incurable, many of the secondary symptoms that accompany it (pain, weakness, muscle tightness/spasm, and inflammation) can be managed by physical therapy.
Symptoms may include:
- Stiffness/pain in the hip that is worse after prolonged periods of rest
- Grinding/crunching in the hip that is also painful
- A dull ache after prolonged use of the hip (walking, standing) that ends with increased stiffness
- A loss of extension motion of the hip (during gait this leads to a shortened step and a flexed posture/limp)
THA: Stands for “Total Hip Arthrosis,” previously called a total hip replacement. In this procedure, the ball of the femur and the socket of the hip are replaced by a metal prosthetic. Currently there are two possible procedures for this surgery: an anterior approach and a posterior/lateral approach. These terms describe the location of the incision and the area disrupted by the insertion of the prosthetic. Each procedure has some restrictions for the first several weeks after surgery, so it is important to discuss this with your surgeon.
Physical therapy is designed to help you regain the range of motion, flexibility, strength, and function lost by your hip arthritis and recent hip replacement. Treatment helps to quickly restore your mobility and quality of life.
Muscle strains (quadriceps, adductors (groin)/hamstrings): are somewhat common in the hip area, and typically occur with athletics. A muscle strain describes the damage done to the individual muscle fibers when the outside force exceeds the strength of the muscle/fibers. This “tearing” of the muscle fibers within the muscle can also damage small blood vessels, causing local bleeding (bruising) and pain (caused by irritation of the nerve endings in the area).
Symptoms may include:
- Pain/stiffness of the muscle
- A loss of mobility and strength of the affected muscle (usually most apparent with joint motion)
- Bruising, swelling, and tenderness over the muscle
Bursitis: A bursa is a fluid-filled sack that decreases friction forces between tissues of the body. Trochanteric bursitis (inflammation of a bursa) is caused by excessive stress on the bursa between the gluteal muscles/IT Band (of the hip/lateral thigh) and the greater trochanter (a bony prominence on the femur). When the bursa becomes inflamed it fills with swelling and becomes a rigid, firm mass that causes pain and further propagates the irritation.
Symptoms may include:
- pain over the outer aspect of the hipbone, which often is worsened when lying on the affected side, standing on the affected leg, or excessive walking
- difficulty moving the hip and pain with excess motion
- visible redness/swelling on the outside of the thigh