Hip Pain
Hip pain can be debilitating and can impede on many activities of our day to day lives. It can be caused by a wide variety of musculo-skeletal conditions as well as sometimes being referred from other areas such as our backs. This means figuring out and diagnosing the exact cause of your hip pain will change how it needs to be managed. Best Physiotherapy clinicians have years of experience and are experts at diagnosing and managing different types of hip pain with graded physiotherapy rehabilitation programs. This is the key to achieving good outcomes.
What causes hip pain?
Hip pain can be caused by a variety of factors, including:
Osteoarthritis: Osteoarthritis is a degenerative joint disease that can cause pain, stiffness, and limited range of motion in the hip. One of the first signs of hip arthritis is a limited range of internal rotation of the hip. Osteoarthritis tends to present with a pattern of morning stiffness for 30 minutes or less, and pain that is worse with activity and improves with rest. When osteoarthritis causes pain at rest or at night, this often is an indicator that the condition is severe.
Bursitis: Bursitis is the inflammation of the bursae, small fluid-filled sacs that cushion our joints. Bursitis can be thought of as a blister that fills up with fluid due to friction or rubbing from the surrounding structures. This often feels worse when lying on the hip, sitting for prolonged periods, or climbing stairs. Medication can often be helpful to mask your pain in order to enable you to complete effective physiotherapy rehabilitation. Physiotherapy works to address hip and pelvic stability as well as glute strength to deload the inflamed area and reduce irritation.
Tendinopathies: Tendinopathy is para-inflammation of a tendon which is the part of the muscle that attaches it into bone. Tendinopathy, which can cause pain, limited range of motion and affect function. It tends to present as a problem after an increase in load, for example starting a new exercise routine. It is most common over the age of forty, and is over twice as likely in women than men. Hip (gluteal) tendinopathy also is irritable when laying on your side at night, with stairs, and with sitting, standing or walking. A graded physiotherapy strengthening program is the key to successful rehabilitation.
Labral tear: A labral tear is a tear in the cartilage that surrounds the hip joint, which can cause pain and instability. It can present with pain, stiffness and a joint that clicks, locks or catches. Walking, pivoting, prolonged sitting and running often aggravate symptoms. Some labral tears can be pain free, requiring little input from doctors or physiotherapists, whereas some require graded rehabilitation and others if severe enough may require onward referral for a surgical opinion should the rehabilitation program be unsuccessful.
Fracture: A hip fracture is a break in the bones of the hip, which can cause severe pain and disability. X-rays are ordered to check the integrity of the hip bone and pelvis, with follow up scans sometimes being required. Fractures are initially managed in conjunction with doctors and often require surgery, with physiotherapy rehabilitation being the key to good outcomes and return to function.
Hip joint dysfunction: Femero-acetabular impingement (FAI) is an issue with the shape of the ball and socket joint in your hip which could be genetic or a change/maladaptation response to load and activity. It occurs when extra bone grows along one or both of the bones that form the hip joint causing a pinching. This is often seen in the athletic population, or those who do repeated hip flexion movements. FAI often presents with pain in the groin during or after activity or with prolonged sitting, and may cause stiffness and difficulty in flexing the hip beyond a right angle.
Hip muscle injury: the muscles around the joint act as stabilisers which may not be able to do their job properly if weak or injured. Muscle strains can occur for a number of reasons; impact injuries such as a fall onto a hard or pointy surface, overstretching injuries, or when muscles are forced to contract beyond their capacity. Muscle injuries are graded by severity according to factors such as size of the tear and whether there is weakness as well as pain. The grade of injury will determine recovery timeframes and the type of rehabilitation being done.
How can physiotherapy help manage hip pain?
Our team of clinicians at Best Physiotherapy have expert knowledge and skills to help you manage and rehabilitate your hip injury. Physiotherapy can help with hip pain by:
Accurately diagnosing and educating you on your condition.
Pain and symptom management: We can use a variety of manual therapy techniques (mobilisations, massage and needling) and biomechanical modification (changing or improving the way you move your body) to reduce pain. This reduces reliance on medication. It should be noted however that if a medical review is required we will always refer on.
Graded exercise rehabilitation: Movement is medicine so learning how to move safely and what exercises you should be doing, in what order, is the key. We will work on a range of exercises for flexibility, strength and endurance of the hip and surrounding muscles to improve function and reduce pain. These programs are individualised to you. If you are a gym-goer you may get a gym-based rehab program whereas if you prefer to do your rehab at home we can give you a body-weight only or resistance-band based program.
Functional rehabilitation: Ultimately the goal of any rehabilitation program is to get back to doing the things you love as well as the basics that you need for day to day life. We will work with you to create a personalised program that will help you to regain your functional abilities. This may be as simple as being able to manage a day sitting at a desk at work, or as complex as returning to marathon running.
Prevention of further injury: A successful physiotherapy rehabilitation program ensures that you are not at risk of repeated or additional injury. Ensuring that you have dealt with the underlying cause of an injury and reducing reinjury risk is the final stage of rehabilitation.
What can I expect during my physiotherapy treatment?
During your initial assessment, you will receive a comprehensive assessment of your condition. We will assess to rule out groin-related pain and lower back referral as these can often be felt in a similar area as hip pain. We will then differentiate between the different causes of hip pain to give you an accurate diagnosis and develop an appropriate individualised treatment plan. Treatment sessions may include a combination of manual therapy, exercise therapy, modalities, education, strengthening and functional rehabilitation, tailored towards your goals. Your physiotherapist will monitor your progress throughout your treatment and make adjustments to your treatment plan as necessary.
At Best Physiotherapy, our team provides empathetic, expert care. We understand that hip pain can often be scary and frustrating and we pride ourselves on having the skills and knowledge to help you achieve your rehabilitation goals.
Contact us today to learn more about how we can help you manage your hip pain and improve your quality of life at Best Physiotherapy, 72 Maribyrnong Street, Footscray.