Hip joint pathologies are a common complaint that I see in clinic. True hip pain can be quite debilitating. Walking, climbing stairs and even doing your shoelaces up can be an exercise in patience and futility.
So what is the hip, and what are common hip injuries or soreness that can plague your sport or day-to-day activities? How can we treat them? How can we get back to doing what we love to do?
The Hip (Femoral Acetabular) Joint
As most of you know the hip joint is a ball and socket joint, where head of the femur (the “ball”) fit into a concave surface on the side of the pelvis called the acetabulum. It is quite complex in terms of muscles that cross over the joint. These muscles serve two fundamental purposes: enabling stability for high loads of weight bearing exercise and allowing proper movement and flexibility needed for that exercise.
Hip Problems…. The list is long but not so distinguished.
We can usually divide our hip pain into 2 areas: factors causing pain from inside the hip capsule and factors outside the capsule.
Intracapsular (inside the capsule)
The most common issues contributing to hip pain are either an abnormality in the structure of “ball” and/or “socket side” of the joint. These two lesions are commonly expressed in a condition known as hip impingement syndrome. Other conditions can be degeneration of the joint surfaces leading to osteoarthritis, and tears in the “grissly” ring surrounding the joint surface called the labrum. Most of these at a moderate to advanced stage will need surgical intervention to repair the damage and reduce the associated pain.
Extracapsular (outside the capsule)
Now this is where things get interesting! Referred pain from the lumbar spine is one common consideration (I know a good chiropractor for this one). Muscular imbalances in the hip, groin, abdominals, and lower back are the other.
Any imbalance that causes the hip joint to either “sit” in the capsule incorrectly, or causes the hip to move in a problematic fashion has the potential to cause pain. It can also lead to the more serious problems inside the hip capsule later on.
So how do we go about treating hip pain and dysfunction?
I loved this recent quote from a fellow myotherapist that rang true with me:
“My job is to get you to a point where you don’t need me anymore….. as fast as possible.”
So with this in mind, assessment is crucial to the success of any targeted treatment plan. We need to rule out any of those more serious pathologies and get a concise view of where, when and how the hip is sore. Analysis of how you move “as-a-whole”, and how this may affect your hip pain is particularly important as serves two purposes:
It shows the quality of your whole body movement including your hip and can give us some baseline measurements.
It enables us to retest and compare the improved quality of movement, and any increase in hip range or reduction in pain.
Secondly when it comes to true soft tissue treatment of the hip, I have been lucky enough to study a technique with renowned Australian soft tissue therapist, educator and friend Stuart Hinds. Developed during Stuart’s 4th Olympic Games role with the Australian Men’s Hockey Team in 2012, it has some truly amazing results with increasing the range of motion in the hips and reducing discomfort in the region. When indicated, it is the best hands on treatment technique I have used to date that is effective with respect to treatment time and results.
If you would like to talk with me about your hip pain, or would like an appointment please give Body and Spine Solutions a call today on (02) 5310 6259.