Hip pain can be due to various things; bio-mechanical compromise, previous or recent injury, developmental conditions, and degeneration, to name a few. The good news is that often a lot that can be done conservatively to help the hip out of trouble, as stand-alone treatment or in conjunction with other interventions where necessary. The aim is to ensure you receive appropriate effective help and advice that provides you with an understanding of your own body health and how to achieve the best results as quickly as possible.
The hip joint
The hip is an amazing joint, it helps the body deal with pretty big forces with each step we take – it’s a key part of the body’s power house in anything we do, like getting out of a chair, running for the bus, or serving in tennis match.
It’s a ball and socket joint, which means it’s amazingly 3D and moves in all directions, compared to something like the knee joint which is pretty dominant in one plain (forward-back).
As a key piece of kit in our anatomical arsenal – it supports the weight of the whole body and, importantly, the big powerhouse muscles cross or attach very close to it. The gluteus maximus, the quadriceps, the hamstrings muscles all rely on healthy hip movement for their own good function.
Hip pain, injury and dysfunction
For problems with joints, ligaments, muscles and tendons anywhere in the body, hands-on osteopathic treatment combined with movement strategies can be powerful in helping to understand the cause(s) and resolve symptoms.
When the hip struggles it can have a big impact on its neighbours, the low back and knee, and even the foot and neck further afield. Conversely, they can also have a big impact the hip and can be a significant contributing factor to pain in the area.
Hip problems can involve various structures – the tough, flexible articular cartilage that lines the joint, the cushioning fibro-cartilagenous labrum, muscles, ligaments, bursae… it can also include inflammation from infection or systemic conditions so it’s important to get the right kind of treatment with the right specialist.
How I can help with hip problems
The goal of treatment is to help to resolve symptoms such as pain as quickly as possible. It is also to provide you with a good understanding of the problem and why it developed, as well as physical and behavioural strategies to help avoid recurrence.
Your response to treatment is key and your progress will be at the forefront of the care you receive. Treatment often involves:
- Whole body assessment in movement and at rest to get as much information as possible about what is contributing to the issue. This is done after taking a full medical history to make sure you are in the right place for the right kind of treatment, or establish if you need a referral for other specialist advice, tests or scans.
- I may use hands-on treatment in the area where you feel symptoms as well as further afield. Understanding the hip in the context of the whole body can be essential in addressing the problem.
- Strategic movement behaviour and analysis is often key in helping to resolve musculo-skeletal problems causing hip pain, so that the whole body works better in helping to take pressure off the problem area.
- Understanding good whole-body function can make a huge difference to the choices you make about how you use your body, so education and understanding are often a significant part of treatment so that you can maintain good body health into the future.
Conditions of the hip
Muscular
Muscular problems around the hip joint can be surprisingly painful, muscle trigger points/knots can cause pain in the area and down the leg and make walking or other activities very uncomfortable. They can easily be mistaken for other conditions like sciatica (pinching of the sciatic nerve). Often muscular issues are due to the structure being overloaded in someway or being unable to move well due to dysfunctional joint movement – both can be caused by issues elsewhere in the bio-mechanical chain: foot function feeds that of the knee-hip-low back etc. and vice versa. These types of issues usually respond really well to conservative treatment. The key is to keep moving and find different ways of stretching and loading that help you regain pain free movement.
Osteoarthritis
This can occur in any joint, commonly knees and hips. It involves the wearing of the articular cartilage. This degeneration is essentially a normal process and happens to us all to some degree. For some people it can be excessive, for various known and unknown reasons. Some people experience mild or no symptoms, others may experience pain and stiffness.
Movement is essential in managing osteoarthritis to help avoid further degeneration, it helps with inflammation and keeps surrounding muscles and soft tissues as healthy as possible. Hands-on treatment combined with movement strategies can be powerful in addressing the symptoms associated with hip osteoarthritis and the impact on surrounding structures. Treatment involves developing strategies that makes movement easier to maintain good function of the hip and the rest of the musculo-skeletal system.
If you have had joint replacement surgery, treatment can assist with rehabilitation and recovery, as well as help with any ongoing effects of altered walking and mobility which you may have experienced prior to your operation.
Developmental Dysplasia of the Hip (DDH)
This is when the hip hasn’t developed properly resulting in the hip socket being shallow and can cause hip dislocation as a new-born. Conversely it can remain asymptomatic and undetected until later in life when pain or a limp may develop as a teenager or young adult. Pain is typically in the groin area with activity, and there may be clicking or popping. Some symptoms caused by DDH can respond well to conservative help (without surgery). However, further investigations may be necessary and surgery might be indicated. Everyone is different and remember that hip symptoms can be caused by a number of things and are not necessarily DDH.
Trochanteric Bursitis
This is inflammation of the bursa on the outside of the hip joint. Bursae are cushions that resolve friction between bones and muscles or tendons around joints. Pain is felt on the outer aspect of the hip but the joint itself isn’t involved. Pain relief (ice, pain killers or anti-inflammatories) and other interventions such as steroid injections can be helpful, however a conservative approach using hands on and movement strategies is often very successful in addressing this kind of bursitis.
Hip fracture
This is more common in older adults, especially with osteoporosis. A hip fracture won’t always prevent you from standing or walking but if it remains untreated it can cause serious complications. If you’ve had a fall and are experiencing any of the following you should seek emergency medical help:
- Can’t lift, move or turn your leg
- If you can’t stand or put weight on your leg
- If there is bruising/swelling around the hip area
- The injured leg seems shorter than the other leg
