Do you have hip pain? Most of us think of hip pain as something that happens as we get old, and is associated with arthritis that leads to an eventual hip replacement. But, many teens and young adults complain of hip pain, and most of those complaints come from otherwise healthy and active individuals. A recent study, as reported on the APTA's website, states that 87% of hip pain in young and active individuals is caused by impingement in the hip. This is called acetabular impingement, and is caused by bony changes at the hip joint. Think of it as a pinching of the structures of the hip between the bones.
Anatomy of the Hip Joint
The hip joint is made up of the acetabulum, or socket on the pelvic bones, and the head of the femur, or the ball portion of this ball and socket joint. Surrounding the joint is a capsule and a labrum, or lip, around the edge of the joint. There is cartilage on the surfaces of the bones that form the joint.
The Difference Between Hip Osteoarthritis and Impingement
Hip osteoarthritis is caused by a wearing down of the cartilage on the ends of bones in the joint. Eventually, this can lead to bone on bone rubbing in the joint and is painful, and is usually dealt with by having a hip replacement. Hip impingement is the pinching of the labrum, cartilage, or joint capsule between the bones due to misalignment. This misalignment can be caused by imbalances between the muscles of the front of the hip and the back and side of the hip. The muscles can be shortened, over stretched, weak, strong, and usually in a combination of these states. These imbalances cause abnormal pull on the bones of the hip joint leading to increased bone growth/spurs in certain areas. This leads to pinching and inflammation of the joint and surrounding tissue causing pain, not to mention the mechanical pain of the pinching itself.
Symptoms Associated with Hip Impingement Include:
- Stiffness or deep ache in the front or side of the hip and/or upper thigh. This can occur with prolonged positioning, especially sitting and leaning/bending forward.
- Sharp/stabbing type pain with transitional movements such as standing up from a chair, squatting, jumping, cutting, twisting, etc...
- Pain usually begins gradually, or can present with another injury and then lingers.
- Decreased flexibility of the involved hip during inward rotation of the thigh.
How Physical Therapy can Help
Physical therapy can help reduce pain and inflammation of the joint, help to correct muscle imbalances, and restore range of motion to return a person to pain free movement of the hip. If you have symptoms of hip impingement, see a physical therapist. During the evaluation the therapist will check your range of motion and perform special tests to determine if hip impingement is occurring. They will assess muscle length and strength, and identify faulty movement patterns that contribute to the condition. They will assess strength of core as well as range of motion of the spine and knees, ankles, and feet to determine if there are other contributing factors to the hip impingement. Your therapist will then work with you to correct any problems that were found, including prescribing specific exercises and/or stretches to correct imbalances, and performing manual joint mobilizations and soft tissue mobilization.
For more information about how physical therapy can help with hip pain, please contact us with your questions or call for an appointment today!