Bursas are fluid filled sacs located throughout the body and are responsible for providing lubrication between muscles and skin. Typically through impact or repetitive movements, a bursa will become inflamed and will be very tender to the touch.
Bursitis tends to be characterized as pinpoint pain that is dull or achy at rest and sharp during aggravating movements or when there is pressure over the bursa. Hip bursitis is typically characterized as having pain over the outside of your hip. Pain while laying on your side is very common. Bursitis responds well to manual techniques and application of modalities as well as fixing movement faults to reduce the overall amount of stress placed on the inflamed bursa.
Bursitis tends to respond well to passive treatments such as corticosteroids shots to reduce inflammation in conjunction with active treatments.
General hip tendonitis is characterized as having swelling of the tissues (tendons) connecting muscle to the bone in the hip joint.
Hip tendinitis is typically caused by repetitive overuse or stress of the tendons, such as from running or working out. Symptoms include pain that feels like a dull ache, and stiffness. Pain is increased when performing the aggravating activity.
A hip labral tear involves the ring of cartilage that follows the outside rim of your hip joint. The hip joint is a ball and socket joint and the labrums responsibility is to not only provide cushion and shock absorption during walking, running, and landing but also to deepen the socket to provide stability of the hip joint.
A hip labral tear is characterized as deep hip pain or pain that radiates to the glute or into the groin. It is often reflected on as C-sign hip pain.
Rehabilitation is important to improve muscle stabilization and strength to reduce the risk of additional sprains. Using ice, grade IV laser, and E-stim is useful at reducing inflammation, swelling, and pain to allow for proper healing.
Hip labral tears do not always require surgery in a normal adult population but are more common for people who are still involved in sport activities.
Physical therapy and acupuncture to improve hip strength, muscular imbalances, and to improve balance are important for pre-operative hip labral tears. Physical therapy protocols are involved for post-operative care based on the type of surgery performed.
Hip arthritis is one of the most common causes of pain in the hip. It is a progressive disorder, which means that it typically starts gradually and gets worse with time. In the beginning stages of arthritis pain may be minimal but as it progresses pain will increase, become more severe, and begin limiting function of the hip.
Hip arthritis is aggravated by progressing age, hip dysplasia, previous hip injury, or obesity placing increased stress to the hip. Prolonged sitting or standing tends to increase pain with hip arthritis and is improved through movement such as walking.
Improving strength, improving hip mobility, and losing weight are important to reduce the pain associated with hip arthritis.
Hip impingement, also known as femoroacetabular impingement (FAI), is a condition in which there is abnormal and wearing contact between the ball and socket of the hip joint. The result is increased friction during hip movements that may damage the joint.
With hip impingement syndrome, there tends to be a rubbing on the tendons, muscles, ligaments, cartilage, labrum, or bones of the hip causing pain. Impingement syndrome is aggravated based on position and pain is common in sitting or with leg crossing.
Successfully reducing pain with hip impingement syndrome is reliant on determining what is being impinged.
In general, pain is alleviated by reducing muscle imbalances and reducing inflammation through various exercises, modalities, and manual treatments.
A hip fracture is a fracture of the femur, which is the strongest bone in the body. A hip fracture in young adults or kids is usually as a result of intense trauma or falls and in older adults or the elderly is associated with a fall or a diagnosis of osteopenia or osteoporosis.
Hip fracture may require surgery depending on the severity of the injury. Following surgery, physical therapy is important to regain strength and mobility and is important to improve balance and proprioception to reduce the risk of further falls. Additional assistive device training may be important to improve balance.
A muscle pull of the hip happens when a muscle of the hip is stressed or stretched beyond its limit. This can be during an explosive activity such as running or kicking or an intense moment of stretching.
Common muscle strains or pulls in the hip are the hip flexors, the glutes, the quads, or the hamstring muscles. Reducing inflammation of the muscle strain and alloying the muscle to rest and heal is important to reduce re-injury or further injury of the muscles.
Following healing of the muscle, further neuromuscular re-education, strengthening, and stretching is important to regain stability and resilience of the muscle.