Hip Pain- Part 1
I’m not sure if I would go so far as to say that hip pain is the new black, but over the past decade its popularity has been on the rise due to innovative arthroscopic surgeries. These techniques are similar to those used for years to help knee and shoulder problems. The major exception is that the hip is a much deeper joint, and by nature built for stability. It has taken a little bit longer to figure out how to do a less invasive procedure which includes an exterior camera and weighted traction. The huge plus is that many things that weren’t treated by the open procedure surgeries are now able to be corrected.
Why would a bodyworker be so excited about the advancement of hip surgery? It is quite simple -research must support the things we do in medicine. Twenty years ago, as a new physical therapist, the only hip problems referred for rehabilitation were bursitis, and post-operative care following hip fracture and hip replacement. Today we have a much better understanding of what is happening if you have hip pain. This improved system of differentiation, offers more treatment options and the ability to screen those that may be at higher risk for more severe hip problems later in life.
Let’s consider hip anatomy
Here’s what you want in terms of having a good hip. Nice congruent and well aligned surfaces between the thigh bone (femur) and the pelvis (acetabulum), and normal cartilage spacing between these two bones that make up your hip socket.
What if you don’t have these things? Here is where the biggest questions live. Are you more prone to develop hip arthritis? Will performing arthroscopic surgery to help improve the contour and alignment of your hip joint today, prevent a hip replacement later on in your life? Since this is all pretty new, the jury is still out on the final answer, but I believe things are looking pretty hopeful for the future of our hips.
So you have hip pain what do you do?
I recommend getting a consult with an orthopedist that specializes in arthroscopic hip procedures. You will have to do your homework as this training is still relatively new. For instance, in Austin, at the time of this blog, we have only two physicians with this expertise. They will rule out if you have a true joint problem, a muscular problem, or a combination of both. Once you know this, the options are pretty well laid out, and include medication, corticosteroid injection, soft tissue mobilization, rehabilitation and/or surgery.
Rehab Perspective- A good assessment is imperative!
An individual program should be designed to support your hip alignment and correct movement dysfunction. Common findings are functional pelvis asymmetry, decrease in hip range of motion and muscular flexibility, and neuromuscular imbalances which include both weak and overactive muscles in the hip, abdomen and pelvic floor. It is important to pick someone skilled in these areas of assessment to assist you in figuring out a corrective program you.
Your biggest job is to figure out and stop the irritating factor(s). A good rule of thumb is any pain brought on during or after an activity or exercise should be discontinued or modified for the time being. With this effort and putting a knowledgeable team in place, you should have the best opportunity to return to doing all the things you liked to do before your hip started to hurt.
“The obstacle is the path.”- Zen proverb
Hip pain: Part II will examine hip injuries and treatment in more detail.