Treatment for hip pain and injuries requires a unique approach, given the specific characteristics of this joint. Unlike other bodily structures, the hip joint is inherently stable, designed to bear repetitive loads and resist wear and tear. It is the largest ball-and-socket joint in the body, characterized by its robust ligamentous support system.
Two primary ligaments, the ischiofemoral and the iliofemoral (also known as the Y ligament), play significant roles in maintaining the joint’s stability. Acting like a sling, these ligaments, thick and resilient, ensure the femoral head (the “ball”) remains securely within the acetabulum (the “socket”).
Furthermore, the hip joint is protected by a layer of cartilage that cushions the joint and reduces friction as the femur moves within the socket. This combination of structural elements makes the hip a unique and sturdy joint, and the treatment of its injuries must be approached with these considerations in mind.
When patients describe hip pain, the “hip” can encompass many different areas including the buttocks, the pelvis, the area where the thigh meets the flank, or the groin.
The more typical presentations of hip pain have usually to do with feelings of muscle and tendinous tightness rather than with instability. This tightness can alter body mechanics in the spine and create low back pain. This feeling of tightness can also spread to the anterior thigh and groin as well.
Despite the hip joint’s durability, the hip joint can still be prone to injury. Hip cartilage can wear down from bad body mechanics and a chronically tight hip, or from repetitive damaging activities. Additionally, muscles and tendons of the hips can get overused – or for frail and osteoporotic patients, the neck of the femur can fracture after a fall. Any of these injuries can cause hip pain to develop.
The following are a few of the conditions we see at Stride Strong Portland Area PT Clinics, but we also treat a myriad of other hip pain conditions like osteoarthritis or rehab after total hip replacements. Whatever your condition, it is first and foremost that you describe the location of your pain to your therapist and include a history of the activities you were largely participating in – even as a young adult.
Also, it is important to let your PT know whether you were born breached (i.e., feet first instead of head first) as this could give us a hint as to the cause and prognosis of recovery.
HIP FLEXOR STRAIN TREATMENT
This is one of the most common benign conditions we see at Stride Strong PT. The hip flexor set of muscles is commonly used in activities that require picking the leg up in a powerful motion. Common activities that could strain these muscles are running, kicking soccer balls, kickboxing, hurdles, and sometimes in even performing sit-ups.
The main hip flexors comprise the iliacus, the psoas muscle, and the rectus femoris. In addition, several adductors are also involved in helping with the movement of hip flexion. It is because of where these muscles attach that the pain can vary anywhere from the low back, the hollow of your pelvis, the front of the hip, and the groin.
Hip pain physical therapy can be very effective and quick to solve muscle tenderness and tightness by way of stretching and manual soft tissue mobilization. Click on the header link above to view how to perform a proper hip stretch.
Your physical therapist should also gauge how strong your core is – most often hip flexors are overused because of a weak core. Strengthening this anterior stability group of muscles may prevent re-injury and recurrence of any more hip pain. If you want more info please read more about hip flexor strains here.
GROIN STRAIN PHYSICAL THERAPY
Moving back to problems felt in the front of the hip, groin strains are usually traumatic in onset and happen from a slip and fall, or repetitive sports activities. They, too, hint at a weaker muscle system up and down the kinetic chain so a good physical therapist must be able to identify where these weaknesses and loss of motion are.
Physical Therapists are very adept at honing in problems in movement that lead to hip pain: we are experts in movement analysis and gait analysis and in so doing, we save the patient and insurance companies from spending healthcare dollars on imaging and special tests.
An example of how the weakness of another body system can affect the frequency of groin strains: a soccer player who has had repetitive ankle sprains will develop a weakness of balance in the frontal plane (side-to-side motions). This weakness will translate into an unwillingness of the body to navigate through frontal plane motions – such as kicking to the side or shuffling to the side. What this can cause is an overuse of the groin muscles and powerful kicks of the soccer ball.
A good physical therapist can not only identify movement pitfalls like these but can also help in the healing of muscle strains in the groin. Manual therapy can help with fibrous and muscle tension, and exercise therapy by way of stretching and strengthening exercises can not only allow for the healing of the muscle but also help strengthen weaker body systems that may have contributed to the groin pull strain in the first place.
Stride Strong Physical Therapy prides itself on its team of quality physical therapists. We have a dedication to movement analysis that very few clinics have. Rather than being trained to only treat painful areas, we know that we need to see the body system as a whole – that one weaker area can contribute to a strain in the other. Fortunately, exercise can be a very powerful remedy to dysfunctions – patients just need to be taught the right way to move.