Hip pain is a common presentation in my practice, and everyone’s differentiation of hip pain is different. The true hip joint is located to the medial side of your thigh, where your femur (thigh bone) attaches to the acetabulum of the pelvis, more commonly referred to as the groin. The joint is a ball and socket joint, designed for high levels of mobility which aids us in playing sports and our daily activities.
Common causes
Occupation related – Hip and lower back pain are commonly seen in professions with a lot of sitting and a lot of driving, trades that have heavy toolbelts can commonly cause problems in the hip as well.
Sport – Overuse and traumatic accidents can cause a multitude of hip injuries. Often sports with high running and jumping loads are frequently the cause of grief to the hip.
Chores – activities (or hobbies) such as gardening can cause hip complaints, especially around Spring time when that load increases, spending lots of time in a semi- squat position or on our hands and knees trimming bushes and pulling out weeds. Even activities such as vacuuming seems to cause pain in many individuals.
Posture – Any prolonged posture position has the potential to cause pain, whether it is sitting or standing all day. It is very important thing to keep changing your posture to get that blood moving and to keep using your muscles!
Potential structural causes of hip pain
Because of the high joint mobility and strength required through the hip there are many structures that can be the cause of hip pain. Some common causes are:
Referred gluteal pain – the glutes are a group of muscles attaching to the posterior part of our hip. Trigger points, weaknesses and strains can refer to the joint as well as the front of the hip and groin pain.
Impingement – Labral tears or femoral impingement are a frustrating injuries commonly seen in athletes of high intensity sports and runners. This can present as ‘catching’ and sharp pains especially on rotation.
Tendinopathy/Bursitis – As the hip and pelvis are common attachment sites for our muscles many tendons can become unhappy. These include quadriceps, adductors and gluteal tendinopathies. These present as moderate pain at the beginning of an activity or early in the mornings gradually improving with exercise, only to come back as a gnawing pain a few hours after exercise. This will require activity modification to enable return to sport or activity. Bursitis can be directly related to a gluteal tendinopathy and will often cause pain laying on the affected hip resulting in restless sleep and an inflamed/burning pain.
Osteoarthritis – Common in Seniors although osteoarthritis can be seen in those aged in their 40s. This can be due to natural ageing or from previous traumas or overuse from sports or active jobs. Pain can usually be managed through exercise, weight loss and healthy lifestyle choices.
SIJ sprains and misalignment– Your sacroiliac joint is where your hips, tailbone and lumbar spine all connect. Depending on which, or how many of the ligaments are irritated, the pain can spread from the lower back through the hips and to the groin. Pain is often most noticed going from a sit to stand position, with feelings of unsteadiness - particularly when doing exercise loaded onto one leg (like a lunge or getting in and out of the car). This is also an area commonly sore with pregnant women.
Treatments
Soft and Deep tissue massage
Assisted Stretching
Manipulation and articulation
Exercise prescription
These are just a few of many structures causing hip pain and most have different treatment and management strategies.