From anterior hip joint pain to gluteal tendon tendinopathy, there are a lot of things that can cause pain in and around the hip.
Diagnosing the problem is essential in getting the right stretches and exercises to help you through the rehab phase of injury, as well as a structured program for post-operative hip and tendon surgery.
Hip Flexor Strains
A hip flexor strain is in fact a grade of tearing of one or more of the muscles that flex (bend) your hip and typically causes pain in the front of the hip or groin region.
This can be associated with muscle tightness, spasm and weakness.
We mostly see hip flexor pain in people who are runners or are playing sports involving kicking.
Many may develop a tendinopathy gradually due to repetitive or prolonged strain on the hip flexor muscles.
With acute severe tears there is limping, tenderness and shape pain with loading.
Rehab not only involves strengthening weak muscles or tendons, but also a deep dive into the hip biomechanics to diagnose possible underlying causes.
Labral Tears and Repair Surgery
The hip joint is a ball and socket joint – and the socket itself is lined by strong cartilage known as the labrum which attaches around the rim, adding stability to the hip joint.
Occasionally the labrum can be torn or damaged and catching or discomfort on movement can occur.
Our Physios can test this with specific movements and if positive usually an MRI is needed to confirm the extent of the damage.
Injury to the labrum mainly occurs under traumatic circumstances in sports that require sudden changes of direction and twisting movements.
Sometimes patients may develop this condition over time through gradual wear and tear associated with overuse into flexion like with cycling and rowing.
In older patients, degenerative changes to the joint may also be present, so injury to the labrum can occur during normal movements of the hip.
Groin Tears and Tendinopathy
Similar to the hip flexors, a groin strain is characterised by tearing of the muscles or tendinopathy.
The adductors act to stabilise the pelvis and mostly move the leg towards the midline of the body and are particularly active when loading on one leg like in running, changing direction and with sports involving kicking.
Graded strength and stability exercises involve progressing from simple isometric load to active leg movement, then sport specific drills.
Usually, groin rehab involves a significant amount of complementary glute exercises in the program.
Trochanteric and Gluteal Bursitis
A common condition characterized by inflammation to the bursae causing acute tenderness and pain in the hip.
Greater trochanteric bursitis being on the very side of a hip over the bony prominence and gluteal bursitis behind bony point.
Bursitis is mostly causes from repetitive strain through an increase in walking or running load over time with an underlying poor pelvic stability and weak gluteal muscles.
It can also come about through acute trauma or contusion (i.e. falling on the side of your hip).
Strengthening the glutes, external rotator muscles and working on hip mobility as part rehab for both conditions.
Sometimes intervention is needed with Cortisone injections to settle the bursitis and allow strengthen to occur.
Hamstring Tears and Tendinopathy
In many athletes and long distance runners we see injuries to the hamstring muscle, tendon as well as origin tendinopathy, sometimes called a high hamstring strain.
These types of injuries tend to be from overuse or incorrect training and usually involve muscle imbalances or biomechanical dysfunction.
Effective hamstring injury rehab requires specific rehabilitation exercises, like isometric and then eccentric movements to improve the pain and increase the strength progressively and carefully.
