The hip joint can withstand repeated motion and a fair amount of wear and tear. This ball-and-socket combined–the body’s largest–matches together in a means that enables fluid motion. Whenever you use the hip, a layer of cartilage helps prevent friction as the hip bone moves in its socket.
Despite its durability, the hip joint tends to weaken over time. With use and age, the cartilage can wear down or become damaged. Muscles and tendons in the hip may get overused. Bones from the pelvis can break through a fall or other injury. Any of these conditions can result in hip pain. If your hips are sore, here’s a rundown of what may be causing your distress and the way to get hip pain relief.
These are a few of the conditions and causes that generally lead to hip pain:
- Bursitis: Bursae are sacs of liquid found between cells such as muscles, bone, and tendons. They facilitate the friction from such tissues rubbing together. When bursae get inflamed, they can lead to pain. Inflammation of bursae is usually due to repetitive activities that overwork or irritate the hip joint.
- Tendinitis: Tendons are the thick bands of tissue that connect muscles. Tendinitis is inflammation or irritation of the joints. It’s usually caused by repetitive stress from overuse.
- Muscle or tendon pressure: Repeated activities can place strain on the muscles, tendons, and ligaments that support the hips. When they become vulnerable due to overuse, they could lead to pain and prevent the bone from functioning normally.
- Hip labral tear: This is a rip at the ring of cartilage (known as the labrum) that follows the outside rim of the socket of the hip joint. Together with cushioning your hip joint, then your labrum acts like a rubber seal or gasket to help hold the ball at the top of your thighbone securely inside your hip socket. Athletes and people who perform repetitive twisting moves are at higher risk of developing this issue.
- Cancers: Tumors that start in the bone or that spread into the bone may lead to pain at the hips, as well as in other bones of the body.
- Arthritis: Osteoarthritis and rheumatoid arthritis are among the most common causes of hip pain, especially in elderly adults. Arthritis leads to inflammation of the hip joint and the breakdown of the cartilage that cushions your hip bones. The pain gradually gets worse. People with arthritis also feel stiffness and have a reduced range of movement in the hip.
- Hip fractures: With age, the bones can become weak and brittle. Weakened bones are more likely to break through a fall.
Occasionally, pain from different regions of the human body, like the spine or groin (from a hernia), can radiate to the hip. You might notice that your pain gets worse with activity—especially if it’s brought on by arthritis. Along with the pain, you may have a reduced range of motion. Some people can develop a limp from chronic hip pain.
Muscle or tendon strains, osteoarthritis, or tendinitis, can usually be alleviated with an over-the-counter pain medicine like acetaminophen or a nonsteroidal anti-inflammatory medication (NSAID) such as ibuprofen or naproxen. Rheumatoid arthritis treatments also include prescription anti-inflammatory medications such as corticosteroids, disease-modifying anti-rheumatic drugs (DMARDs) such as methotrexate and sulfasalazine, and biologics, which target the immune system.
At On the Mend Physical Therapy, our PT’s have effective ways to help increase pelvic mobility and reduce or eliminate hip discomfort. Here are a few tactics On the Mend physical therapists will use to improve your hip health:
- Array or range of motion measurements: Range of motion (ROM) refers to how much your body and joints are turning, bending, or rotating. Assessing Range of motion is generally a painless process. Typically, three different types of ROM that are measured: passive (PROM), active-assistive (AAROM), and active (AROM). There are cases after surgery or injury where measuring ROM may be painful, but the pain is usually short-lived and only occurs throughout the procedure. Your PT can use special tools to quantify the way your hip joint is moving to help direct therapy, such as a goniometer. A goniometer is a plastic device that is handheld, made of metal or plastic, and has two arms—it almost resembles a protractor. Numbers representing angular distance are on the device. Your therapist will place the goniometer along certain angles on your body and appendages to determine where they may be able to help if your PT determines you have limited ROM.
- Palpation: Palpation is the process of a medical professional using their hands to check a patient’s body, especially while diagnosing an injury, disease, or illness. This procedure involves using the hands to touch various structures or possible abnormalities around the hip to assess whether a bone structure is painful to touch. Palpation is an integral part of the physical examination. Physical therapists develop great skill in palpating problems below the surface of the body, able to detect things that untrained individuals would not.
- Gait evaluation: A gait evaluation is an assessment of how you walk. Physical therapists are trained to detect small changes in the hip during distinct phases of walking. This test can help lead to appropriate management. Sometimes an injury or illness can change the way you walk, and this can lead to an altered gait cycle. Your PT can analyze your gait and offer strategies to help you walk better. Your physical therapist may also execute a video gait analysis to identify nuances in your gait that may be leading to your pain.
- Strength dimensions: There are many muscular attachments around the hip and measuring strength can help determine if muscular weakness or imbalance is causing your hip pain. Manual muscle testing is the most popular way to test strength. Your physical therapist will push on your body in certain directions while you resist the pressure. A score or grade is then assigned, depending on how much you were able to resist the movements of your PT. Strength is measured on a five-point scale. Another method to measure resistance is by using a device called a dynamometer. Your physical therapist will hold the dynamometer as you press it. The device will display the amount of force you are exerting in pounds or kilograms. Smaller, handheld dynamometers can measure grip strength; even smaller pinch-grip dynamometers can measure your pinch strength. N A dynamometer can test for any increases or decreases in your ability to contract a specific muscle or muscle group. While a dynamometer is the standard device physical therapists use to measure your muscle force, they can be quite pricey and large, making it difficult to use during home care settings.
- Functional mobility evaluations (FME): Your PT may watch you walk, climb stairs, jump up and down, or run to determine how your hip pain affects your overall mobility. The purpose of FME is to find deficient areas of mobility and stability in healthy individuals that may be overlooked with routine mobility testing. Predicting how an athlete or active individual might become injured is very applicable and is seen as a proactive measure the intends to prevent injury, rather than treat an existing complication.
- Special evaluations: Special tests are specific maneuvers performed around the hip to help determine which structure could be at fault and may be causing the issue. These procedures could include testing of the low back to determine if your hip pain is genuinely coming from your spine. Special tests are often performed to assist in diagnosing musculoskeletal disorders. There are various special tests, each specific for a precise diagnosis. Disorders of muscles, joints, tendons, and ligaments can all be confirmed with a positive finding if the correct special test is performed.
Exercises to enhance the mobility or strength of your hip are vital to keeping it healthy. Even light exercises performed once daily are a fantastic way to keep the pelvic bone working properly. As your hip pain decreases, advanced hip strengthening may be an additional option to make the most of your hip function. After your initial tests and clinical evaluation at On the Mend Physical Therapy, we’ll work with you to initiate a comprehensive treatment and exercise plan to manage your hip pain, increase mobility, and get you feeling your best again.