The hip joint consists of a deep socket formed where the thigh bone (femur) meets the pelvis (acetabulum). Although this shape makes the hip joint quite stable and relatively low risk for injury, its role in supporting our body weight raises our risk for arthritis. Poor muscle support, excess weight and inefficient movements contribute further to this risk.
In addition to arthritis there are several other structures that can cause pain around the hip joint. Bursitis and tendonitis are common conditions. Strains to the muscles in the buttock or front of the hip are a frequent source of symptoms. More recently the cartilaginous lip around the hip socket, labrum, has been implicated as a source of harder to diagnose symptoms. And as if this is not complicated enough the low back will often mimic hip pain.
The outer aspect of the hip has a fluid filled sac (bursa) which helps the tendons to glide over the roughened bony surface (greater trochanter). If this structure becomes inflamed it causes pain whenever the tendons contract and squeeze the bursa, i.e. as we walk, stand or climb stairs.
Low back referred pain.
The low back is a frequent contributor to pain in the hip and pelvic area. This means that an assessment often looks at both areas to determine the primary source of the symptoms. The location of the pain can sometimes help as the hip typically causes pain in the groin and the low back causes pain in the buttock however pain on the outer aspect can be caused by either structure.
Piriformis syndrome and IT band syndrome are common diagnoses for pain in the buttock or outer thigh however these muscular strains are frequently symptoms of other imbalances. These areas are often strained when other muscles are providing insufficient support. The muscles at the front of the thigh, hip flexors, can also become inflamed if they are over-used. Although direct treatment can temporarily relieve your pain, a thorough analysis is required to determine the underlying cause and to develop a plan to correct these muscular imbalances.
Whether your symptoms are caused by the hip joint, muscles, bursa, labrum or are being referred from your low back the most important first step is to understand what you have. At The Orthopaedic Therapy Clinic your therapist will provide a thorough assessment and partner with you to determine the best course of treatment for your injury.
Once the injury is diagnosed the next step is to determine where you are in the recovery sequence. Treatment is based on your stage of healing as more acute injuries typically require a plan to reduce pain and inflammation. The use of traction, Kinesio-taping or electro-therapeutic modalities i.e. ultrasound, can be helpful to reduce pain and allow you to remain more active as you heal. As you continue to progress the restoration of flexibility, rebuilding strength and re-establishing normal movement patterns becomes the focus of your therapy. The final stage is to determine a strategy to help you return to full activity, work, sport and long-term prevention.