Sinead Coyle - Chartered Physiotherapist - writes :
Hip pain can be caused by irritation to the joint or the soft tissue (muscles/ligaments/tendons) which surround and protect the joint. It can cause us pain and stiffness ranging from mild to severe in nature. There are many reasons for hip pain, common reasons being hip muscle weakness, inadequate movement/mobility of the hip, and in some cases hip osteoarthritis (OA). We know that in Ireland there are around 915,000 people living with hip osteoarthritis (French et al, 2015).
The hip is a ball and socket joint. The top of the thigh bone (femur), which is rounded in shape, fits into a curved groove in the pelvis (acetabulum). It is held in this position by our muscles and ligaments, which are key contributors to good joint health and optimal function. Both the ball and socket are covered with different types of cartilage which allow for smooth movement within the hip and prevent bone on bone contact/excessive friction.
What can cause hip pain?
There are many factors that can influence the presence of pain and reduced function of the hip joint. Age can be a factor but it is not the only factor and it is not a guarantee that we will all suffer with pains in our hips as we age. Females are at higher risk and obesity can also contribute along with some other factors such as previous injury to the joint and our genes (Arthritis Ireland, 2017). If you tick all, or some of these boxes, you can still get back to normal every day and active function. Hip pain is not a life sentence and we can help.
So what are the signs and symptoms?
The main symptom of irritation in the hip is the presentation of pain and stiffness. In hip osteoarthritis pain can present itself around the groin area with stiffness more noticeable in the morning time or when getting moving after a period of prolonged sitting . You may notice that once you have warmed up your symptoms begin to ease. On a particularly active day whereby you have exceeded the load tolerance of your hip joint and the surrounding structures it wouldn’t be unusual to see similar symptoms returning in the evening time.
It must be noted that symptoms can vary, from day to day and from person to person, our approach in treating these injuries are to focus on each individual patient and their own circumstances, environment and concerns. Basing our intervention on these factors ensures a patient centred approach and subsequently the best possible outcome for the patient. Taking into account old or long standing injuries is key as there may be other contributing factors which are putting the hip joint under excessive pressure, and thus resulting in discomfort and irritation.
Googling your injury is not the answer. While Google has the answer to many things, the actions you take to resolve your injury must be specific to your individual case and generic online advice is not the gold standard care you deserve. At McEntee Performance Physio we treat you, the patient, first and foremost.
Diagnosis
Although hip osteoarthritis can be suspected following a thorough assessment, diagnostic imaging is required to confirm its present. The most commonly used test to confirm the present of hip osteoarthritis is an x-ray. It must be noted however that in all incidences of hip pain, imaging such as an x-ray or MRI may be useful information to help us guide your treatment, but they do not show muscular strength, quality of movement, range of motion or stability/control of the joint. More often than not, it is the influence of these factors that are driving your pain. We know from experience that there is not a direct correlation between findings on an x-ray/MRI and function/dysfunction. They are afterall a static picture.
How can we help?
Fortunately there are actions we can take to help to minimise the effects of hip pain. Our goals, as physiotherapists, are to improve your strength, mobility and increase the range through which you can move your hip joint. All of these combined can make the activities of daily living achievable and comfortable.
Should anyone tell you that exercise can harm your hip joint or to avoid certain activities, my advice to you is to take this with a pinch of salt (and then throw it away!) While it is important to acknowledge pain and respect one's symptoms, it might also be pleasing for you to know that correctly prescribed exercises can actually improve the health of the cartilage in your hip joint. Further to this, strengthening the muscles around the hip joint can help to reduce the stress on the cartilage and other joint structures. Most importantly, all of this in combination can decrease your pain levels and optimise your function.
It can be reassuring to have someone guide you on this journey and for this reason it is important to find someone who will take the time to listen to your concerns, because no two journeys are the same. Don’t let your pain stop you from doing the things you enjoy.
If you are experiencing hip pain, why not give us a call to arrange an assessment. If you have any specific questions in relation to the above I am more than happy to discuss them with you. You can reach me via email sinead@mcenteephysio.com or by calling us on 046 9062265
Sinead Coyle is a Chartered Physiotherapist @ McEntee Performance Physio, You can book an appointment online with Sinead via our website - https://mcenteephysio.com/online-booking-1
References
Bricca A et al. (2019) Impact of exercise on articular cartilage in people at risk of, or with established, knee osteoarthritis: a systematic review of randomised control trials. Br J Sports Med.
Arthritis Ireland. (2017). Living with Arthritis. Available: https://www.arthritisireland.ie/go/information/about_arthritis.
H.P. French, R. Galvin, N.F. Horgan, R.A. Kenny. (2015). Prevalence and burden of osteoarthritis amongst older people in Ireland: findings from The Irish LongituDinal Study on Ageing (TILDA). European Journal of Public Health . 26 (.), Pages 192–198.