Hip Pain: How Physical Therapy Can Help
Hip pain is often overlooked and untreated until it becomes severe. However, it’s important to have hip pain evaluated by your physical therapist early on to determine the cause of the pain. Hip pain is commonly due to repetitive strain on and overuse of the hip from a sport or work activity. A physical therapist can effectively treat and reduce hip pain, improve flexibility and mobility, and return the patient to daily activities with greater hip strength and ability.
Anatomy of the Hip Joint
The hip joint is where the thigh bone (femur) meets the pelvis, forming a ball and socket joint. Ligaments connect the ball of the femur to the socket, which stabilizes the hip and forms the joint capsule. The joint is lubricated by synovium fluid and bursae (fluid-filled sacs that cushion between the muscles, tendons, and bones).
The hip joint is surrounded by muscles that support the hip and enable movement: gluteal muscles (muscles of the buttocks located on the back of the hip), abductor muscles (inner thigh muscles that pull the leg inward), hip flexors (begin in lower back and connect to the upper femur), quadriceps (four muscles on front of thigh that run from hip to knee), and hamstrings (back of the thigh muscles that run from hip to just below knee).
Causes of Hip Pain
The hip is a major weight-bearing joint that is responsible for the ability to walk, run, rise from a sitting position, and climb stairs. Hip pain is often due to repetitive strain on and overuse of the hip from a sport or work activity. Hip pain can be felt in the groin area, the front of the hip, and the side of the hip; pain may be due muscle strain, arthritis, or inflammation of the hip bursa.
Hip osteoarthritis (OA) is a common condition that causes hip pain. Osteoarthritis occurs when injury or inflammation in the joint causes the cartilage that lines and cushions the joints’ surfaces to break down. Once the cartilage is damaged, the hip joint can become extremely painful, inflamed, and swollen, resulting in muscle weakness, stiffness, and pain.
Symptoms of hip osteoarthritis include:
Sharp, shooting pain or dull ache of pain in the hip, groin, thigh, knee, or buttocks
Stiffness in hip joint, particularly after sleeping or sitting
Weakness in lower extremity muscles
Crunching sound when hip joint moved (bone rubbing on bone)
Difficulty and pain when getting out of bed, standing up from sitting, walking, or climbing stairs
Physical Therapy Treatment for Hip Pain
Physical therapy is an effective, non-surgical treatment for hip pain that decreases pain, increases mobility, and improves flexibility and strength of the hip joint. A physical therapist analyzes hip, low back, and leg function to assess the origin of the hip pain. The physical therapist evaluates a patient’s gait, balance, range of motion, and strength to assess if the pain is due to injury or a muscle imbalance. The therapist also palpates the hip to evaluate the structure of the hip and determine the source of pain and swelling.
Physical therapy for hip pain includes manual therapy, an exercise conditioning program, stretching and strengthening exercises, and balance and gait training. A therapist uses various modalities to address pain in the hip: ice to reduce swelling and pain; heat to relax the muscles and stimulate blood flow to accelerate healing; an ultrasound to deeply heat, penetrate, and relax deeper soft tissues; and TENS unit to relax tight muscles and improve blood flow to the joint.
Manual Therapy: used to decrease pain and improve mobility.
Exercise Conditioning Program: improves control and function of the muscles that stabilize the hip. Once the muscles strengthen, the physical therapist works with the patient to perform specific functional movements. Physical therapists also use exercise to improve core strength and stability.
Stretching Exercises: used to stretch muscles to restore range of motion, address joint stiffness, and reduce muscle soreness by keeping the muscles flexible. With the prevalence of desk jobs, it’s common to have tight hip flexors that are tight or shortened. Runners and cycling athletes can have tightness in the muscles and structures on the outside of the hip due to the repetitive motion of their sport. Stretching aids in relieving pain and improving function of the muscles affected.
If the hip condition becomes severe, hip surgery may be required. A physical therapist plays a critical role in preparing a patient for surgery as well as post-surgery rehabilitation to ensure a safe recovery and restored function of the repaired hip. Pre-surgery rehabilitation helps to strengthen the hip through a gentle exercise program. Studies show those who do “pre-habilitation” prior to surgery have faster recovery times and less intensive therapy after surgery. Post-surgery rehabilitation helps the patient regain mobility, strength, and balance, walk by themselves, and return to daily activities safely and more quickly.
Are you experiencing persistent hip pain? Call your physical therapist today to address hip pain early on and regain hip function and movement!
