Hip PAIN, HIP Joint Injuries, and Physiotherapy

The Hip joint is a ball and socket joint like the shoulder joint. The articulation of this joint is between the pelvic acetabulum and the head of the femur and is held by very strong ligaments.  The acetabulum is a hollow-like hole on the infero-lateral aspect of the pelvis; this is where the head of the femur fits into.  This joint connection is covered by cartilage which allows for weight bearing.  

Ligaments of Hip Joint Injury

     There is one intracapsular ligament which runs from the acetabular fossa to the fovea of the femur. The extracapsular ligaments include the Iliofemoral ligament which start at the Anterior Inferior Iliac Spine and splits into two and inserts into the intertrochanteric line of the femur.  This prevents hyperextension of the hip and is one of the strongest ligaments in the entire body. 

Another ligament is the Pubofemoral ligament which originates at the superior pubic rami and connects to the intertrochanteric line of the femur; it reinforces the joint anteriorly and inferiorly.  It prevents hip abduction and extension in the event that it becomes excessive. 

The last of the extracapsular ligaments is the Ischiofemoral ligament which spans at the ischium and connects to the greater trochanter of the femur and reinforces the hip joint posteriorly.  This joint prevents hyperextension and assists in holding the head of the femur in the acetabulum.  

Functions of the Hip Joint 

   The main function of the hip joint is to bear weight and there are numerous factors that stabilize this joint.  The first stabilizer is the acetabulum. It is a deep capsule that encapsulates the head of the femur, since it has that function the probability of dislocating the femur is very low.  Around the acetabulum is known as the acetabular labrum or lip that increases the depth of the acetabulum increasing stability of the hip.  The extracapsular ligaments noted above all stabilize and thicken the joint articulation making it the strongest joint in the body.  

Movements and Muscles of the Hip Joint 

Hip Injuries

    Hip Dislocation:

More common to dislocate in the posterior direction when the femur gets pushed backwards out of its socket.  The lower leg is in a fixed position with the knee and foot internally rotated.  When the hip is dislocated all tissues, muscles, and nerves as well as the acetabular labrum around the joints become damaged or injured.  

      Causes:

Causes of a hip dislocation stems from a motor vehicle accident when the knee hits the dashboard, and the head of the femur drives out of the hip socket.  A fall from a significantly high height can also dislocate the hip.  Another cause can be possible fractures in the pelvis, legs, knee, or back.  

     Treatment:

Treatment includes reduction, a reduction is when a doctor manually manipulates the bone back in its joint.  The doctor will provide the patient with a sedative to reduce the amount of felt pain.  After the reduction the surgeon will ask for x rays to make sure the bones are in the proper place.  

     Complications:

Nerve injuries are possible because it can stretch nerves, more particularly the sciatic nerve.  An injury to the sciatic nerve causes a sharp, shooting pain that radiates all the way down the leg and affects the knee, ankle, and foot. Osteonecrosis happens when the femur is pushed out and damages blood vessels.  When there is no blood supply to a tissue or a bone it can die resulting in avascular necrosis.  It can lead to the degeneration of the hip and arthritis can set in.  

     Recovery:

Can take up to 2-3 months rehabilitation. Recovery can take slightly longer when there are damaged muscles and fractured bones.  Limiting hip motion is important because the risk of a second fracture is high if you are too mobile.  

   Hip Pointer:

This is a deep bruise to the upper bone on the outside or your hip called the iliac crest. It is caused by a direct blow or a fall.  It is common in those who play contact sports like football and hockey.  

     Symptoms:

Swelling, bruising, severe pain or tender to touch, limited ROM and feeling of weakness in the muscles.  

     Diagnosis:

Though can be seen on the hip, to make sure there is no other serious injury, doctors will perform an x-ray, MRI, or ultrasound.  

     Treatment:

Rest, Ice, Compression helps and if continuing to play sports a protective pad over the injured area is ideal. Some serious cases require the use of crutches.  Rehabilitation consists of strengthening the muscles and joint through a series of exercises and stretches around the hip.  

   Piriformis Syndrome:

Prolonged sitting or overuse, a sudden increase in physical activity, direct buttock trauma that can cause a hemorrhage or a spasm and can lead to increased pressure on the sciatic nerve.  This muscle is deep to and in between gluteus medius and gluteus maximus. 

     Signs and Symptoms:

Numbness and tingling in the buttocks and the thigh posteriorly, tender upon palpation, if actively resisting external rotation feel pain and if completing passive internal rotation feelings of tingling appear.  

     Treatment:

Decrease muscle spasm, stretch the piriformis to relieve stress and correct pelvic mechanisms.  

How to strengthen the Hip Joint? 

Stretches 

1. Scissors (Lying on back with knees bent and feet off the floor straighten one leg and hold then bring it back then repeat on other leg for a total of 8-12 times) 
2. Hip Flexor Kneeling Stretch (Kneel and move body forward) 
3. Figure 4 Stretch for Piriformis 
4. Hip Flexor Stretch (Lying on back bring a knee to the chest and hold repeat with other leg) 
5. Butterfly Stretch 
6. Pigeon Stretch

Exercises 

1. Clamshell Exercises (Use any type of resistance band)
2. Monster Walks (Any type of resistance band) 
3. Single Leg Romanian Deadlifts 
4. Lateral Step Up with Knee raise (Can hold a weight in front of body) 
5. Fire Hydrants (Use of any resistance bands) 

Immediate Help through Physiotherapy for Hip Injury:

Have you been experiencing aching pain in the right hip, left hip, lower back or hip bone? Or is it more like hip AND lower back pain, or hip and lower back pain on one side? Have you been having any back and hip spasms? Is the back of hip pain overwhelming?

Or are you looking for the best hip stretches or exercises for hip pain? Or simply exercises to loosen hips?

At Curezone Physiotherapy, our expert therapists aim to improve hip strength and flexibility through targeted hip joint stretches, customized hip pain exercises and lower back stretches to relieve hip pain. If you are looking for the best physio NEAR ME to learn the exercises to eliminate hip pain, look no further! We aim to be YOUR best physiotherapist in Mississauga and Oakville areas, and are here and ready to teach you the best exercises for hip pain.

We welcome you to call us or click below to book an appointment with one of our expert physiotherapists to let us immediately start assisting you in your road to recovery.

Mississauga:

Physiotherapy Clinic Mississauga – Curezone Physiotherapy, Heartland Mississauga.

Physiotherapy Clinic Erin Mills – Curezone Physiotherapy, Erin Mills Mississauga.

Oakville:

Physiotherapy Clinic Oakville – Curezone Physiotherapy, Burloak Oakville.