Tag Archives: hip pain

Understanding Hip Bursitis: Physio 101

Hip bursitis is a common yet painful condition that affects many individuals. This condition often leads to discomfort, limited mobility, and decreased quality of life. Fortunately, physiotherapy can be an effective approach to alleviate pain, improve mobility, and enhance strength. In this blog, we will explore what hip bursitis is, its symptoms, and how physiotherapy can help in managing and treating this condition.

Understanding Hip Bursitis

Hip bursitis is the inflammation of one or more bursae in the hip joint. Bursae are small, fluid-filled sacs that cushion and reduce friction between bones, tendons, and muscles around joints. In the hip, two bursae commonly become inflamed: the trochanteric bursa on the outside of the hip and the iliopsoas bursa on the inside.
Inflamed bursa in hip bursitis

Diagram showing greater trochanteric bursitis

Causes of Hip Bursitis

  1. Repetitive Overuse:  Firstly, continuous activities that involve repetitive hip movements, such as running, cycling, or climbing stairs, can lead to bursitis.
  2. Trauma or Injury: Additionally, a fall or direct impact on the hip can cause inflammation of the bursae.
  3. Muscle Imbalances: Similarly, weak or tight hip muscles can disrupt the biomechanics of the hip joint, increasing the risk of bursitis.
  4. Certain Medical Conditions: Unfortunately, conditions like rheumatoid arthritis or gout can contribute to bursitis.
  5. Bone Spurs: Also, abnormal bone growth around the hip joint can irritate the bursae and trigger inflammation.

Symptoms of Hip Bursitis

The symptoms can be quite distressing and may include:
  • Pain on the outside of the hip, which can radiate down the thigh.
  • Pain that worsens with activities such as walking, climbing stairs, or standing for prolonged periods.
  • Swelling and tenderness over the affected bursa.
  • Reduced range of motion and stiffness in the hip joint.
  • Discomfort while lying on the affected hip.

How Physiotherapy Can Help:

Physiotherapy plays a crucial role in managing and treating hip bursitis. Here are some ways in which it can help:
  1. Pain Relief: Physiotherapists use hands-on techniques to reduce pain and inflammation in the hip joint. Additionally, they use modalities like heat, ice, laser therapy to alleviate pain and promote healing.
  2.  Exercise Prescription: Specific stretches can improve hip flexibility and reduce muscle tightness. Similarly, targeted exercises enhance the strength of the hip muscles, helping to stabilize the joint. Finally, exercises that improve balance can reduce the risk of falls and further injury.
  3. Gait Training: Physiotherapists can analyze your walking pattern and provide guidance to reduce stress on the affected hip.
  4. Education and Lifestyle Modification: Educating patients about proper body mechanics and ergonomics can prevent further aggravation of the condition. Also, recommendations for activity modification may be provided to reduce strain on the hip.
  5. Assistive Devices: Depending on your condition, a physiotherapist might recommend assistive devices such as crutches or braces to aid mobility.

What can I do about my hip pain?

Hip bursitis can be a painful and debilitating condition, but with the right approach, you can manage and alleviate its symptoms. Physiotherapy offers a holistic solution by addressing pain, mobility issues, and muscle imbalances. If you suspect you have this condition or are experiencing hip pain, consult a physiotherapist for a personalized treatment plan to help you regain your mobility and improve your quality of life. Remember, early intervention and a dedicated physiotherapy program can make a significant difference in your recovery journey.

Hip fracture

Anatomy of Hip
A hip fracture is a break in the upper quarter of the femur (thigh) bone. The extent of the break depends on the forces that are involved. The type of surgery used to treat a hip fracture is based on the bones and soft tissues affected or on the level of the fracture.
Older people are at a higher risk of hip fracture because bones tend to weaken with age (osteoporosis). Multiple medications, poor vision and balance problems also make older people more likely to trip and fall — one of the most common causes of hip fracture.

? Signs and symptoms of a hip fracture include:
• Inability to move immediately after a fall
• Severe pain in your hip or groin
• Inability to put weight on your leg on the side of your injured hip
• Stiffness, bruising and swelling in and around your hip area
• Shorter leg on the side of your injured hip
• Turning outward of your leg on the side of your injured hip

? Causes of Hip fracture
• falling on a hard surface or from a great height.
• blunt trauma to the hip, such as from a car crash.
• diseases such as osteoporosis, which is a condition that causes a loss of bone tissue.
• obesity, which leads to too much pressure on the hip bones.

? Types of Fractures
In general, there are three different types of hip fractures. The type of fracture depends on what area of the upper femur is involved.
Intracapsular Fracture
These fractures occur at the level of the neck and the head of the femur, and are generally within the capsule. The capsule is the soft-tissue envelope that contains the lubricating and nourishing fluid of the hip joint itself.

Intertrochanteric Fracture

This fracture occurs between the neck of the femur and a lower bony prominence called the lesser trochanter. The lesser trochanter is an attachment point for one of the major muscles of the hip. Intertrochanteric fractures generally cross in the area between the lesser trochanter and the greater trochanter. The greater trochanter is the bump you can feel under the skin on the outside of the hip. It acts as another muscle attachment point.

Subtrochanteric Fracture

This fracture occurs below the lesser trochanter, in a region that is between the lesser trochanter and an area approximately 2 1/2 inches below .

In more complicated cases, the amount of breakage of the bone can involve more than one of these zones. This is taken into consideration when surgical repair is considered.

Treatment for hip fracture: usually involves a combination of surgery, rehabilitation and medication.

? Surgery
The type of surgery you have generally depends on the location and severity of the fracture. Are the broken bones properly aligned? (displaced fracture. What is your age? What are your underlying health conditions?

The options include:

• Internal repair using screws. Metal screws are inserted into the bone to hold it together while the fracture heals. Sometimes screws are attached to a metal plate that runs down the upper thigh.

• Partial hip replacement. If the ends of the broken bone are not lined up or damaged, your surgeon may remove the head and neck of the femur and install a metal replacement (prosthesis).

• Total hip replacement. Your upper thigh and your hip socket are replaced with an artificial one (prostheses). Total hip replacement may be a good option if arthritis or a prior injury has damaged your joint. This may have been affecting your hip function even before the fracture.

? Rehabilitation

Rehabilitation is begun as soon as possible after hip fracture surgery, often within a day. The initial goals are to help people retain the level of strength they had before the fracture. You want to keep moving to prevent loss of muscle. You also want to prevent problems that result from bed rest. The ultimate goal is to restore your ability to walk properly without a limp.

Benefits of Rehab

Rehab will help you:

• Restore normal movement in your joint
• Build up strength in the joint and surrounding muscles
• Ease pain and swelling
• Let you get back to your normal activities including walking without a limp
• Help with circulation, particularly right after surgery, so you don’t have problems with blood clots

If you have or someone you know has fractured a hip or had hip replacement surgery, please call PhysioNow. Our experienced physiotherapists would be happy to help with your recovery! Call today to book an appointment!

Trochantric bursitis


Trochanteric bursitis

 

The Trochanteric Bursa is a fluid filled sac near the hip joint. It cushions between the bones and the muscle and acts as a shock absorber. Trochanteric bursitis is the inflammation of the bursa which is at the outside of the hip.

When this bursa is irritated it causes pain on the outside of the hip and thigh.  Sometimes you may feel the pain down to the knee on the same side.  Another symptom is pain which will stop you from lying on your painful side.  It will be painful when you press on a specific spot on the outside of the hip.  The pain gets worse when climbing stairs, getting up from a low chair getting out of a car.  Sitting with crossed legs hurts.  Both  walking and running may also cause increased pain.

Causes of Trochanteric Bursitis

  • Any direct Injury to the outside of the hip like falling, or bumping into an object.
  • Incorrect posture due to muscle imbalance
  • Leg length difference.
  • Stress of soft tissues surrounding the hip due to hip Osteoarthritis
  • Friction of the ITB (Ilio Tibial Band: a muscle along the side of the hip)
  • Overuse injuries like standing for long periods of time
  • Other diseases which affect the hip like Rheumatoid Arthritis
  • Previous surgeries around the hip
  • Very rarely infection of the bursa

Registered Physiotherapy Treatment

Your Registered Physiotherapist can help you to reduce the pain and inflammation.  They will use electrotherapy modalities, taping, or acupuncture.  They will give you  advice on activity limitations in the early stages.

Later the treatment is focussed towards increasing the flexibility and strength in the muscles.  Your Physiotherapist will  increase the hip joint range of movement and correct your hip joint mechanics.

Trochanteric bursitis

Trochanteric bursitisTrochanteric bursitis

Finally the focus is towards preventing it from happening again.

General Advice on prevention

Your Registered Physiotherapist will look at your posture, hip stability, and core strength.  They will look to see if you  need Orthotics to address any problems with your legs or feet.

 Tips for prevention of Trochanteric Bursitis:

  • Whenever you start a new activity, try to take it slow and build up your activity level gradually.
  • Start with  less force or resistance, less repetitions and progress gradually.
  • Avoid or modify repetitive activities if it is putting any stress on the hip joint
  • Your footwear should be comfortable
  • Maintain flexibility and strength in your lower extremity muscles
  • Improve your core muscle strength

If you or someone you know may have Trochanteric bursitis, call PhysioNow Today!  We would be happy to get you started on your treatment and back to enjoying all the things you love to do!