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Trouble lying on one side because of discomfort?


By Cierra Washington, ATC

Bursitis. Tendonitis. Muscle Strains. Labral Tears. Hip impingement. Osteoarthritis. These are all common hip issues that can be seen throughout all ages and activity levels. The hip is a ball-and-socket joint that allows for multi directional movement, as well as rotation. The hip joint, also known as the acetabulum, gets its structure from the head of the femur (the ball) and the articulation of the pelvis (the socket). Due to the hip’s ability to move freely throughout all directions, its surrounding structures must provide optimal strength. The strongest ligament in the body, the iliofemoral ligament, is actually located in the hip and functionally attaches the leg to the main skeleton.

Most people complain of difficulty with lying on the affected side, walking, going up and/or down the stairs, with all levels of impact, or even something as simple as lifting their leg up. When we are younger, most of our hip issues tend to originate from repetitive stress or muscle imbalances. As we age, the causes of injury become more surrounded by our level of inactivity, inefficient preparation before physical activity and “freak” sudden accidents such as car crashes. With repetitive stress, the joint begins to wear and tear causing a loss of cushioning. For instance, bursitis and tendonitis are both caused by repetitive stress to the bursa or muscle tendon, which causes inflammation. Trochanteric bursitis is one of the most common types of bursitis due to it’s location and daily use. What exactly is a bursa? A bursa is a fluid-filled sac that decreases friction between a bone and/or muscles and tendons. For tendonitis, let’s take a look in the front of the hip where the hip flexor is located. The hip flexor’s main function is hip flexion, or bringing the knee up towards the chest. Imagine having a soccer player that practices kicking 100 goals a day. That’s about 400-500 repetitive movements per week. With every forceful kick, there is friction created when the hip flexor rubs against its surrounding tissues. Over time, this leads to over-stretching, micro tears and possible full tears.

Next up, we’ll take a look at hip impingement and labral tears. Both conditions involve the cartilage, the smooth surface inside of the joint that allows for smooth movement. When you are dealing with hip impingement, one of the two bones, or even both, are irregularly shaped causing uneven wear in the joint. If the condition is not found and rehabilitation does not begin to stop the process it will progress to a labral tear. Labral tears occur when the cartilage is completely torn and causes clicking or grinding in the joint. Both conditions are very painful and can impact daily activities.

Many people tend to have a wait and see attitude about their discomfort, which makes sense given our busy schedules. It’s hard to always find time to address pain or injuries right away, especially if they aren’t debilitating.  However, ignoring the initial symptoms of hip pain can quickly mean those symptoms make it impossible for the person to perform activities of daily living or activities that they enjoy. As the symptoms go on without attention, it’s likely the condition will worsen, leading to a longer rehabilitation session or even surgical repair.

Here at Loudoun Sports Therapy Center, we take the time to assess all aspects of the location of pain, including the joints above and below the pain, as well as the surrounding musculature. For instance, when the hip joint is injured, the surrounding musculature becomes tight in order to “protect” the injury, which can lead to imbalances on the unaffected side. Therefore, our physical therapist will take an in-depth look at the affected side, the unaffected side, the knee on the affected side and the lumbar musculature for compensatory involvement. Once the issue has been determined, our team here at LSTC takes the time to loosen the tightened structures, realign the pelvis to create a solid foundation and then proceed to build the hips on all sides as well as the core for functional stability.

Don’t let hip pain or a hip problem impact your life any longer. Call our office at 703-450-4300 TODAY. CLICK HERE for more on how physical therapy can help you.

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