Is discomfort getting in the way of your exercise plan?

By: Devin Wurman, DPT
In physical therapy we see a lot of hip injuries. These injuries range from bursitis to fractures to replacements. Some injuries happen to healthy joints, while others occur in the elderly due to osteoporosis or because of congenital deformities. Either way, physical therapy can be beneficial and help strengthen the muscles around the injury, improve balance, and help patients return to normal function whether it is walking around without an device or return to sport.  
Bursitis:  Hip bursitis is a common problem that occurs when the fluid around the joint becomes irritated.  The most common complaint is pain on the outside of the upper thigh that may radiate down the side of the leg and gets worse with walking or running.  The person will complain of tenderness to the touch to that area and also have pain with lying on the involved side in bed. Physical therapy can work on decreasing the pain by incorporating the proper stretches followed by strengthening the muscles around the joint to ensure stability.  In addition, manual therapy will be provided to address knots in the muscles and improve joint mobility.
Labral tear:  Another very common problem is a hip labral tear.  The labrum is the lining of the socket of the hip joint and allows the leg bone (femur) to glide and move normally.  Labral tears can be a result of repetitive movements of the hip as well as in osteoarthritis when excess bone forms inside the joint and damages the labrum.  This is another condition that affects a wide range of ages. Younger people may injure the labrum from playing sports while older individuals will have tears as a result of a fall or arthritic changes in the joint.  Physical therapy is a great option for treatment as many labral tears do not require surgery. Specific exercises are given to the patient to strengthen the muscles around the joint in order to give support and therefore decrease pain.  The same would be the case if the patient required surgery in order to return to an active lifestyle. In addition to general strengthening and balance exercises, a return to sport program would be instituted to ensure prevention of re-injury.
Total hip arthroplasty:  The hip is the second most commonly replaced joint in the body next to the knee.  Hip replacements are performed when there is a significant amount of arthritis present in the joint and are preventing the patient from performing normal daily activities without pain.  This is a last resort after other conservative treatments are performed without success. We have been seeing more and more patients coming in that are in their 40’s getting hip replacements.  This is usually a result of congenital deformities. Many patients come to physical therapy before surgery because it allows the patient to come out of surgery stronger and progress faster. In addition, we are able to educate the patient on what to expect post surgery as far as pain, use of an assistive device, and any home modifications that may be needed.  
Our main goal is to help you manage your symptoms and get you back to doing your normal daily activities as well as hobbies and/or sports pain-free!  

CLICK HERE for more on how physical therapy can handle your hip problems.