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July 2018

Hip pain – it’s not just for “old” people anymore!

By | Pain Relief, Physical Therapy | No Comments

Let’s admit it – we expect pain as we age!

When we are young, our bodies seem to be able to get away with anything. We can run, jump, play, fall off our bikes, jump on a trampoline, and basically run ourselves ragged without any further complications. We go to bed and wake up feeling fine the next morning – and we run out to do it again! This is the joy of youth.

However, what happens when our young ones start complaining of a pain that will not go away? We take them to the doctor to start figuring out what is wrong and how we can help them.

In the case of hip pain, long term pain that does not go away with rest can often lead to a consultation with an orthopedic surgeon. The surgeon will often have X-rays or an MRI taken to assess how the bones inside the hip look. In the past 10 years, this has led to a new diagnoses or CAM or PINCER hip morphology. This means that there is a bony abnormality that is causing the hip to “pinch”, which is what brings about the pain in younger people as they tend to be more active. Of course, if the problem is a bone issue, surgery is what is recommended to fix it.

This increase in hip surgery in our younger population has become extremely concerning to myself and many other Physical Therapists. That is why there are now studies assessing hip strength, hip motion, and how the hip moves while also looking at the bony structure of both hip joints.

A recent study in the Journal of Orthopaedic and Sports Physical Therapy (JOSPT) was looking at that specific issue. The study assessed sub-elite football (soccer) players for pain, motion, strength, and motion analysis. They also took an X-ray to see what each hip actually looked like.

What they found was that the hip structure looked the same on X-ray between the painful hip and the pain free hip. Both of the hips had the same structure but only one hip had pain! Both the hips had the same bony changes that would be classified as needing surgery. However, sub-elite athletes were able to continue their sport and only have pain in one hip. Where they did see a difference between hips was in how the person was walking and the muscles they used while jumping.

This study shows that your hip pain may not be caused by how your bones look on X-ray. The pain may be caused by how your muscles are functioning while you walk, work, and play. Therefore, I strongly urge you to consider visiting a Physical Therapist to see if changing how you move through space can change your hip pain. It may help you to avoid surgery and the painful recovery that follows. Plus, you may be able to get back to your sport, your work, or your life more quickly!

Sub-elite Football Players with Hip-Related Groin Pain and Positive Flexion, Adduction, and Internal Rotation Test Exhibit Distinct Biomechanical Differences Compared with Asymptomatic Side. JOSPT: 48(7):584-593.