Conditions
Gluteal Tendinopathy
There are three gluteal muscles that make up the back of your hip. They insert into the head of your femur on the side of your hip, and this is often the location of pain. The glutes work to keep you upright when on one leg, so tendinopathy often causes pain with single leg activities, ascending stairs, or lying on the affected side. Tendinopathy refers to damage of the tendon, but usually there is still enough muscle to strengthen and create support. Exercises are crucial to restore function and allow recovery of the irritated area.
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Bursitis
Bursitis refers to inflammation of the bursa, which are a series of fluid-filled sacs throughout your body to take pressure off of the joints. Symptoms are similar to gluteal tendinopathy, as the trochanteric bursa is close to the glute tendons on the outside of the hip. Typically this condition is most painful with lying on the affected side and movement can be painful as well. Manual therapy including trigger point dry needling of the surrounding muscles can help relax the tissue along with strengthening to provide support and offload the structure. Short term decrease of activity may be necessary, but full activity should be resumed once tolerated.
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Labral Tear
The labrum is non-contractile tissue that enhances joint stability of the hip by creating more of a surface for the head of the femur. The labrum can be torn by certain twisting motions and it can be identified with rotation and pressure typically towards the groin. It can feel like a pinching sensation with deep hip flexion or rotation. Soft tissue mobilization of the surrounding structures can allow for increased movement and strengthening can decrease tension in the area. Non-operative success rates are high with labral tears, but exercise is crucial.​
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Femoroacetabular Impingement (FAI)
Hip impingement refers to the fact that motion is limited and possibly painful due to a structure being pinched. Typically, FAI is due to bony overgrowth in the form of a cam or pincer which refers to where the extra bone is located. Pain is usually worse with deep flexion of the hip such as when squatting. Surgery is sometimes necessary to shave the bone away, but sometimes the excess bone is a result of stress on the hip which is resolved through manual therapy and exercises. Learn more about FAI here.
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Arthritis
Arthritis refers to inflammation of the joint and the hip can be a possible location. Arthritis can be a normal part of aging and is usually accompanied by other pathologies if pain or disability are present. It is important to decrease joint stress by making sure that other joints and muscles are moving as they should along with strengthening surrounding areas. Wear and tear at one segment is typically due to other segments not taking their share of the load, and sometimes gaining mobility elsewhere is all that is needed to resolve symptoms.
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Dislocation/Subluxation
Dislocation involves the head of the femur coming apart from the joint and remaining out of place. Subluxation occurs when the femur goes out of place but spontaneously returns. Dislocations are serious medical issues and should be addressed by a health professional, as nerve damage is possible. Rehabilitation from these injuries involves strengthening the surrounding tissue to hold the hip in place while decreasing compensatory muscle guarding with techniques such as cupping or scraping.
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Groin Strain
The groin is made up of many muscles, but primarily the adductor muscle group on the inside of your thigh. These can be injured with rapid stretch such as doing a splits motion or contraction such as jumping or cutting. The pain can be located anywhere in the muscle, but typically it is localized to the tendon nearest the groin. Exercise is crucial to gradually strengthen the muscle after manual therapy including trigger point dry needling to decrease spasm. These muscles are often weak as they are rarely the focus of conventional strength training.
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Postoperative
Hip surgery is always intimidating. Rehabilitation after surgery can also be stressful, as you want to assure that the surgery went well. We have worked with hundreds of clients after hip surgery so we are familiar with how the experience should progress. We are available to answer any questions, even when you do not have an appointment scheduled. We are also intimately familiar with healing timelines and can give you ideas of what your return to activity should look like. Read more about postoperative physical therapy in our blog.
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Snapping Hip Syndrome
Snapping hip syndrome can be related to different pathologies, primarily restrictions to the iliotibial (IT) band or the iliopsoas muscle in your hip flexors. Many people feel a snapping at the front of their hip or the outside of their knee, but sometimes the tissue can become irritated and painful. Relative rest may be required along with a movement assessment to ascertain if a lack of mobility or strength is leading to the issue. Treatment should be individualized based on your presentation. Read more about Snapping Hip Syndrome in our blog here.