Hip Sprain / Strain
Sprains refer to injuries of the ligaments (connect bone to bone) and strains refer to injuries of the muscles or tendons (connect muscle to bone). Sprains and strains occur from quick over-stretching of the tissues sometimes under contraction, causing micro-tearing and subsequent injury. Swelling begins as part of the inflammation process, causing pain and difficulty with movement.
What is Trochanteric Bursitis?
The ending of the word “itis” is defined as inflammation. Therefore, bursitis is inflammation of a bursa and tendonitis is inflammation of a tendon. A bursa is a fluid filled sac that sits between muscles or tissues to cushion and reduce friction. In the hip there is a rather large bursa on the outside between the bony area (tronchanter) and the thick band of tissue stretching from your hip to your knee (iliotibial band). This is called the tronchanteric bursa.
This bursa can often become inflamed due to abnormal joint movements and weakness of the surrounding musculature. This causes strain to the tissues and excessive friction on the bursa. People with bursitis tend to feel pain with prolonged walking or standing. It is often very tender to touch on the outer hip and thigh.
What is Piriformis Syndrome?
The piriformis muscle is deep in the buttocks and helps with rotating the hip. The sciatic nerve typically dives underneath the piriformis muscle as it makes it way down to the leg. With excessive sitting, loss of movement in the hips, or trauma, the piriformis muscle can press down onto the sciatic nerve. Typically, mild symptoms cause aching into the back, deep into the buttock, and often radiating pain to the outer thigh. With more severe cases, tingling, numbness or severe pain can radiate down the thigh.
It takes us at least 12 months as a baby to learn the fundamentals of walking. It takes even longer to learn how to walk properly and eventually run. Walking is very complex and requires good balance, the ability to know where your joints are in space (proprioception), the ability to know how your joints are moving (kinesthesia), good range of motion and strength.
When walking patterns change due to age, injury, or disease, abnormal stresses from everyday activities can be transmitted to areas it shouldn’t. This can result in pain and discomfort in the hip and other areas of the body. The good news is that if you have difficulty walking, you can be helped. Physiotherapists are the experts uniquely trained to do so.
About Osteoarthritis of the hip
Osteoarthritis of the hip can be painful as the hip is needed to move with sit to stand, walking, squatting and bending. As the cartilage wears over time, due to aging, genetics, or past injury, the joint becomes stiffer and the muscles of the buttocks generally weaken over time. In advanced stages, bony spurs can form around the joint and even change the shape of the joint. This can result in a very painful situation.
Most minor to moderate cases of hip osteoarthritis can highly benefit from physical therapy. In advanced stages a total or partial hip replacement may be needed to repair the damaged joint. Physiotherapy in the hospital and outpatient facilities is highly important in the recovery from a hip replacement surgery.
About Total Hip Replacement / Partial Hip Replacement
When the hip has suffered a significant trauma such as a fracture or with long-term arthritis that is affecting your ability to move and walk, a total hip replacement surgery may be needed. In a total hip replacement surgery, the socket of the hip joint and head of the femur are replaced. With a partial hip replacement, either the head of the femur is replaced or the socket of the hip. There have been many advances in the technology of the total hip replacement prosthesis and procedures allowing for less invasive surgery and faster recovery times.
Typically people have suffered for a while before having surgery, leading to changes in walking, muscle strength, and function. Physiotherapy before surgery in general has shown to help the speed and quality of recovery after surgery.
About Post-surgery Rehab
Other types of surgeries for the hip are fracture repairs using pinning or repair from trauma. The amount of force it takes to break bone means that the soft tissues around the hip are most likely significantly injured also. After surgery, due to limited movement, range of motion and strength are lost rather quickly. Since walking is a very complex action of different muscles moving in a coordinated action, it can be difficult to walk after a hip surgery.