The hip is a common source of musculoskeletal pain and dysfunction. It can be isolated or coexist with low back and pelvic pain. Pain from the hip can refer into the groin, knee, or pelvis. Pain from the back and pelvis can refer into similar areas and often be difficult to differentiate from hip pain. At KIMA, we specialize in treating this complex area and we will work with you and your physician to understand your pain and eliminate it.
To identify the underlying cause of your pain, your physician can order MRIs and X-rays to diagnose poor bony anatomy and labral tears or do injections to rule out intra-articular pathology. Your physical therapist can help to identify muscle imbalances as a cause of your pain.
Your physician and physical therapist will then work together to establish a treatment program.
Common Hip Conditions treated at KIMA include:
Labral Tears: The labrum is a ring of fibrocartilage that exists around the socket of the joint to increase its depth and improve its inherent stability. Labral Tears are typically the result of some underlying abnormality in the bone as a result of trauma or due to muscle imbalances. Our therapists use expert manual therapy and corrective exercises to reduce the strain on the labrum and eliminate pain.
Osteoarthritis is the breakdown and eventual loss of the articular cartilage of the hip. It coexists with loss of joint range of motion and weakness. To decrease the progression of the disease, our therapist use techniques to restore optimal joint capsule and muscle length while prescribing specific therapeutic exercises to improve joint stability.
Snapping Hip: There are two common types of snapping hip, external and internal. External snapping is a result of iliotibial band tightness. The band snaps over the greater trochanter of the femur. Internal snapping is a result of joint laxity and is a deeper click inside the joint. Both are secondary to muscle imbalances and are treated with soft tissue release techniques and corrective exercises.
Trochanteric Bursitis: The trochanteric bursa is located on the side of the hip over the greater trochanter of the femur. When this bursa becomes inflamed, it is called bursitis. It is commonly a result of a tight ITB, which rubs over the bursa. The ITB commonly becomes tight in the presence of lateral muscle weakness. Strengthening of the abductors of the hip is a very successful way of treating the underlying cause of the bursitis. Modalities such as ultrasound, ice and iontophoreses can be used reduce inflammation and pain.
Tendonopathies: A tendon is the way a muscle attaches itself to the bone. Tendonopathies are small tears in the tendinous attachment. In the hip, they are most commonly seen in the gluteus medius and minimus muscles. Pain is experienced over the lateral aspect of the hip and can cause weakness and gait disturbances. Physical therapy treatment addresses the specific underlying muscle weaknesses to reduce the strain on the tendon.
Athletic Pubalgia: also know as a sports hernia or Gilmores groin is a condition of groin affecting mostly athletes. It is characterized by chronic groin pain with particular movements such as hip extension, twisting and turning. The pain often radiates into the adductor muscles and even the testicles, although it is difficult for the patient to pin point the location. The exact lesion may differ, but common pathology includes torn external or internal oblique aponeurosis, tear in conjoint tendon, tear in transversus fascia, and entrapment of the ilioinguinal nerve or genitofemoral nerve. At KIMA we treat Athletic Pubalgia both post operatively and conservatively. Treatment of Athletic Pubalgia is about the correction of muscle imbalances. Our therapists will work with you to identify what specific muscle imbalance in causing your symptoms and prescribe targeted exercises and soft tissue release to eliminate it.
KIMA Physical Therapy Examination: We begin by listening to you and your problem. We then perform a thorough examination to test for hip, spine, and pelvis pain sensitive structures, joint range of motion and mobility, muscle length and strength. We analyze your biomechanics and look for specific movement patterns that may be causing strain on the painful structures, like the labrum. We help you to understand your problem and set up a treatment plan on your first visit.
KIMA Physical Therapy Treatment: A treatment session involves 45 min one-on-one with your therapist who uses manual therapy and soft tissue release techniques to restore optimal range of motion and biomechanics and reduce pain. Since there are more than 30 muscles that surround the hip joint, a lot can go wrong! Research has shown atrophy in the deep hip stabilizers and that restoring motor control and strength to these muscles is a priority. You will be given exercises to center the femur in the socket to reduce pain and allow the tissues to heal. To assist you in activating the key deep hip muscles, we often use Real Time Ultrasound Imaging as a biofeedback tool. These exercises will be performed both under our supervision and as an individualized home program.