This page contains information about some of the most common hip injuries, including labral tears, tendinopathies, arthritis and cartilage damage.
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This is a condition of the hip where the shape of the ball and socket are abnormal. This causes pinching in the hip joint when moved in certain directions. It is not clear whether this develops due to wear and tear, or whether you are genetically predisposed to it. It is likely to be a combination of the two. It is most common in a younger, active population, and can result in damage to the cartilage rim in the hip joint (acetabular labrum). Physiotherapy can help reduce your pain, and improve your range of movement and strength around your hip. If your pain is severe, or it doesn’t settle with physiotherapy you may be advised to see an orthopaedic surgeon. Arthroscopic surgery may be required in certain cases, and will be followed by a long rehabilitation process guided by your physiotherapist.
The labrum is a layer of cartilage that lines the rim of the socket in the hip joint. It provides stability and cushioning to the hip, and can be a source of pain. Tears can occur suddenly due to an accident, or more gradually over time with repeated stress (often in conjunction with femoroacetabular impingement). They can cause pain, and sometimes mechanical symptoms such as clicking, catching, or locking. If your physio suspects this problem you are usually sent to see an orthopaedic surgeon or sports physician, and may need an MRI scan with an injection of dye into your hip joint. A surgical repair of the torn cartilage may be required, followed by a lengthy rehabilitation process.
Articular cartilage damage
Articular cartilage is the shiny white cartilage that covers the ends of bones to allow smooth joint movement. Damage to this layer of cartilage may occur suddenly as in a tear from a sports injury, or may happen slowly due to wear and tear. If you damage the articular cartilage in an injury you will often be advised to see an orthopaedic surgeon. These injuries need to be carefully managed to try and avoid arthritis occurring later in life. Pain from wear and tear is more likely to be managed with a good exercise programme and activity modification.
There are several tendons around the hip that can cause pain, including the gluteal tendon, proximal hamstring tendon, adductor tendon, and illiopsoas tendon. Similar to other tendon dysfunctions, there may be tearing, inflammation, or degenerative changes contributing to your pain. Treatment will depend on levels of irritability, but is often initially aimed at reducing pain and may include soft tissue massage techniques, joint mobilisation or acupuncture. Following this a graduated strengthening programme is essential, along with analysis of muscle balance and biomechanics. Training loads may need to be altered for athletes, and rehabilitation tends to be a lengthy process. It is important to get treatment as soon as possible to avoid irreversible changes occurring in the tendon.
The hip is a ball and socket type joint, and arthritis is the wearing away of the thin layer of articular cartilage on the surface of the ball and/or socket. This causes pain, stiffness, and reduced mobility. Your ability to exercise becomes reduced, and your muscles weaken. The best treatment for you will depend on the severity of your condition, your level of function, and your age. If it is mild, physiotherapy has shown to be very beneficial in helping to regain mobility and strength. Treatment may involve joint mobilisation, gentle stretching, range of movement exercises, and strengthening. If your arthritis is severe you may need a hip replacement operation to regain function and reduce your pain. This however depends on a variety of factors (including age and medical history) that would best be discussed with your surgeon. Following surgery you will need to do exercises to regain the strength of your hip muscles.