COMMON INJURIES

Hip

*If you are experiencing persistent pain, diminished function, loss of strength, range of motion, and/or sensation, BCPT recommends that you contact your physician, as a serious underlying physical condition may be present.

Bursitis

Bursitis is an inflammatory response to overuse. Often caused by a direct blow to the hip or irritation from the iliotibial band on the side of the leg, bursitis is accompanied by severe pain and localized tenderness along the side of the hip. Active range of motion, specifically lifting the leg out to the side, ambulation, and lying on the involved side exacerbate the symptoms. Treatment involves reducing the inflammatory response through the use of symptomatic modalities (heat, ultrasound, cold laser and ice), followed by progressive flexibility and strengthening exercises. Proper education to correct poor postural movements and faulty bio-mechanics to eliminate the cause of the irritation are also important.

Degenerative Joint Disease

DJD, or osteoarthritis, is the most common pathology affecting the hip. A progressive deterioration of the joint combined with an overgrowth of bone surrounding the joint, leads to reduced range of motion and pain, especially after long periods of weight bearing. There are two types of DJD, primary and secondary. The primary type develops spontaneously in middle age with no known cause. The secondary type occurs in response to a known injury, deformity, or disease. The degree of functional limitation corresponds with the amount of joint degeneration and related pain. Although DJD cannot be cured, it may be controlled with appropriate treatment. Goals of treatment are to relieve the symptoms (pain, inflammation and decreased range of motion) while managing its progression. Treatment involves symptomatic modalities, flexibility and strengthening exercises, ambulation assistive devices, and patient education.

Hip Replacement

Often, the pain and functional limitations associated with degenerative joint disease require surgical intervention for correction. In the hip, there are several types of surgery that can be performed; hip resurfacing, partial hip replacement and total hip replacement are examples. Rehabilitation is important and often begins prior to the surgery with a preoperative evaluation, education of precautions, exercises, and gait training with an appropriate assistive device (walker, crutches, or cane). After the surgery the exercises are progressed as indicated by the physician, healing rate, and patient tolerance.

References: Norkin, CC and Levangie, PK: Joint Structure and Function, A Comprehensive Analysis Magee, DJ: Orthopedic Physical Assessment Richardson, JK and Iglarsh ZA: Clinical Orthopaedic Physical Therapy