Common Hip Injuries
Hip injuries are extremely common in people of all ages. Children, teens and young adults who participate in sports run a great risk of hip injuries. Senior citizens are also prone to hip injuries due to falls because bone density decreases with age as does joint elasticity. People who carry too much weight are susceptible to hip injuries, too, due to the excessive pressure on the hip.
Even when the injury occurs in the hip, the pain and subsequent compromised mobility may occur in other areas of the body, such as the leg, sciatica, groin or spine. When the symptoms don’t manifest in the injured area, it can be difficult for doctors to diagnose the problem correctly. For instance, a groin injury is more likely to indicate a hernia than a hip injury. Sciatic pain usually is attributed to nerve issues, not hip injury. Gluteus medius tears, a rip in the muscle controlling movement away from the body, may cause persistent pain, which can mimic trochanteric bursitis.
Many of these conditions may be treated through arthroscopic surgery or other minimally invasive procedures. The specialists at Vanguard Chicago Center for Orthopedics administer thorough tests and examinations to properly identify and diagnose the source of the pain and follow up with the appropriate plan of action.
Athletic Injury Overview
The labrum is the seal that “glues” the ball and socket—the femoral head to the acetabulum. When the labrum tears, the ball and socket may dislodge, causing instability and loss of lubrication. Symptoms of a labral tear include sharp pain in the groin, thigh or leg, stiffness, “popping,” and decrease in range of motion.
One of the most common causes of labral tears is known as Femoroacetabular Impingement (FAI). There are two types of FAIs: Pincer impingement and Cam Impingement. Pincer impingement involves an excess of rim tissue of the acetabulum. When the hip moves, the leg bone rubs against the pincer lesion. If not addressed quickly, pincer impingement may crush the labrum where it serves as a cushioning agent between the femoral neck and the acetabulum. Cam Impingement is a lesion or bump that forms right on the femoral head. When in motion, the lesion bumps against the labrum and the cartilage of the acetabulum.
A loose body is a small piece of dislodged cartilage or bone that floats within the joint. While moving, the hip joint may “hit” the loose body, causing sharp pain. People diagnosed with a rare disorder called Synovial Chondromatosis are at extreme risk, as the syndrome produces multiple loose bodies within the joint.
Iliopsoas Impingement and Snapping Hip
The iliopsoas (hip flexor) muscle runs along the front of the hip, connecting the spine to the femur. If special care isn’t taken to properly stretch the iliopsoas before rigorous activity, its muscles and tendons may tighten, causing iliopsoas impingement. Many times this is associated with a “snapping hip,” where the iliopsoas tendon snaps over the labrum. This in turn causes rubbing against the labrum, which may lead to a tear.
Avacular Necrosis (AVN) is a condition resulting from a lack of blood supply to the femoral head, causing part of its bone to die. AVN may occur from dislocation, excessive use of cortisone, or excessive alcohol use over a long period of time. If untreated, AVN may eventually result in collapse of the bone.
A bursa is a closed, fluid-filled sac that exists to reduce friction between tissues of the body. Bursae are located near major joints such as shoulders, elbows, hips and knees. Bursitis occurs when bursae become inflamed. Two major types of bursitis exist in the hip: trochanteric bursitis and the iliopsoas bursitis.
Trochanteric bursitis causes pain on the outer portion of the hip while iliopsoas bursitis typically causes pain in the front of the hip near the groin.
Treatment options include cortisone injections, PRP injections, physical therapy or stretching. If bursitis does not resolve with these measures, arthroscopic surgery may be used to remove the painful bursa.
Gluteus Medius Tears
The gluteus medius is a muscle on the outside of the hip that controls abduction (lateral movement away from the body, like leg extensions, kicks, etc.) If undetected and/or untreated, gluteus medius tears may cause severe persistent pain.
Hip instability may be the result of a traumatic incident or chronic overuse:
- Traumatic instability ranges from severe dislocation to a subtle hip subluxation (sliding out of place) and most often occurs from motor vehicle accidents and athletic events. These injuries may cause damage to any or all components of the hip joint, as well as contribute to the formation of loose bodies.
- Chronic instability may arise from overuse of the hip joint. This syndrome occurs mainly as a result of repetitive activities found in most sports, dance and ice skating. This stretches the labrum, which physicians treat with anti-inflammatory medication and physical therapy. However, if pain is persistent, arthroscopic measures may be considered.
Any kind of athletic activity, from competitive sports such as football to individual pursuits such as running, involves substantial impact on the hip joint. Even low impact activities, i.e. walking or riding a bike, can potentially result in too much pressure on the hip. Injuries can happen in a single episode, like a clean break or dislocation, or through wear and tear over time.
Hip Ailments of the Elderly
Surgeons perform between 200,000 and 300,000 hip replacement operations each year in the United States; most of the patients are over age 60. Because we use our hips for stability, balance and mobility, hip ailments may result in serious problems including chronic pain, decreased movement and disability—serious concerns among the elderly.
Older people suffering from osteoporosis, a condition that leads to the thinning of bone tissue and loss of bone density over time, are especially prone to hip fractures. A slip on the ice that at one time might have resulted in nothing more than a bruise in a young adult may result in a severe fracture in the hip. Fight osteoporosis with exercise and stretching, which will keep the hip joint healthy and lubricated.
Osteoarthritis, the most common type of hip arthritis is the general wear-and-tear of the cartilage in the hip joint. When the cartilage is worn away, bones rub against bones, resulting in severe pain. While arthritis can strike at any age, people over the age of 60 are more likely to suffer from this chronic condition.
Hip Dysplasia is an abnormal growth of the hip. While usually diagnosed in babies, it’s not uncommon for people afflicted with hip dysplasia to experience any symptoms until adulthood or their senior years. Both genetic and environmental factors play a part in its onset and severity.