Hips

Hip Osteoarthritis (Oa)

Hip osteoarthritis is an imbalance between cartilage breakdown and cartilage formation in the hip joint. This causes thinning of the cartilage, with loss of joint space and can cause small bony growths. There is not one single cause for hip OA but risk factors include increasing age, female gender, overweight, low levels of physical activity and genetic predisposition.   There is strong evidence that exercise provides benefits in terms of reduced knee pain, improved physical function and improved quality of life. 

  • Non-traumatic onset of symptoms. Could present without an obvious mechanism of injury
  • Pain and discomfort in the groin and upper thigh or outer thigh
  • Stiffness and pain in the mornings 
  • Pain and discomfort with staying in one position or from prolonged activities   

This can vary depending on each individual’s symptoms, clinical findings and the goals you want to achieve (can be from a few weeks to many months). An example of a treatment plan might look like:

  • Physiotherapy once or twice a week for two weeks depending on pain levels, followed by weekly or fortnightly reviews for 6-8 weeks
  • Moving to physiotherapy or exercise physiology every 3-4 weeks with weekly group classes 
  • Hydrotherapy under the supervision of a physiotherapist or exercise physiologist is helpful in managing hip arthritis
  • All of our physiotherapists 
  • All of our exercise physiologists 

Trochanteric Bursitis

Trochanteric bursitis is a condition that is characterised by irritation and inflammation of the trochanteric bursa. The bursa is a small fluid-filled sac which is located on the outer part of the hip. The burse lies between the hip muscles and hip bone to minimise friction and to protect the soft tissues.

  • Could be either gradual or sudden onset of symptoms
  • Pain and discomfort on the outer aspect the hip, which can radiate down the side of the thigh
  • Pain with daily activities such as walking, getting in and out of car or chair, walking up and down stairs, lying on the painful hip 

    This can vary depending on each individual’s symptoms and clinical findings (usually requires 6-12 weeks of treatments). This may look like:

    • Physiotherapy twice a week for 2 weeks followed by physiotherapy once a week for 6 sessions. 
    • Exercise physiology can compliment the therapeutic exercise program prescribed by your physiotherapist (i.e. by developing a long-term exercise program to maintain strength). 
    • Moving to monthly physio and exercise physiologists with weekly group classes
    • Hydrotherapy under the supervision of a physiotherapist or exercise physiologist is helpful in managing Trochanteric Bursitis.
    • All of our physiotherapists
    • All of our exercise physiologists

    Gluteus Medius Tendinopathy 

    Gluteus medius tendinopathy is very similar in presentation to trochanteric bursitis and the two conditions often present together. Tendinopathy is characterised by tendon overload, either in a single event or over a prolonged period in which the tendon is not given a chance to recover. The tendon of gluteus medius attaches to the greater trochanter (the bone which can be felt on the outside of the hip) so tendinopathy can cause pain on the outside of the hip. 

    • Usually gradual onset of pain on the outside of the hip
    • Pain may radiate into the outer aspect of the leg
    • Pain with activities involving activation of the hip muscles such as walking, getting out of a chair, walking up and down stairs or lying on the painful side
    • Very similar in presentation to trochanteric bursitis

    This can vary depending on each individual’s symptoms and clinical findings (usually requires 6-12 weeks of treatments). This may look like:

    • Physiotherapy once or twice per week for 2 weeks followed by physiotherapy once a week or fortnightly  for 3 sessions, depending on pain
    • Exercise physiology can compliment the therapeutic exercise program prescribed by your physiotherapist (i.e. by developing a long-term exercise program to maintain strength). 
    • Moving to monthly physio and exercise physiologists with weekly group classes
    • Hydrotherapy under the supervision of a physiotherapist or exercise physiologist is helpful in managing Gluteus Medius injuries.
    • All of our physiotherapists 
    • All of our exercise physiologists 

    Femoroacetabular Impingement (FAI)

    The hip joint is a ball and socket joint between the femur (thigh bone) and the acetabulum (the socket within the pelvis). When the hip is flexed (movement of knee towards the chest), there can be pinching of the soft tissue between the two bones or simply impaction of the bones themselves. 

    • Gradual or sudden onset
    • Usually associated with kicking sports or activities involving the extremes of hip range of motion – i.e. dancing
    • Pain in the front of the hip

        This can vary depending on each individual’s symptoms and clinical findings (usually requires 6-12 weeks treatments). This may look like:  

        • 8 weeks of treatments (Physiotherapy twice per week for 2 weeks followed by physiotherapy once a week for 6 sessions). 
        • Exercise physiology can compliment the therapeutic exercise program prescribed by your physiotherapist (i.e. by developing a long-term exercise program to maintain strength). 
        • Moving to monthly physio and Pilates classes for ongoing core and deep muscle control exercises
        • Hydrotherapy under the supervision of a physiotherapist or exercise physiologist is helpful in managing hip impingements
        • All of our physiotherapists
        • All of our exercise physiologists

        Labral Injuries 

        The labrum is a ring of cartilage in the hip joint that helps to absorb shock and stabilise the joint. Athletes such as dancers or soccer players, who participate in sports with repetitive movements of the hips are more likely to develop labral injuries. 

        • Could be either gradual or sudden onset of symptoms
        • Deep hip pain, often made worse by long periods of sitting
        • Stiffness or limited range of motion in the hip joint 
        • +/- clicking or catching

        This can vary depending on each individual’s symptoms and clinical findings (usually requires 6-12 weeks treatments). A plan may look like:

        • 8-10 sessions of treatment (Physiotherapy once or twice per week for 2 weeks followed by physiotherapy once a fortnight for 3 sessions). 
        • Exercise physiology can compliment the therapeutic exercise program prescribed by your physiotherapist (i.e. by developing a long-term exercise program to maintain strength). 
        • Moving to monthly physio and exercise physiologists with weekly group classes 
        • Hydrotherapy under the supervision of a physiotherapist or exercise physiologist is helpful in managing Labral injuries.
        • All of our physiotherapists 
        • All of our exercise physiologists 

        Sacroiliac Joint (Sij) Dysfunction

        The sacroiliac joints are located on either side of the spine, and are the joints between the sacrum and pelvic bones. SIJ dysfunction is an umbrella term used to describe pain in the sacroiliac joints. SI joint pain more commonly occurs in females, and during pregnancy.

        • pain in lower back/buttock
        • typically pain one-sided pain, common with activities such as climbing stairs, sitting down or lying on the painful side
        • Sharp, stabbing or shooting pain which may extend down the leg

          This can vary depending on each individual’s symptoms and clinical findings. This may look like: 

          • Physiotherapy once a week for 2 weeks, followed by fortnightly sessions for a further 3-4 sessions 
          • Exercise physiology can compliment the exercise program prescribed to you by your physiotherapist
          • Moving to monthly physiotherapy/exercise physiology as required 
          • All of our physiotherapists
          • All of our exercise physiologists