Hip Pain & Sports Injuries

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About hip pain & sports injuries

We treat a wide range of injures and conditions that cause hip pain and sports injuries, including:

Trochanteric Bursitis
IT Band Syndrome
Labral Tears
Contusions

Trochanteric Bursitis

Trochanteric Bursitis is inflammation of the bursa, which is a fluid-filled sac that cushions the greater trochanter part of the hip – the outside point of the hip close to the joint with the femur. It causes pain on the outside of the hip or in the buttock or thigh, which is worse when walking upstairs. The condition may develop as the result of:

  • Injury to the hip
  • Overuse injuries due to standing for long periods of time or climbing.
  • Poor posture which may be due to scoliosis
  • Bony spurs on the hip joint
  • Diseases such as rheumatoid arthritis, gout or thyroid disease
  • Soft tissue damage as a result of arthritis or differences in leg length.
  • Lying immobile on one side of the body for an extended period of time.

As the condition is caused by overuse, the best way to prevent trochanteric bursitis is to avoid repetitive activities that cause strain to the hips. Maintaining hip muscle strength and flexibility may also help, along with maintaining a healthy body weight to avoid putting strain on the hips.

If you experience pain while exercising, stop and working with a coach can help to develop good technique. If you have a condition such as legs of different lengths, wearing shoe inserts may help to correct your posture.

A number of diagnostic tests may be used including:

  • A physical examination to identify where the pain is located and any swelling
  • X-ray may be used to ascertain whether there is a stress fracture or osteoarthritis in the joint
  • An MRI scan may be used to detect damage to the soft tissues or bursa
  • In some cases septic hip bursitis may develop as the result of a puncture wound. If this is suspected the doctor may extract fluid from the bursa with a needle and send it to the lab for analysis

A number of possible treatments may be recommended for trochanteric bursitis including:

  • Resting the affected joint
  • A cold compress and/or anti-inflammatories to reduce swelling
  • Corticosteroid injections to relieve pain and reduce inflammation. An ultrasound may be used to guide the injection
  • Physical therapy to improve movement, strength and flexibility
  • Splints and hot and cold compresses
  • Surgery may be necessary to remove the damaged bursa if other approaches are ineffective. If bursitis has been caused by a problem with the iliotibial band, surgery may be used to lengthen the band and reduce friction

Hip Tendonitis

Hip tendonitis (also called iliopsoas tendonitis) is inflammation of the hip flexor tendon resulting in pain, tenderness and swelling. It is caused by overuse of the iliopsoas muscle, which is used to flex the hip. This muscle is attached to the upper thigh by a tendon which can become inflamed. The pain may come on gradually and is normally experienced in the front of the hip. If untreated, it can worsen, leading to loss of flexibility.

Hip tendonitis most affects athletes who participate in high impact sports such as running, swimming or cycling, as well as those who participate in high-intensity impact training and activities that involve squatting, jumping or kicking.

To prevent hip tendonitis it is important to maintain a strong core and hips. Do exercises to strengthen the iliopsoas muscle and make sure you develop good sporting technique to prevent the iliopsoas having to compensate for weaker muscles. Adjusting seat height so your hips are higher than your knees can also help.

A range of approaches may be used to diagnose the condition including:

  • A physical examination to check the location of pain.
  • X-ray to rule out fractures.
  • MRI scan to identify the type and extent of soft tissue injury

Among the treatments for hip tendonitis are:

  • Following the RICE method – rest, ice, compression, elevation
  • Anti-inflammatories and painkillers to relieve pain
  • Physical therapy to improve hip strength and flexibility
  • Surgery

IT Band Syndrome

Iliotibial (IT) band syndrome is injury or irritation of the iliotibial band, which is a band of tissue that runs from the hip, along the outer thigh and down the outside edge of the shin bone below the knee. It helps to stabilise the outside of the knee and can become irritated and inflamed when overused, for example during running. IT band syndrome causes a sharp burning pain or ache on the outside of the knee which can spread to the thigh or hips. It may be worse when going downstairs. Over time the pain increases and the outside of the knee may become swollen.

The condition often affects runners and other people involved in high impact sports such as footballers, rowers and cyclists.

To prevent IT band syndrome, avoid overtraining or increasing the intensity of training too quickly. The condition can occur when runners run on only one side of a road camber or track, causing the outside of the foot to be lower than the inside and tilting the pelvis. Be careful to alternate sides when running on a road with a camber, or running track. Wear proper running shoes and replace them every 400 miles. Exercises to increase the flexibility of hip, thigh and button muscles can also help to avoid IT band syndrome.

IT band syndrome is normally diagnosed by a physical examination during which the doctor may palpate the knee joint to locate the pain. You may also need an MRI scan to confirm the diagnosis.

Among the treatments for this condition are:

  • Using the RICE method – rest, ice, compression, elevation
  • Taking anti-inflammatories or painkillers to relieve pain and reduce swelling
  • Physical therapy to improve strength and flexibility in the hips. It can also help to correct biomechanical errors
  • Corticosteroid injections to relieve pain
  • Surgery to lengthen the IT band

Labral Tears

The labrum is a ring of cartilage that surrounds the hip socket, acting as a cushion and helping to hold the ball at the top of your thighbone in place. Labral tears can develop as a result of injury to the hip joint or dislocation. They can also develop from repetitive movements, particularly twisting or pivoting motions, or structural abnormalities that can accelerate wear and tear to the joint.

Labral tears occur most commonly in people who participate in high impact sports that put pressure on the hip joint, such as football, ice hockey, golf and ballet. They may have no symptoms or you might experience pain and loss of movement in your hip or groin. You may also experience a catching sensation in the hip joint.

Exercises to build strength and flexibility in the hips can help to prevent labral tears. Correct posture and technique can help to avoid putting too much pressure on the hips so it is important to receive professional sports coaching.

Among the tests used to diagnose a labral tear are:

  • Physical examination to check for pain and loss of movement in the hip.
  • X-ray may be used to rule out fractures and check for structural abnormalities.
  • MRI may be used, with contrast dye injected into the hip joint to show up a labral tear.
  • Anaesthetic injection may be used to pinpoint the precise location of the tear (inside or outside the joint).

Possible treatments for labral tear include:

  • Painkilling medication and/or anti-inflammatories.
  • An injection of corticosteroids into the joint to relieve pain.
  • Physical therapy to improve hip strength and stability.
  • Arthroscopic surgery – also called keyhole surgery, to repair or remove the damaged pieces of labrum.

Contusions

Hip contusion, or a bruised hip, is normally the result of colliding with an object or person, hip injury (including strains and fractures) or being kicked or hit with a ball during sport. Contusions are the result of damage to small blood vessels below the skin, causing blood to leak into the surrounding soft tissue producing a bruise. As well as skin discolouration you may experience swelling and tenderness at the bruise site.

If you injure your hip, applying ice can help to prevent tissue damage and limit swelling. Compressing the area with an elastic bandage may also help to reduce swelling and limit bruising.

The usual way to diagnose a hip contusion is through a physical examination. However, you may also be referred for an MRI scan to determine the extent of the bruise. You may also be given an X-ray to check that your hip is not fractured.

Hip contusions normally heal by themselves. You may be able to speed recovery by following the RICE method (rest, ice, compression, elevation). Anti-inflammatories and painkilling medication may help to relieve any pain and swelling.

Whatever your age, our expertise can help you feel healthy, active and pain-free again.