Why Are So Many Younger People Experiencing Hip Pain?
Recently, I have had quite a few patients complaining of hip pain. Most of these patients have been young and quite active. This is not the typical population to suffer from Hip OA (Osteoarthritis).
Most of the time these patients are younger (under 45), quite active (play sport at least 4-6 times a week), and have day jobs as well.
Once we assess the patient, and rule out the usual chiropractic suspects (pelvic rotation or misalignment, the low back, or a shorter lower limb), our examination points us towards the hip itself.
What can go wrong?
The most common hip complaint is:
1) Osteoarthritis (OA). This is a “wear-and tear” type issue with the hip joint, which is a ball and socket joint. In this case the cartilage wears away (genetics, previous trauma…) which can cause the bone surfaces to rub together. This friction frays and roughens the cartilage, increasing the stress on the joint.
2) Next on the list is femoracetabular impingement.
This condition is believed to be the most common precursor of hip OA. It occurs because the shape of the ball (head of the femur) can predispose the hip to damaging the soft tissues in the hip joint through vigorous hip motion (leading to repetitive damaging collisions in the joint).
In this case, most patients are younger, and are active participants in sporting activities.
How does this happen?
Sports activities and general activities of daily living lead to repeated trauma to the bones of the hip and pelvis, which can irritate the labrum (soft tissue inside the hip improving stability of the hip joint).
10-15% of people are estimated to have this condition.
Patients present with groin pain during and after sports that can refer to the knee. Pain can also occur when sitting too long, and patients sometimes experience locking/catching accompanied by sharp pain in the hip or groin.
The most important symptom which is often ignored is hip stiffness. This mobility often occurs years before the first symptoms appear, so that’s why early assessment and detection is so important/
Treatment can be either conservative and surgical.
We would start looking at assessing all the muscles and joints around the hip, and then ensure that they are functioning normally. Another important strategy is to stretch all the tight muscles, and strengthen all the week muscles. We would also look at all the activities the patient does and try to modify them to minimise pain and impact, and improve the longevity of the hip joint.
Failing this, we would then recommend a referral to a sports physician or an orthopaedic surgeon to assess the hip joint, and to try determine if the labrum (soft tissue inside the joint) is damaged.
If surgery is required, the damage is best repaired through arthroscopic (keyhole) surgery, which would focus on improving the space for the hip motion, minimising impingement.
This would also help to preserve undamaged tissue as well, decreasing the chance of developing full blown hip arthritis in the future.
If you have hip stiffness (or know anyone who has stiffness or pain), early biomechanical assessment is vital, as the earlier the diagnosis, the better the likelihood for avoiding long-term damage. Please feel free to pass this information on to friends and family.
If you want to find out how to overcome hip stiffness give Greg a call today.
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