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SYMPTOMS
Most frequently, the pain that arises from the hip joint is felt in the
groin or on the siteof the hip. When the joint is inflamed the pain could
have a very sharp quality. In the chronic condition the pain is dispersed
over larger area and is felt as dull and achy.
CAUSES
Hip pain disorders unless arising from trauma are mostly a
combination of improper development of hip and pelvis bones and
disturbance of walking mechanics.
DIFFERENTIAL DIAGNOSIS
Differential diagnosis is based on clinical examination and radiology
such as x-ray, ultrasound or MRI. Most common hip conditions include:
labral tears, FAI (femoroacetabular impingement), degenerative hip
disease (hip arthritis), degenerative hip tendon disorders and hip bursitis.
Frequently, pain in the joint on the back or side of the hip is referred
from muscles or joints in the spine. Pain arising from spinal nerve
compressions at L2 - L3, L3 L4 can refer to the hip and groin area.
Spinal joint restrictions from the upper lumbar or lower thoracic areas
can refer to pain in the hip and groin. Occasionally femoral,
illiohypogastrioc and illioinguinal nerves can be impinged.
DIAGNOSIS
At NYDNR we use a thorough clinical exam from both structural and
functional perspective. We use diagnostic ultrasonography to visualize
hip joint, tendons and bursas. We use sophisticated video gait (walking)
TREATMENT ADVANTAGE
at NYDNRehab
The hip joint is the largest joint in the body, and also one of the most
stable. It derives much of its stability from being a ball-and-socket joint. A
ball-and-socket joint is a joint in which the rounded end of one bone
inserts into the depression of another. In this case, the ball is the head
of the femur (the thigh bone) and the socket is the acetabulum, a
sizable concave depression in the lower part of the pelvic girdle. The
acetabulum is lined with a fibrous rim of cartilage known as the
acetabular labrum, which deepens and further stabilizes the hip joint by
helping to keep the ball in the socket. If the acetabular rim is injured, a
patient can develop labrum tears, resulting in pain and stiffness.
The major muscles of the hip region can be divided into four groups
according to their various functions: the flexors, the extensors, the
abductors, and the adductors. The iliopsoas and rectus femoris are
largely responsible for flexion. Along with the hamstrings, the gluteal
muscles assist in extension. (The gluteus maximus, which comprises
much of the buttocks, helps to rotate the hip and leg.) The abductor
muscles, which include the gluteus medius and gluteus minimus,
function to pull the legs away from the midline of the body, while the
adductor muscles pull the legs towards the midline of the body.
DIAGNOSIS
Diagnosing hip disorders may not be an easy job because hip/groin area
is anatomically dense terrain where different structures are so
functionally and structurally intertwined into a robust lumbo-pelvic
engine, which defines human locomotive machine. The groin hip area is
also very richly innervated by nerves of the lumbar plexus and is known
to be a great mimicker. Although, the use of modern radiology is
extremely helpful clinical experience is the key. The recent advances in
the high resolution ultrasonography as well as gait analysis today allows
the hip the clinician a practical arrival to the right diagnosis on the spot.
HIP DISORDERS
consequences for the career of the athlete. While this injury often occurs
because of sudden changes in the intensity of a patients running or the
rate of acceleration, it can also occur because of overuse, poor footwear,
or training on unlevel surfaces. Symptoms may include pain in the hip,
groin, and thigh, pain at night, and pain when engaging in strenuous
activity or bearing weight.
Femoracetabular impingement ( FAI) is a frequent source of hip pain in
males but also affects females as well. The causes of FAI are a
combination of predisposing structural anatomical variations together
with poor gait mechanics and trauma. Hip dysfunction and weakness is
also most frequently present in people suffering from low back pain,
pelvic pain and foot pain disorders.
Hip flexor strain can occur when a patient is flexing his or her thigh and
something happens that forces the thigh to extend. It can also occur
when the thigh is flexing and is suddenly struck by an external force, as
when an athlete extends her leg to kick a ball and is hit in the leg.
Symptoms may include sharp groin pain and pain that increases with
rotation or extension.
The most common cause of groin pain in athletes is adductor
strainstrain of either the adductor longus, adductor brevis, adductor
magnus, pectineal, or gracilis muscles. These muscles can be strained
when an athlete suddenly changes direction or is forced to rotate the leg
while pulling it towards the body. This injury most commonly strikes
hockey and soccer players. Its sometimes mistaken for femoral neck
stress fracture or hip bursitis. Immediately following injury, symptoms
may include piercing groin pain, bruising, and swelling. Later, victims
may experience tenderness of the adductor muscles and associated
tendons and pain when stretching.
Treatment for adductor strain and hip flexor strain typically depends on
the severity of symptoms. Physical therapy is recommended following
rest for the first one to two weeks after injury. A hip pain specialist will
guide the patient in a program of physical therapy to restore motion,
recover strength, motor control restore biomechanics of gait and
functional alignment. Total understanding of all hip disorders is very
important as ignored hip symptoms and functional hip deficit can lead to
hip osteoarthritis. Therefore hip prevention is a duty of every hip
specialist.
When it comes to osteoarthritis, the goals of a hip pain doctor who is not
performing surgery will be to alleviate pain and increase mobility for
patients suffering from this incurable condition. This may include both
medicinal and non-medicinal treatment modalities. Examples of the
former can include NSAIDs, acetaminophen, and right type of hip
physical therapy. Examples of the latter include a general program of
exerciselack of strength in the lower extremities is sometimes a
contributing factor in osteoarthritis; weight loss; and weight reducing gait
therapy which combines aerobic and strength training. Weight reducing
therapy such as AlterG treadmill can be especially helpful because it
lessens the amount of weight placed on the joints and allows for the
performance of exercises that couldnt otherwise be managed. The other
type of most useful hip specific physical therapy is retraining
weight-bearing symmetry and gait stability. This type of therapy is highly
skilled and requires modern equipment.
Patients struggling with FAI, osteoarthritis, femoral hip pain, anterior and
posterior thigh pain, and other hip pain diseases will find help and most
advanced care at New York Dynamic Rehabilitation Clinic
(NYDNRehab). While theres no magical hip pain cure for sports injuries,
we do offer advanced rehabilitative treatment that can assist suffering
patients in getting back on their feet.
The success of our method lies in our ability to incorporate advanced
technologies with various manual techniques. Because medical imaging
(such as MRI) is limited in its ability to detect problems during
movement, we employ computerized gait analysis, a system of viewing
and measuring the forces at work when a patients body is in motion
during walking or running. This not only allows us to see abnormalities,
but to understand the complex relationships between the tissues of the
body when viewed as part of a moving system. We are the first
outpatient clinic in NYC providing a gait analysis lab. When used in
conjunction with diagnostic ultrasonography and X-ray imaging, we can
obtain a near-complete picture of the mechanics of a persons gait and
the integrity of the tissues surrounding the hip joint.
If this analysis reveals damage to the integrity of those tissues, our
doctors for hip pain combine standard rehabilitation techniques with
biological treatment. In some cases extracorporeal shockwave therapy
(ESWT) may be employed. ESWT sends low-intensity, high-frequency
sound waves traveling through the skin at the site of injury to regenerate
damaged tissue. In case of myofascial hip syndrome where trigger
points and fascial adhesions are the sole source of problem we combine
defocused shockwaves with ultrasound guided dry needling.Most
importantly, we use Computer Assisted Rehabilitation Environment
The hip joint is the largest joint in the body, and also one of the most
stable. It derives much of its stability from being a ball-and-socket joint. A
ball-and-socket joint is a joint in which the rounded end of one bone
inserts into the depression of another. In this case, the ball is the head
of the femur (the thigh bone) and the socket is the acetabulum, a
sizable concave depression in the lower part of the pelvic girdle. The
acetabulum is lined with a fibrous rim of cartilage known as the
acetabular labrum, which deepens and further stabilizes the hip joint by
helping to keep the ball in the socket. If the acetabular rim is injured, a
patient can develop labrum tears, resulting in pain and stiffness.
The major muscles of the hip region can be divided into four groups
according to their various functions: the flexors, the extensors, the
abductors, and the adductors. The iliopsoas and rectus femoris are
largely responsible for flexion. Along with the hamstrings, the gluteal
muscles assist in extension. (The gluteus maximus, which comprises
much of the buttocks, helps to rotate the hip and leg.) The abductor
muscles, which include the gluteus medius and gluteus minimus,
function to pull the legs away from the midline of the body, while the
adductor muscles pull the legs towards the midline of the body.
DIAGNOSIS
Diagnosing hip disorders may not be an easy job because hip/groin
area is anatomically dense terrain where different structures are so
functionally and structurally intertwined into a robust lumbo-pelvic
engine, which defines human locomotive machine. The groin hip
area is also very richly innervated by nerves of the lumbar plexus
and is known to be a great mimicker. Although, the use of modern
radiology is extremely helpful clinical experience is the key. The
recent advances in the high resolution ultrasonography as well as
gait analysis today allows the hip the clinician a practical arrival to
the right diagnosis on the spot.
HIP DISORDERS
Treatment for adductor strain and hip flexor strain typically depends on
the severity of symptoms. Physical therapy is recommended following
rest for the first one to two weeks after injury. A hip pain specialist will
guide the patient in a program of physical therapy to restore motion,
recover strength, motor control restore biomechanics of gait and
functional alignment. Total understanding of all hip disorders is very
important as ignored hip symptoms and functional hip deficit can lead to
hip osteoarthritis. Therefore hip prevention is a duty of every hip
specialist.
When it comes to osteoarthritis, the goals of a hip pain doctor who is not
performing surgery will be to alleviate pain and increase mobility for
patients suffering from this incurable condition. This may include both
medicinal and non-medicinal treatment modalities. Examples of the
former can include NSAIDs, acetaminophen, and right type of hip
physical therapy. Examples of the latter include a general program of
exerciselack of strength in the lower extremities is sometimes a
contributing factor in osteoarthritis; weight loss; and weight reducing gait
Patients struggling with FAI, osteoarthritis, femoral hip pain, anterior and
posterior thigh pain, and other hip pain diseases will find help and most
advanced care at New York Dynamic Rehabilitation Clinic
(NYDNRehab). While theres no magical hip pain cure for sports injuries,
we do offer advanced rehabilitative treatment that can assist suffering
patients in getting back on their feet.
The success of our method lies in our ability to incorporate advanced
technologies with various manual techniques. Because medical imaging
(such as MRI) is limited in its ability to detect problems during
movement, we employ computerized gait analysis, a system of viewing
and measuring the forces at work when a patients body is in motion
during walking or running. This not only allows us to see abnormalities,
but to understand the complex relationships between the tissues of the
body when viewed as part of a moving system. We are the first
outpatient clinic in NYC providing a gait analysis lab. When used in
conjunction with diagnostic ultrasonography and X-ray imaging, we can
obtain a near-complete picture of the mechanics of a persons gait and
the integrity of the tissues surrounding the hip joint.