Hip Pain

Hip Pain

There are a number of different reasons that you can be experiencing hip pain. You have had an accident or injury causing some damage to the hip or may be due to the way you are exercising or the pain may have just come on for no reason. Below are some examples of causes of hip pain. Our physiotherapists at Health2u can assess you and then work out the problem causing the pain and treat it to get rid of the pain. If you have had hip surgery our physios can help you rehab back to the hobbies and sports you enjoy.

Impingement and labral tear

The labrum of the hip which is a ring of cartilage that lines the hip joint socket can get caught or can tear. The pain often associated is a pain in your groin, over the hip or deep within your buttock. The main things that tend to cause the pain are heavy lifting, squatting down, a lot of walking or playing sport and twisting. Sometimes there can be clicking, snapping or feeling that your leg may give way. Often with this type of injury an MRI scan is required to find out the exact cause of the symptoms.

Our physiotherapists are able to conduct a full physical assessment. If they suspect that this is the cause of your pain they will recommend a top hip consultant in Singapore for you to see.

Groin strain

A groin strain can happen suddenly or over time and happens to one or more of the tendons and muscles where they are connected to the groin. Also ‘Hernias’ and stress around the pubic symphysis which connects your pubic bones can also cause pain in the groin. Commonly groin problems happen in sports involving kicking such as football but can happen in any sport where there is excessive activity around the groin.

It is very important to start physiotherapy asap if you suspect you have a groin strain as the longer you leave it hoping the pain will go away the longer your recovery will take. One of our sports physios at Health2u can perform a full assessment of you including special tests to give you a diagnosis. This will determine what is causing your groin pain and then they can carry out a number of treatments to help you recover which can include massage, myofasical release, acupuncture, taping and a specific exercise programme. They will also be able to help advise on exercise you can do while going through the rehab to keep up your fitness.

Strain of rectus femoris

This is one of your quads muscles in the front of your thigh and can be strained when playing sport particularly kicking sports especially if it is tight.

One of our physios can help with advising on anti-inflammatory treatment, massage, acupuncture, manual therapy and provide you with exercises to do which will help regain flexibility and strength in your rectus femoris muscle and return you to sport.

Bursitis

A bursa is a fluid filled sac that lie between tendons and bone around the hip. Their function is to ensure a smooth gliding surface for movement. They can become inflamed which can then cause pain. The main one lies near the top of your hip and when this bursa is inflamed can give a burning pain which can be worse when lying on that side and when walking or climbing uphill. The pain when this bursa is inflamed is often worse in the morning. Another bursa which can become inflamed is the ischial bursa which can cause pain in your upper buttock area especially when climbing uphill or sitting for a long time.

Physiotherapy can help by working on any problems you may have with the biomechanics of your walking or running style. They also will teach you stretches for tight muscles and strenghtening exercises for your bottom (gluteal) muscles. Core stability exercises are often useful too. Sometimes a corticosteroid injection may be required to sort any inflammation before exercises are started and we can recommend the best doctors in Singapore for sorting this.

Osteoporosis of the hip

This is something to be wary of if you are older and have a history of low bone density and hip pain. The middle part of the bones that make up the hip joint can weaken and become more fragile and lead to fractures in the hip. No pain is usually experienced until there is a fracture which can happen with a fall or twisting sharply.

Health2u is the only company that has a unique bone conditioning programme with easy to follow exercise videos to help improve the strength of your bones and around your hip helping to avoid fracture. For those who have had a fracture one of our physios can see you at home and help strengthen around your hip and improve your mobility helping you get back to activities you were doing prior to the fracture.

Osteoarthritis and Rheumatoid Arthritis

Osteoarthritis can occur in any joint in the body and is a the process of ‘wear and tear’ where the cartilage covering the area of bone that makes up the joint is gradually worn away over time. Rheumatoid Arthritis is when the immune system goes haywire and attacks the body rather than defending it causing inflammation of the lining of the joints and tendons of the muscles. In both conditions joints in the body that have the arthritis become painful and stiff. The joints sometimes can also become swollen and hot. Morning stiffness on waking is very common. Muscles around the joints often become weaker and doing certain activities of daily living can become more difficult.

We can provide experienced physiotherapists to see you at home and work with you to help manage your condition. The first time the physiotherapist visits they will carry out a thorough assessment which includes looking at your mobility and walking aids, muscle strength, joint movement, posture and function. Following the assessment the physiotherapist will discuss any treatments they can provide and set goals with you to improve your general function and mobility and achieve the maximum potential in your home, work and social life. These treatments can include advice on ice, exercise programmes, massage, taping, acupuncture and mobility programmes.

We can also provide occupational therapists to come to your home. They help people to regain the ability to carry out activities that have purpose and meaning to them and become or remain as independent as possible. Some of the services they can offer include:

• Home assessments including modifications such as rearranging furniture, building ramps, widening doorways, grab bars, special toilet seats etc
• Wheelchair assessments
• Splinting

Chronic Pain

Acute pain is the pain we feel immediately after injuring ourselves and while the injury is healing. Chronic pain is pain that continues even though healing has occurred and it is not unusual to find no direct link between the pain and the original injury that may have healed a long time ago. Chemical changes happen in the brain and spinal cord to re-route signals to pain centres in the brain. Then any normal sensation such as a movement, touch, pressure, stretching etc can be felt as pain. In some instances the pain system can be activated without any physical stimulus ie changes in weather, mood, thoughts or no stimulus at all.

Physiotherapy for chronic pain has to involve many aspects and address other factors that come into play rather than just the pain itself. They will treat the pain and also use methods to help you manage your pain including advice on pacing and coping with flare ups and negative thoughts, graduated exercise programmes and goal setting. They will aim to return to you being able to participate again in activities you were involved in before developing chronic pain whether work, sport of hobby related. We can also recommend top Singapore pain consultants who can help you.

Snapping hip

There are a number of causes of a feeling of snapping in the hip. The snapping can result from the iliotibial band or gluteus medius tendon snapping over the outside of the hip or the iliopsoas muscle snapping over the front of the hip. It can also occur deep in the joint itself.

Physiotherapy can help by determining what is causing the snapping and which factors are contributing to the snapping ie. tight or weak muscles etc. They can then treat accordingly with myofascial release, soft tissue therapy, core stability exercises and stretching/strengthening exercises.

Stress fractures

Stress fractures can occur in lower part of the pelvis, the thigh bone and of the hip joint socket. If this is suspected your physiotherapist will recommend a top Singapore hip consultant who will be able to organize a scan and recommend the appropriate treatment and rest required. During healing your physiotherapist can advise on non-weight bearing exercise as allowed and once healed progress you back to full function.

Sacroiliac stiffness or instability

These are the main joints of the pelvis and can be moving too much or be stiff. This can cause stress on surrounding structures leading to buttock or groin pain. The pain tends to be when doing weight bearing activities or turning in bed.

Physiotherapy can help by performing an in depth examination and use specific tests to determine whether the pain is coming from a problem with the sacroiliac joints. Treatments can be used such as manual therapy, taping, acupuncture, stretching any tight surrounding exercises and teaching specific exercises to increase the stability around the pelvis.

Slipped capital femoral epiphysis

This is a problem with the femur which can cause pain on the inside of the knee. It tends to be more common in teenage boys and being overweight can contribute. The slip of the growth plate over the femur can happen suddenly or more gradually.

Perthes disease

This is a breakdown of bone over the femoral head (top of the thigh bone) which particularly affects boys. Symptoms commonly include a limp and ache in the thigh, groin and knee. Some movement of the hip may be stiff and reduced.

Physiotherapy can help with providing appropriate exercises and advice.

Nerve entrapments

There are a number of nerves that pass around and through the groin that can become entrapped. Your physiotherapist will be able to determine if this is suspected and whether a medical referral is required.

Referred pain

Pain in the hip and groin can actually be referred from another area in the body ie the lower back . Trigger points in muscles away from the pelvis and groin can also refer to the area.

Other possible causes

Your physiotherapist will take a detailed history of your symptoms and past medical history before performing a full physical examination. There are a number of other possible causes of your symptoms which are not appropriate for a physiotherapist to treat in any way or that need a medical opinion alongside physiotherapy treatment. In this case they will recommend you to your GP or an appropriate specialist doctor or specialist consultant. These possible causes include:

• cardiovascular symptoms
• respiratory (breathing) symptoms
• gynaecological symptoms
• urinary or genital symptoms
• digestive symptoms
• immune system symptoms
• lymph system symptoms
• hormonal symptoms
• neurological symptoms
• dermatological (skin) symptoms
• medication side-effects
• virus
• infection
• cancer
• disease process
• psychological problem ie. depression, anxiety