Physiotherapy for Hip & Thigh Injuries

The UK is a country with a rapidly growing elderly population, which means that there is an increasing pressure on the NHS in terms of geriatric patients presenting with injuries or illness particular to their age group. A large number of these are hip issues brought on by wear and tear. Hip injury however is not exclusive to the aging population. Your hips and the thigh beneath link your lower and upper body, and hence are a common site for injury/

Common hip injuries

Examples of commonly occurring hip and thigh injuries include:

• Hamstring injury (Hamstring strain or pull) –The Hamstring is one of the key thigh muscles responsible for a lot of lower body motion, and is actually composed of three muscles working together to achieve hip and knee movement. This muscle is very commonly injured in sports and often in slips or falls, it occurs as the Hamstring is taken beyond its limits by either a sharp force that stretches it or the like. Sometimes the muscle tears and becomes a strain, which ranges in severity from a first degree strain (minor and affecting a few muscle fibres) to a third degree strain (ruptured muscle). Depending on the severity of the injury, symptoms can range to slight stiffness and cramp to immediate and burning pain that prevents any motion involving the muscle.
• Osteoarthritis of the hip (Hip arthritis) – A very common ailment amongst the middle aged to elderly, it involves both inflammation and progressive degeneration of the joint. The hip is a ball and socket joint, its motion is facilitated by an enclosed capsule of a lubricating agent called Synovial fluid. Over time these elements that facilitate smooth movements wear down, until the bone of the hip (pelvis) and thigh (femur) begin to rub against one another causing painful micro-fractures. Hip arthritis can be exacerbated by exercise, but is typically a product of normal aging. Pain is the typical presentation, which centres around the hip and groin but can often radiate outwards. A physiotherapist will observe a change in gait typical of the condition.
• Hip Bursitis (Trochanteric Bursitis) – Bursitis is simply the inflammation of a fluid filled sac called the Bursa which serves to protect different tissues from friction during movement. Damage to this structure by means of either trauma or prolonged stress results in its inflammation, which presents in pain on the outside of the hip where the hip’s Bursa is located.

Physiotherapy and hip and thigh injuries

Physiotherapists conduct their own assessments using a range of manual tests established by a large body of research and practical experience, these allow for a very specific diagnosis of conditions affecting movement. Hip and thigh injuries can present with a fairly non-specific pain which doesn’t provide much diagnostic information. A physio will conduct careful manipulations and ask you to move the affected region in such a way as to establish where exactly pain is being caused and experienced. Using the data from this exam, your physio can provide a specific diagnosis, and from this determine the best course of treatment.

Hamstring injuries are treated by means of the RICE (Rest, Ice, Compression, and Elevation) protocol which reduces bleeding, hence minimising damage and reducing recovery time. Rest is vital becayse if your injury is a minor one, further trauma will exacerbate it, potentially leading to more serious and debilitating injury. Your physio will suggest stretches and exercises that increase in difficulty to correctly align the healing tissue, improve blood flow, and strengthen both the muscles that are healing and those that stabilise them. Resistance bands will be used eventually, but often your physio will suggest you wear support or compression shorts, at least initially.

Hip injuries involving inflammation (like arthritis or Bursitis discussed above) are initially treated medically by means of anti-inflammatory drugs. If the extent of the damage is severe enough to warrant surgery, than physical therapy will come after the procedure through a rehabilitation programme designed to restore functionality. The application of ice is standard practice, done in twenty minute sessions regularly throughout the day. This serves to reduce inflammation and irritation as well as relieve some pain. Similarly warm compression shorts are worn to improve blood flow and provide support.

With arthritis a physio will suggest preventative measures as well as exercise. If you are fortunate enough to get an early diagnosis, than there are many steps you can take to limit the profession of the condition. Your physio will suggest a healthy level of activity and regular stretching exercises. Everyone’s anatomy is different, and your therapist will help determine what specific movements and factors exacerbate your condition. Upon establishing these parameters, a physio will often make suggestions as to how you can adjust your posture or movement to avoid pain and further information. Small lifestyle changes like these are part of a physio’s role, and can make a huge difference in your quality of life.

Physiotherapy will also work to strengthen your Gluteal muscles located around your behind. These muscles support your hip, but in the presence of hip pain, are often disengaged and thus weaken over time. A physio will also suggest swimming and water based exercises. Running and other exercises like that place a lot of weight on your hip, while swimming itself involves no real weight bearing on the hip, and yet allows for a range of movement with some resistance.

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