Hip / Pelvis

… Solutions for Hip Pain and Injuries

Physiotherapy hands on treatment and exercise programs are available for hip pain and injuries to decrease pain, progress towards optimum function and prevent recurrence of the problem.

 

Treatments Available Include:

  • Biomechanical Analysis
  • Soft Tissue Techniques
  • Joint Mobilisation
  • Stretching, Strengthening & Stabilizing Exercises
  • Motor Control Exercises to Train Correct Patterning of the Hip, Knee, Ankle & Core
  • Runners Pelvic Stability Program

 

This approach is beneficial for conditions such as:

  • Hip Bursitis
  • Gluteus Medius Tendinopathy
  • Hamstring Muscle Sprains
  • Labral Tears
  • Hip Osteoarthritis
  • Osteoporosis
  • Post-Operative Rehabilitation
  • SIJ Instability
  • Stress Fractures
  • Symphysis Pubis Dysfunction / Pain
  • Running Injuries

 

Hip/ Pelvis-Gluteal Pain: A Multimodal Rehabilitation and Treatment Approach

Gluteal pain is a common presentation due to sport or everyday activities, presenting with pain and discomfort in various areas of the hips and pelvis.

The pain can be of gradual onset and vary in intensity with daily activities or of sudden onset during or after a sporting event.

Treatment is based on assessment and identification of the specific structures involved, as gluteal pain may arise from various sources these may include the lumbar spine, sacroiliac joint, pelvis and extremities.

Hip and Gluteal Pain Management

Initial management is focused on pain reduction and optimization of movement. Using activity modification, education, manual therapy and an individualized exercise program to prevent reoccurrence.

Hip and Gluteal Pain Assessment

  • Lower limb alignment and muscles
  • The pelvis alignment and sacroiliac joint function
  • Lumbar spine
  • Hip muscles balance and control
  • Abdominal and core strength
  • Hamstrings and neural tension
  •  Palpation of muscles for myofascial pain
  • Biomechanics of the hip joint
  • Specific functional testing

 

Some Common Sources of Pain:

Lumbar spine. Due to its proximity and nerve supply to the pelvis, pain may be referred from the lumbar spine to the gluteal region.

Sacroiliac joint. The articulation between the pelvis and sacrum, better known as the sacroiliac joint with ligamentous structures may also be a source. The pain may be local on one side or refer laterally, downwards or anteriorly.

Myofascial pain posteriorly may include strains due to overload in the various soft tissues such as muscle and ligaments.

On the lateral side, the abductor muscles of the hip may be the source due to abductor Tendinopathy, trochanteric bursitis, Iliotibial band syndrome and the lateral cutaneous nerve entrapment.

Hip Joint pain can be due to Labral tears, CAM lesions, stress fractures, hip joint arthritis and other hip joint diseases.

On the posterior inferior border we have hamstring muscles, bursas and the sciatic nerve.

 

Groin Pain in Sport: A Multimodal Rehabilitation and Treatment Approach

Acute and chronic groin pain are a frequent occurrence in sports and are one of the three most common injuries seen in the various codes of football. They are frequent in sports that involve running, kicking, sprinting, and a change of direction.

The onset of groin pain may be acute or gradual. In gradual onset groin pain or stiffness in the early stages of physical activity, with the symptoms reducing as they warm up. Longstanding groin pain may lead to more complex presentations, involving other muscles and structures that may need rehabilitation.

A multimodal approach has been found to be the most effective treatment protocol and this may include manual therapies, dry needling, exercise and functional training.

Treatment

  • In the initial stages, Pain management is important.
  • Analgesics, manual therapies, Dry Needling, taping and compression garments may be useful.
  • Adequate range of motion, and mechanotherapy to load the injured structure is important for tissue capacity.
  • The Copenhagen adductor exercise has been found to be a good indicator of adductor muscle strength in rehabilitation.
  • Train for sport specific risk factors that may influence injury, such as kicking sprinting and eccentric loading.
  • Lumbo-pelvic stiffness, strength or stability may influence performance.
  • The maintenance of cardiovascular fitness is of optimal importance during recovery.

 

Risk Factors for Groin Injuries in Athletes

  • Prior groin injury
  • Higher level of play
  • Lower adductor strength relative to abductors
  • Reduced relative, and absolute adductor strength
  • Having lower levels of sport specific training
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