HIP AND KNEE PAIN

ABOUT HIP AND KNEE PAIN

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Hip:

Hip pain can be extremely frustrating because most often the discomfort is worse when weight bearing. Hip pain can arise for a variety of reasons and most commonly caused by hip osteoarthritis (OA), Trochanteric Bursitis, and Piriformis Tendinitis .

Osteo-Arthritis is of a chronic nature, most commonly characterized as a form of chronic arthritis. This can present with joint pain, swelling, stiffness, and reduced mobility.  Risk factors include being overweight or obesity, joint injury and increasing in age.  At present, there is currently no cure for OA, but there are many treatments and approaches to managing the long-term symptoms of this disease.

 

Bursitis

Inflammation of the bursa is a slow process, which progresses over time. This bursitis most often occurs because of friction, overuse, direct trauma or too much pressure.  There are two types of bursitis:

 

Acute bursitis occurs because of trauma or a massive overload. After a few days’ symptoms like pain, swelling and a warm feeling when touching the affected area can be noticed. It will also be very painful to move the joint.

 

Chronic bursitis which is caused by overuse, too much pressure on the structures or extreme movements. Wrong muscle strain can also be a cause of chronic bursitis. The main symptom – which is always present – is pain.

There are many predisposing factors that can cause Trochanteric Bursitis:

  • Gender:  Women more commonly affected than men.

  • Overweight/Obesity

  • Trauma: e.g. injury of the greater trochanter: this can deface the bursa.

  • Overuse of the muscles around the bursa or the joint underneath the bursa.

  • Incorrect position: this can cause an increase in pressure.

  • Too much pressure on the bursa (caused by friction of the Iliotibial band)

  • Dysfunction of the insertion of the muscle gluteus medius.

  • Repetitive strain: e.g. frequent training with too much weight or training in a bad position

  • Poorly cushioned shoes: results in increased pressure on the muscles, joint and bursa

  • Excessive pronation/ extreme movement

  • Leg length differences

  • ITBS (Iliotibial Band Syndrome)

  • Other inflammatory diseases

 

Psoas Strain / Tendonitis

There are two main hip flexor muscles, these are the Psoas and the Iliacus. The Psoas runs from the lumbar spine to the top inside area of the femur (leg bone).  The Iliacus runs from the inside of the hip (Ilium) combines with the Psoas to form one tendon as it crosses the pubic bone and attaches to the femur.  When this tissue is over stretched it can damage the tendon at the attachment site on the femur resulting in inflammation and pain.  Tendonitis may also occur due to repetitive over use usually seen in athletes. With strains and tendonitis of the Ilio-Psoas muscles pain may radiate in to the front of the hip and down the leg. 

Hip Impingement Syndrome

Femoroacetablar impingement, often referred to as FAI, is a condition where bone spurs form along the edges of the ball-and-socket hip joint and cause limited mobility of the joint and damage to soft tissues including the labrum. FAI is thought by many surgeons to be a precursor to arthritis of the hip joint.

SacroIliac Dysfunction

Sacroiliac joint dysfunction or sacroiliitis are common terms used to describe the pain of the sacroiliac joint. It is usually caused by abnormal motion (i.e. hyper- or hypo-mobile) or improper alignment of the sacroiliac joint. Sacroiliac joint syndrome is a significant source of pain in 15% to 30% of mechanical low back pain sufferers.

Sacroiliac Joint Syndrome is a condition that is difficult to diagnose and is often overlooked by physicians and physiotherapists.  The joint can be unstable or immobile which either can cause pain.  Pain is usually localized over the buttock. Patients usually describe the pain as sharp, dull, achy, stabbing, or shooting pain directly over the affected joint.  

Patients can often complain of sharp, stabbing, and/or shooting pain which extends down the back of the thigh but usually not past the knee.  Pain can frequently mimic and be misdiagnosed as radicular pain (pain that radiates from an issue in the lumbar spine.  Patients will frequently complain of pain while sitting down, lying on the same side of pain, or climbing stairs.

The pain associated with sacroiliac dysfunction will only be on one side.  If you are experiencing pain on both sides then your issue is most likely not Sacroiliac Dysfunction.

 

How We Treat

If you are experiencing hip pain WAV PT can help!  When you come in for your Initial Evaluation we will do a thorough investigation to determine what is going on and then develop a Plan of Care that will consist of Manual Therapy to relieve chronic tensions in the soft tissue along with joint manipulation to allow for increased mobility and pain relief.  We will also be using the Gyrotonic Method to increase strength, mobility, and improve movement patterns to allow you to return to an improved level of function free of pain.