The hip joint is the bridge between the legs and the body. It supports the weight of the head, posture and retaining balance; and allows us to walk, run, and jump.
Hip Anatomy & Function
The hip is a ball and socket joint and the largest weight-bearing joint in the body. The upper end of the thigh bone (femur) is the ball that fits into the socket (the acetabulum) in the pelvis. The acetabulum is lined with cartilage that allows the joint to glide easily and offers a wide range of motion. A strong ring of cartilage on the acetabulum called the labrum deepens the socket and helps to stabilize the hip joint. The inherently strong hip joint is fortified by strong ligaments and muscles that form the hip joint capsule to stabilize the joint.
There are 17 muscles in the hip. The buttocks are made of the gluteal muscles which are responsible for extension, abduction, and internal and external rotation of the hip joint. The adductor muscles allow us to bring the thighs together. The Iliopsoas muscles run from the lumbar discs in the spine to the hip and the thigh bone. These muscles are hip flexors important for posture standing, walking and running. Tight hip flexors can cause back and hip pain. The lateral rotators rotate the thigh bone and include the Piriformis muscle through which the sciatic nerve runs. Piriformis syndrome is a condition where this muscle irritates the sciatic nerve causing sciatica. However, sciatica is typically caused by a herniated disc in the spine.
When hip pain occurs with low back pain there may be a common cause. For instance, prolonged sitting can cause the gluteal muscles to atrophy which can result in low back pain and difficulty getting into and out of a seated position and climbing. When you have hip pain, the specialists at Grossmont Orthopedics in San Diego, California can help to identify the source of your pain and the best treatments.
Hip conditions and treatments
There are numerous hip disorders and diseases that can cause hip pain. The most common cause of hip pain is osteoarthritis. Hip injuries like a strain, bursitis, dislocations and fractures can occur from sports, running, overuse or a fall.
Strains and sprains are a common cause of both hip and back pain. A strain is the result of a torn or stretched tendon. A sprain is a torn or stretched ligament.
Tendons attach a muscle to bone. Tendinitis is most often caused by overuse. Inflammation and degeneration of the tendon is initially treated with conservative measures. Steroid injections may provide short-term relief. Physical therapy can help in some cases. When tendinitis interferes with essential daily activities, surgery may be recommended. A tendon rupture is a serious complication of tendinitis and requires surgical repair.
Bursitis is inflammation or breakdown of soft tissues. Bursitis is often the result of gout, pseudogout, blood or kidney disease and some drugs including statins. Treatment involves rest, pain medication and icing. When pain fails to resolve, a cortisone injection can help. when pain fails to resolve after 6-12 months, surgery may be necessary to repair damage and relieve pressure.
The labrum is a ring of cartilage that lines the hip socket to seal the joint and help keep the thighbone in place. A labral tear can result from trauma, overuse, and structural problems. Athletes who play ice hockey, soccer, football, golf, ballet are at increased risk of a labral tear. Treatment depends on the severity of the tear. Nonsurgical treatment may be tried, but if symptoms fail to resolve, arthroscopic hip surgery will be necessary.
Femoroacetabular Impingement (FAI)
FAI is caused by the overgrowth of bone (bone spurs) around the ball (the head of the thigh bone) and along the socket (acetabulum). FAI occurs in people with abnormally formed hip bones. Over time, tears can form in the labrum and breakdown the articular cartilage causing osteoarthritis. Nonsurgical treatment includes activity modification, anti-inflammatory meds, and physical therapy. If joint damage is found, and nonsurgical treatments fail, surgery will be recommended.
A dislocated hip is extremely painful medical emergency. It is caused by trauma (auto accident or a fall) or hip dysplasia. Treatment depends on whether there are additional injuries including fractures of the pelvis and legs. Complications from hip dislocation include nerve injury, damage to the blood supply that results in osteonecrosis, and post-traumatic arthritis.
This is a serious injury and can be life-threatening. Treatment is surgical repair or total hip replacement. Hip fractures are common in older people due to osteoporosis, balance problems, trips and falls.
OA is “wear and tear” arthritis, a degenerative condition that causes pain and stiffness and limits motion. OA breaks down the articular cartilage that lines the hip socket. Nonsurgical treatment includes lifestyle modifications, physical therapy, using a cane, walker or crutches, and pain medications. When hip OA causes disability that can’t be relieved with nonsurgical options, hip replacement surgery will be recommended.
When you have hip pain, contact the Grossmont Orthopedics in San Diego, California. Our orthopaedic surgeons are board-certified and fellowship trained in advanced arthroscopic surgery, joint replacement and sports medicine.