Hip

Hip

If you suffer from hip pain, there is no reason why you have to stay in pain. In fact, we have designed this portion of our site with you in mind.

On this page you will find information on how to manage old conditions, with our Feeling Fab exercises and to learn more about the anatomy and more complex information in our know your body section. 

Ankle problems account for less than 5% of the patients accessing Physio Med services from our clients.

We see patients with hip problems occuring from:

  • Domestic situations
  • Work aggravated
  • Accidents at work

 

Feeling Fab

Occupational physiotherapy exercises for your hip

 

Our Feeling Fab programme is a set of stretching and strengthening exercises. They have been designed to manage and prevent an onset of a range of musculoskeletal conditions.

There are certain activities in the work place that may contribute to developing problems with your hips. The nature of these activities can, if not addressed lead to the gradual build-up of tension and stiffness in the hip.

Guides

Maintaining a fit and healthy workforce

Full Body Stretching and Strengthening Exercises: Occupational Physiotherapy - Getting You Back To Work

How to choose an office chair

There are many types of office chairs and many factors that influence the choice of which chair to use. Ergonomic chairs that offer better leg, pelvic and lumbar positioning have become popular, but they still have their own drawbacks.

Common Condition

A common condition that Physio's treat in the hip is a Trochanteric Bursitis.

Common Condition

A common spot for a bursitis is on the side of the hip. Here a large tendon passes over the bony bump on the side of the hip. The bony bump is called the greater trochanter. Inflammation in the bursa between the tendon and the greater trochanter is called trochanteric bursitis. This problem is common in older individuals. It may also occur in younger patients who are extremely active in exercises such as walking, running, or biking.

This guide will help you understand the following:

  • how trochanteric bursitis develops
  • how doctors diagnose the condition
  • what treatments are available

Portions of this document copyright MMG, LLC.

Anatomy

Where is the trochanteric bursa, and what does it do?

Anatomy

The hip joint is one of the true ball-and-socket joints of the body. The hip socket is called the acetabulum and forms a deep cup that surrounds the ball of the upper thigh bone (femur), or femoral head. Thick muscles of the buttock at the back and the thick muscles of the thigh in the front surround the hip.

The greater trochanter is the large bump on the outside of the upper end of the femur. This bump is the point where the large buttock muscles that move the hip connect to the femur. The gluteus maximus is the largest of these muscles. It attaches lower down on the femur.

Where friction occurs between muscles, tendons, and bones, there is usually a structure called a bursa. A bursa is a thin sac of tissue that contains fluid to lubricate the area and reduce friction. The bursa is a normal structure.

The body will even produce a bursa in response to friction.

Portions of this document copyright MMG, LLC.

Causes

Why do I have this problem?

Causes

Sometimes a bursa can become inflamed (swollen and irritated) because of too much friction or because of an injury to the bursa. An inflamed bursa can cause pain because movement makes the structures around the bursa rub against it.

Friction can build in the bursa during walking if the long tendon on the side of the thigh is tight.

The gluteus maximus attaches to this long tendon. As you walk, the gluteus maximus pulls this tendon over the greater trochanter with each step. When the tendon is tight, it rubs against the bursa.

The rubbing causes friction to build in the bursa, leading to irritation and inflammation. Friction can also start if the outer hip muscle (gluteus medius) is weak, if one leg is longer than the other, or if you run on banked (slanted) surfaces.

Most cases of trochanteric bursitis appear gradually with no obvious underlying injury or cause. Trochanteric bursitis can occur after artificial replacement of the hip joint or other types of hip surgery. The cause may be a combination of changes in the way the hip works, the way it is aligned, or the way scar tissue has formed from the healing incision.

A fall on the hip can cause bleeding into the bursa, forming a hematoma. The bleeding is not serious, but the bursa may react to the blood by becoming inflamed. The inflammation causes the bursa to become thickened over time. This thickening, constant irritation, and inflammation may result in the condition becoming chronic, or long lasting.

Hip 4

Portions of this document copyright MMG, LLC.

Symptoms

What does the condition feel like?

The first symptom of trochanteric bursitis is usually pain. The pain can be felt in the area of the hip right over the bump that forms the greater trochanter. Eventually the pain may radiate down the outside of the thigh. As the problem progresses, the symptoms produce a limp when walking and stiffness in the hip joint. Eventually, the pain will also be present at rest and may even cause a problem with sleeping.

Portions of this document copyright MMG, LLC.

Diagnosis

At Physio Med, diagnosis of trochanteric bursitis begins with a history and physical examination.

The physical examination will be done to determine how much stiffness you have in the hip and if you have a limp. Further physical tests may be done to rule out other causes of your hip pain. Our physiotherapist will also want to know when the pain began and which motions cause the pain.

Some patients may be referred to a doctor for further diagnosis. Once your diagnostic examination is complete, the Physiotherapists at Physio Med have treatment options that will help speed your recovery, so that you can more quickly return to your active lifestyle.

Portions of this document copyright MMG, LLC.

Our Treatment

Non-surgical Rehabilitation

At Physio Med, treatment of trochanteric bursitis usually begins with simple measures used to calm inflammation, and may include heat or ice applications. Our Physiotherapists use hands on treatment and stretching to help restore your full hip range of motion. Improving strength and coordination in the buttock and hip muscles enables the femur to move in the socket smoothly and can help reduce friction on the bursa. Time required for recovery and rehabilitation varies for each patient, but as a guideline, you may expect to attend Physiotherapy sessions for four to six weeks before full motion and function return.

Younger patients who have this condition because of overuse can usually be treated by reducing their activities or changing the way they do their activities. Decreased activity, combined with our exercise Physiotherapy program of stretching and strengthening, and perhaps a brief course of anti-inflammatory medications, will usually resolve the problem. Patients may also want to consult with their Doctor or Pharmacist regarding the use of pain relief or anti-inflammatory medication.

Although the vast majority of our patients with trochanteric bursitis never require surgery, if you do, the Physiotherapists at Physio Med can provide a personalised post surgical Physiotherapy programme to help speed your recovery so that you can more quickly return to your active lifestyle.

Post-surgical Rehabilitation

If you have surgery, your hip will be bandaged with a well-padded dressing. Although the amount of Physiotherapy a patient needs relates to his or her own speed of recovery, as a general rule, you may expect to attend Physiotherapy sessions at Physio Med for up to two months after surgery.

Our first few treatment sessions will focus on controlling the pain and swelling after surgery. We will then have you begin exercises that gradually stretch and strengthen the muscles around the hip joint. Our physiotherapist will help you retrain these muscles to keep the ball of the femur moving smoothly in the socket. We will also provide you with tips on ways to do your activities without straining the hip joint.

At Physio Med, our goal is to help speed your recovery so that you can more quickly return to your everyday activities. When your recovery is well under way, regular visits to us will end. Although we will continue to be a resource, you will be in charge of doing your exercises as part of an ongoing home programme.

Portions of this document copyright MMG, LLC.

Physician Review

Your Doctor may order X rays to make sure that there are no other abnormalities in the hip.

X rays will usually not show trochanteric bursitis. If X rays are suggested, they are to rule out other problems that may be causing your hip pain. Sometimes it is difficult to tell whether the pain you are suffering is from a trochanteric bursitis or underlying arthritis of the hip joint. An X-ray may give more information about the condition of the hip joint itself.

An injection of a local anaesthetic into the bursa can also help your Doctor diagnose trochanteric bursitis. If the injection removes the pain immediately, then the diagnosis is probably trochanteric bursitis. Most Doctors will also add a bit of cortisone medication to the novocaine to help treat the condition at the same time. Cortisone is a powerful anti-inflammatory medication. It can reduce swelling and pain when injected directly into the bursa. The injection may not cure the problem however it may control the symptoms for months.

Portions of this document copyright MMG, LLC.

Surgery

Surgery is rarely needed to treat trochanteric bursitis.

When all else fails and the pain is disabling, your doctor may recommend surgery. Several types of surgical procedures are available to treat trochanteric bursitis.

The primary goal of all procedures designed to treat this condition is to remove the thickened bursa, to remove any bone spurs that may have formed on the greater trochanter, and to relax the large tendon of the gluteus maximus. Some surgeons prefer to simply lengthen the tendon a bit, and some prefer to remove a section of the tendon that rubs directly on the greater trochanter.

Portions of this document copyright MMG, LLC.

Hip Problems Solved

2774

We have helped employees all over the UK get back to match fitness

Find out how

What we do

Our blended approach to workplace physiotherapy

We provide occupational physiotherapy services to small or large workplaces nationally, aiming to get their employees back to work as quick as possible. Our average ROI is 10:1. Watch our video to find out how your staff benefit from physiotherapy access.

Case Studies

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Index fire rescue

Physio Med Ltd has worked with West Yorkshire Fire & Rescue Service for 11 years providing access to its managed network.

Second time using the service, consistently excellent!!!! Thank You.

Unknown

I was very impressed with the swift & prompt service which has I believe made real difference to my progress.

Sally T

In 2011, North West Ambulance Service saved 32 working days per employee as a direct result of using Physio Med's service.

North West Ambulance Service

Frequently Asked Questions

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If you suffer from pain and mobility issues it is quite common for us to get by, using over the counter pain killers and ointments. Often we don't seek the support of a Physio until we have been referred via a GP or until the pain is so bad.

Physiotherapists are trained professionals that help injured patients get back to the highest range of movements. If left untreated injuries often don't heal as well as if you were on a treatment plan. Injuries, if left for 12 weeks can become chronic and chronic injuries are a lot harder to treat. Injuries also heal a lot quicker if you work with a physiotherapist, with the added benefit of often having less pain and more range of movement than before you had your injury.   

If you feel it is only a minor injury and you are still in pain 48 hours after the injury, make an appointment with a physiotherapist. If you feel the injury is more serious make an appointment immediatley. If for an extended perioid, you have been living with chronic pain and or limited mobility and range of movement make an appointment with a physiotherapist.  

 

Our Physiotherapists use different treatment methods in order to deal with a wide range of injuries. Depending on the nature and severity of your injury, you may require:

Manipulation or mobilisation of joints

Electrotherapy (Laser, Ultrasound, Interferential, Short Wave Diathermy)

Acupuncture

Exercise therapy

Stretching and strengthening

Core stability training

Soft tissue massage

Heat or cold therapy

Patient education, home exercises

Biomechanical analysis

Wear something comfortable. Bring a pair of shorts if it is a lower back, hip, knee, ankle, or a foot problem. Bring a tank top / vest if it is a neck, upper back, shoulder, elbow, or hand problem.

Physiotherapy can be helpful for people of all ages with a wide range of health conditions, including problems affecting the: 

bones, joints and soft tissue – such as back pain, neck pain, shoulder pain and sports injuries

brain or nervous system – such as movement problems resulting from a stroke, multiple sclerosis (MS) or Parkinson's disease

heart and circulation – such as rehabilitation after a heart attack

lungs and breathing – such as chronic obstructive pulmonary disease (COPD) and cystic fibrosis

Physiotherapy can improve your physical activity while helping you to prevent further injuries.

Yes. These can be arranged for patients who are disabled or are too ill to attend the practice.

Yes, Physio Med is a registered provider for most medical insurance companies.

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