Hip Pain

Hip arthritis is a common condition characterized by the deterioration of the cartilage in the hip joint. It may cause pain and stiffness in the joint and typically worsens over time. 

Hip arthritis can result from wear and tear of the cartilage, inflammation, and lead to joint damage. 

Snapping hip syndrome is a condition characterized by a snapping or popping sensation in the hip. Types of snapping hip syndrome include:

• Internal snapping hip syndrome: Occurs when muscles or tendons slide over each other near a bony prominence in front of the hip joint and is typically felt in the front of the hip or groin
• External snapping hip syndrome: Involves a tendon snapping over the bony prominence on the side of the hip and is typically felt on the outside of the hip

An acetabular labrum tear is a condition that affects the ring of cartilage-like material that follows the outside rim of the acetabulum (hip socket). The labrum helps secure the femoral head and allows smooth movement of the hip joint. A tear in the labrum can cause pain, instability, and decreased range of motion.

Hip flexor tendinopathy is a condition characterized by inflammation, irritation, or degeneration of the tendons of the hip flexor muscles, primarily the iliopsoas and rectus femoris tendons. The iliopsoas muscle, composed of the psoas and iliacus muscles, is a major hip flexor responsible for lifting the thigh towards the abdomen. The rectus femoris muscle, composed of a direct and indirect head, assists with both flexing the hip and extending the knee. Its tendon is found just above the front of the hip joint.

Iliopsoas and rectus femoris tendinopathy often affect athletes and people who engage in activities involving repetitive hip flexion.

Gluteal tendinopathy is inflammation, irritation, or degeneration of the tendons that connect to your buttocks muscles, also known as gluteal muscles. These muscles play a crucial role in stabilizing the hip and pelvis during activities such as walking, running, and climbing stairs.

Partial tears in the tendons of the gluteal muscles can occur from repetitive activities that overstrain the gluteal tendons, sudden injuries, and poor posture. 

Adductor tendinopathy affects the tendons of the adductor muscles, which are located on the inner thigh, causing inflammation, irritation, or degeneration. The adductor muscles help bring the legs together and stabilize the pelvis during movement. 

Repetitive activities, sudden injuries, poor posture, and muscle strain can also cause partial tears in the adductor tendons.

Hamstring tendinopathy refers to inflammation, irritation, or degeneration of the tendons that attach the hamstring muscles at the back of your thigh to the pelvis and knee. These muscles are crucial for bending the knee and extending the hip, helping with activities such as running, jumping, and climbing. 

The hamstring tendon can partially tear from repetitive activities involving high levels of hamstring use, sudden injuries, weak hamstring muscles, and poor posture.

Greater Trochanteric Pain Syndrome (GTPS) refers to pain and inflammation in the outer part of the hip, specifically around the greater trochanter. The greater trochanter is the bony prominence on the side of the hip where several tendons and muscles attach. It is typically seen in females between the ages of 40 and 60. 

Trochanteric bursitis occurs when a bursa near your hip joint gets irritated or inflamed. Bursae are small, fluid-filled sacs that cushion the bones and tissues around your joints. This condition can lead to GTPS. 

Ischiofemoral impingement is a condition characterized by abnormal contact between the top of the femur and the back of the hip bone that we sit on. Typically, these two bones touch smoothly without causing pain, but trauma, overuse, or surgery can damage them.

This impingement can lead to irritation of the soft tissues, including muscles, nerves (the sciatic nerve), and tendons, located in the space between these two bones. It can also cause the growth of bone spurs, which can rub on the femur and hip bones, causing more damage and pain.

Sports hernia occurs due to a tear, strain, or injury in the soft tissues of the lower abdomen or groin. It is a common musculoskeletal injury often seen in athletes involved in sports that require sudden changes of direction or intense twisting movements. Sports hernias typically involve an injury to the rectus abdominis and/or adductor tendons, as well as the tendons of the oblique muscles.

Nerve entrapments or impingements occur when nerves are compressed or irritated by surrounding tissues, leading to hip pain, numbness, tingling, or weakness in the affected area. 

Common nerves that cause hip pain due to entrapments include:

• Sciatic nerve: The longest nerve in your body, it originates from the lower back and runs down the back of your thigh
• Femoral nerve: Arises from the lower back and travels through the pelvis to the front of the thigh, providing sensation to the front of the thigh and allowing you to activate your anterior thigh muscles, such as the quadriceps
• Obturator nerve: Emerges from the lumbar spinal cord and passes through the pelvis to innervate the medial thigh and inner thigh muscles
• Lateral femoral cutaneous nerve: This sensory nerve provides sensation to the outside portion of the thigh, classically in a patch-like distribution, and can cause pain and altered sensation when compressed in the anterior hip region
• Iliohypogastric/Ilioinguinal/Genitofemoral nerves: These primarily sensory nerves provide sensation from the front of the hip region to the groin and can become entrapped anywhere from the lower back to lower abdomen or front of the hip