Did you know that hip problems are common in active people? Many people are unsure of the reason for their ongoing hip stiffness and soreness associated with sport and exercise. Three main categories typically classify hip problems in physically active people 18-50 years of age, femoroacetabular impingement (FAI) syndrome, acetabular dysplasia and other causes. The three categories relate to the bony shape of the ball and socket hip joint structures and the health of tissues inside the joint during activities.
The symptoms can range from stiffness to pain, clicking and giving way. Many describe feeling their symptoms in front of the hip deep in the groin area, while others report of buttock and thigh pain.
FAI syndrome is the most common of the three categories. It refers to symptoms linked to early contact of the thighbone (femur) and hip socket. The Cam and/or Pincer shapes, at the ball and socket of the hip joint, might limit the available joint movement and contribute to the early contact. The bone shape development might be related, and in response, to the level of sport played at a young age before bone growth has been completed.
Acetabular dysplasia also relates to the bony shapes of the ball and socket structures of the hip joint. Particularly the development and orientation of the socket (acetabulum). While the symptoms can be like FAI syndrome the cause is related to joint instability rather than early contact.
Other possible causes of hip problems include tissues inside the hip joint e.g. cartilage and ligaments that can co-exist with FAI syndrome and acetabular dysplasia.
In the presence of either category the hip joint can react to activities that place the joint at or near its end range of movement. Early symptoms of tightness and soreness see many people starting to stretch their hip(s) hoping this might help. The paradox to this is that stretching, might place the hip joint at or near its end of range, potentially increasing the symptoms and prolong the recovery.
A combination of clinical testing and scans are typically used to classify these hip presentations. Did you know that you can do the clinical testing accurately from the comfort of your location without travelling to a clinic? A recent study showed that telehealth clients (18-80 years of age) who performed clinical hip tests online were significantly more accurate in making the correct diagnosis (FAI syndrome) compared to in-clinic standard testing. At Performance Health Management we include the client performed clinical hip tests used in the study.
What can I do?
The good news is that rehabilitation programs can improve hip pain, function and strength. The current guidelines based on available evidence shows that physiotherapist led targeted strength training programs of at least 12 weeks are recommended first choice treatments. An increased knowledge of how to manage your hip health and hip surgery (e.g. arthroscopy) are strategies to consider that might provide complementary benefits.
Key take home messages
→ Ongoing hip tightness and soreness might not be muscular.
→ Stretching might irritate some common hips categories.
→ Online client performed clinical hip examinations show higher accuracy than standard testing for the most common hip presentation.
→ Physiotherapy guided targeted strengthening is recommended first choice treatment.