Hip injuries, including bursitis, hip labrum tears, hip FAI (femoroacetabular impingement), and snapping hip, are frequently encountered in physical rehabilitation. These injuries can be painful and debilitating, affecting everything from walking to sleeping and significantly restricting your daily activities. Fortunately, with the appropriate treatment, you can effectively manage and recover from hip injuries promptly.
Whether you are a professional athlete or simply living your daily life, understanding the causes and symptoms of these injuries, and the treatment options available is a must.
What is Bursitis?
Bursitis is a painful condition that affects the small, fluid-filled sacs known as bursae. These sacs cushion the bones, tendons, and muscles near your joints. When bursae become inflamed, it can cause significant discomfort. The most common areas for bursitis are the shoulder, elbow, and hip. This condition often develops in joints that undergo frequent repetitive motion, such as those used in sports or manual labor.
In hip bursitis, the bursa near the hip joint becomes inflamed, making it painful to move or put pressure on the hip. Some of the symptoms of hip bursitis include pain, tenderness, and swelling in the hip area. The pain may worsen with activities that involve the hip joint, such as walking, climbing stairs, or standing for long periods.
How Is Bursitis Detected?
A doctor can diagnose Bursitis with a comprehensive assessment of the patient’s medical history and physical examination. However, in some cases, additional testing may be necessary to confirm the diagnosis and rule out other potential causes of discomfort.
Imaging tests, such as X-rays, can help exclude other possible causes of pain. When physical examination alone is not enough, ultrasound or MRI can aid in the diagnosis. Your doctor might also order Lab tests to analyze fluid from the inflamed bursa and identify the underlying cause of joint inflammation and pain.
With proper treatment, bursitis pain typically subsides within a few weeks. However, it is not uncommon for the condition to recur. Your healthcare provider can help you develop a treatment plan to alleviate your symptoms and prevent future flare-ups.
What is a Hip Labrum Tear?
The hip labrum is a ring of cartilage that surrounds the hip joint, providing cushioning and stability. A tear in the hip labrum can occur due to sports injuries, repetitive motions, or degenerative changes. It can cause pain and discomfort in the hip joint, especially during activities that require bending or twisting of the hip.
Many factors can cause hip labral tears, including structural ailments, injury, and degenerative health conditions. Structural ailments, such as femoroacetabular impingement (FAI), can cause abnormal hip movement and lead to long-lasting groin pain and movement limitations. FAI is the most common cause of labral tears and can affect people of any age. Without proper treatment, it can even result in osteoarthritis in some patients.
Injury is another common cause of hip labral tears, particularly for those who engage in high-impact sports like ice hockey, football, soccer, and golf. Repetitive movements can put undue stress on the hip joint, leading to tears in the labrum.
Degenerative health conditions like osteoarthritis can also increase a person’s risk of developing hip labral tears. As the cartilage wears down over time, it becomes more prone to tearing. Older age and excessive weight can further increase this risk. Those with osteoarthritis often experience pain and stiffness in multiple joints, including the hip and knee.
How Is Hip Labrum Tear Diagnosed?
Some hip labral tears symptoms include hip pain or stiffness, pain in the groin or buttocks area, clicking or locking sound in the hip area when you move, and feeling unsteady on your feet. These can worsen when you bend, move, rotate the hip, exercise, or play sports. However, it is also possible to have a hip labral tear with no symptoms at all.
To diagnose a hip labral tear, a physical examination is necessary. The doctor may ask you to move your leg or walk around. Imaging tests can also help doctors diagnose a hip labral tear. The doctor may order X-rays to alert them to problems with the hip bones, such as femoroacetabular impingement or osteoarthritis, that may contribute to a labral tear and a painful hip. Magnetic Resonance Imaging (MRI) is another test that can show where a labral tear is and how severe it is.
What is Hip Femoroacetabular impingement FAI?
Femoroacetabular impingement (FAI) is a condition where bone spurs, or bone overgrowth, develop around the femoral head or along the acetabulum. This extra bone causes abnormal contact between the hip joint and the socket, hindering movement during physical activity. Over time, this can result in tears of the labrum and the breakdown of articular cartilage, ultimately leading to osteoarthritis.
There are three types of FAI:
Pincer impingement occurs when extra bone extends out over the normal rim of the acetabulum, crushing the labrum under the prominent rim of the acetabulum.
Cam impingement, is when the femoral head is not round and cannot rotate smoothly inside the acetabulum. This results in a bump forming on the edge of the femoral head that grinds the cartilage inside the acetabulum.
Combined impingement means that both the pincer and cam types are present.
Pain is the most common symptom experienced by individuals with FAI. It typically occurs in the groin area, although it may also be felt toward the outside of the hip. Activities such as turning, twisting, and squatting can trigger a sharp, stabbing pain. In some cases, the pain may be a dull ache.
Femoroacetabular impingement (FAI) Diagnosis
During your initial appointment, your physician will take the time to discuss your overall health and any symptoms you may be experiencing in your hip. Additionally, your doctor should thoroughly examine your hip to determine the root cause of your discomfort.
One test that your physician may perform is the impingement test. Your doctor will bring your knee up toward your chest and rotate it inward toward your opposite shoulder. If this maneuver recreates your hip pain, it is a positive indication of impingement.
Your doctor may order imaging tests such as X-rays, CT scans, or MRI scans. X-rays provide clear images of bone structure and can reveal any abnormalities associated with FAI. CT scans offer more details of the hip’s abnormal shape, while MRI scans can identify damage to the labrum and articular cartilage. In some cases, your doctor may also administer a local anesthetic to the hip joint as a diagnostic test. If the numbing medicine provides temporary pain relief, it confirms that FAI is the underlying issue.
What is a Snapping Hip?
Snapping hip syndrome, also known as dancer’s hip or coxa saltans, is a clinical condition characterized by a palpable or audible snapping sensation during the movement of the hip joint. This condition is caused by overuse, or trauma, such as intramuscular injection into the gluteus maximus or surgical procedures. Approximately 5-10% of the population is affected by snapping hips, with the majority experiencing painless snapping.
The snapping hip syndrome can be a frustrating and uncomfortable condition for those who experience it. While it is often painless, the snapping sensation can disrupt daily activities and even interfere with athletic performance. With proper treatment and management, most people can successfully manage their snapping hips and return to their normal activities.
Snapping hip or coxa saltans is classified into two distinct types:
External snapping hip is caused by the iliotibial band moving over the greater trochanter of the femoral head during hip movements such as flexion, extension, and external or internal rotation. This type of snapping hip is the most common and can cause discomfort and pain for those affected.
Internal snapping hip occurs when the iliopsoas tendon snaps over bony prominence in the hip area, such as the iliopectinal eminence or the anterior aspect of the femoral head. This type of snapping hip is difficult to diagnose without a thorough physical exam and imaging.
Differentiating between the two types of snapping hips is necessary to provide proper treatment and relief for patients. By understanding underlying causes and symptoms, healthcare professionals can provide targeted care and improve patient outcomes.
Diagnosing a Snapping Hip
The external snapping of the hip is typically more obvious during a clinical exam, with patients experiencing a snapping or sensation of subluxation of the hip. In some cases, physicians can even visualize or palpate the snapping phenomenon under the patient’s skin. Tests to provoke the snap usually include femoral rotation or flexion.
Internal snapping hip is usually described by the patient as a snapping or locking of the hip with an audible snap. Weakness in the gluteus medius may also be present.
If a diagnosis cannot be made through history and physical exam, imaging is used to confirm the diagnosis. Plain radiographs should be done to rule out anatomical variations, developmental dysplasia, or other hip pathology. A positive response to anesthetic joint injection in the affected area can help distinguish between external and internal snapping hip syndrome. The internal snapping hip syndrome can be confirmed using iliopsoas bursography combined with fluoroscopy, dynamic ultrasonography, magnetic resonance imaging, or magnetic resonance arthrography. By utilizing these diagnostic tools, physicians can accurately diagnose and treat the snapping hip syndrome.
How to treat Bursitis, Hip Labrum Tear, Hip FAI, and Snapping Hip
How to treat bursitis, hip labrum tear, as well as determining what to do for snapping hip or the best treatment for hip FAI requires a comprehensive approach that includes accurate diagnosis, personalized treatment plans, and careful management of symptoms. Healthcare professionals must work collaboratively with patients to determine the most appropriate treatment plan while minimizing risks and maximizing outcomes. These are a few examples of medical treatments for these conditions:
Prescription Medication: anti-inflammatory drugs, pain relievers, or muscle relaxants may manage the pain and inflammation associated with these conditions.
Injections: Joint injections such as corticosteroids or hyaluronic acid may provide pain relief and reduce inflammation.
Surgery: In severe cases, surgery may be necessary to repair or remove damaged tissue or to correct structural abnormalities in the hip joint.
Physical Therapy: can provide targeted exercises and stretches to improve mobility, strength, and flexibility in the hip joint.
Recovering from hip injuries can be a lengthy process that requires patience and dedication. The recovery process for bursitis, hip labrum tear, hip FAI, and snapping hip varies depending on the severity of the injury.
When to Seek Professional Medical Care
While many hip injuries can be treated with rest and home remedies, some may require professional medical care. Here are some signs that it’s time to seek professional medical care:
Severe Pain and Limited Mobility: If you experience severe pain and limited mobility in the hip area, it’s essential to seek medical attention to determine the underlying cause of the pain.
Sudden Onset of Symptoms: If you experience the sudden onset of hip pain, it’s important to seek medical attention to rule out any underlying medical conditions.
Difficulty Performing Daily Activities: If you experience difficulty performing daily activities due to hip pain or limited mobility, it is essential to seek medical attention to determine the underlying cause of the problem. Hip injuries can be painful and frustrating, but with the right diagnosis, treatment, and preventative measures, you can get back to a pain-free life.
If you are experiencing any symptoms of bursitis, hip labrum tears, hip FAI, or snapping hip, you must seek medical attention as soon as possible. Working with a healthcare professional to determine the best care and attention plan will help you get back to doing the activities you love without the pain and discomfort of hip injuries.