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Hip & Groin Pain

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What causes Hip & Groin Pain?

Do you have nagging pain in your hip or lower back? Is your back causing hip pain? Or is your hip causing back pain? Do you have groin pain that only comes on with exercise? Do you feel as though you may have a hernia but have been told other wise? Have you had scans on your hip but still do not have a definitive diagnosis as to what is exactly wrong? Maybe you are about to have hip surgery and need some help with your post operative rehab? If yes to any of the above, you have come to the right place.
Without a doubt, hip and groin pain can be highly complicated, primarily owing to the multitude of structures that can contribute to pain. The hip joint, surrounding muscles, tendons, ligaments, and even referred pain from other areas pose challenges in pinpointing the exact source of the pain. Effectively addressing and treating hip and groin pain often requires the expertise of a highly skilled and experienced physio team.

What Are The Most Common Symptoms Of A Hip & Groin Problem?

Hip and groin problems can manifest with a variety of symptoms, and the specific signs will vary depending on the underlying cause. Common symptoms associated with hip and groin issues include:
  1. Pain in the hip, groin, buttock, front of the thigh and can even radiate in to the lower back.
  2. Pain will exacerbate with walking or sitting.
  3. Pain or noticeable loss of movement when trying to bend forward to put socks on.
  4. Hip may give way and feel unstable.
  5. Pain at night that disturbs sleep and/ or pain laying on the affected side.
  6. Laying with your foot rotated out tends to feel more comfortable.
  7. Groin pain when coughing or sneezing.
  8. Pain near your sitting bones (ischial tuberosity) when sitting. This is usually reduced when shifting on to the opposite side and aggravated by sitting on a hard surface.
  9. Symptoms are aggravated by squatting.

Is my hip causing back pain? Or is my back causing hip pain?

Many patients may find themselves experiencing both back and hip pain simultaneously, a situation that can lead to confusion regarding where the origin of the problem actually is. What’s worse, we often encounter numerous patients who, in their pursuit of relief, undergo multiple scans and invest significant financial resources in treating lower back pain, only to discover that the underlying issue resides in the hip.

A thorough clinical examination of the lower back and hip joint can swiftly identify the root cause of discomfort and distinguish whether the problem is the lower back or hip joint. This approach not only streamlines the path to receiving the most effective treatment but also saves valuable time and money.

Hip and low back pain can present similarly due to the intricate relationship between the structures of the lumbar spine, pelvis, and hip joints. The nerves in particular that innervate the low back and hips often have overlapping pathways. Irritation or compression of these nerves can lead to referred pain that is perceived in both the low back and hip regions.

Common hip problems that can cause pain in the hip, groin and lower back region include hip arthritis, labral tears, hip impingements and hip dysplasia. This can make diagnosis challenging but clinical examination is key to differentiating between hip joint or lower back problem.

Top 9 most common hip & groin problems we see at Sharp Physiotherapy

Many hip and groin problems can cause pain, discomfort, and reduce your activity levels. Here are the top 9 hip and groin problems we treat at Sharp Physiotherapy:

  1. Hip Arthritis/ Joint Replacement
  2. Hip Labral Tears
  3. Femoral Acetabular Impingement (FAI)
  4. Hip Dysplasia
  5. Inguinal/ Sportsmans Hernias
  6. Adductor Muscle Strains
  7. Hamstring Muscle/ Tendon Injuries
  8. Gluteal Tendinopathy
  9. Hip Bursitis

Have you got a hip impingement?

Hip impingement, also known as femoroacetabular impingement (FAI), is a condition characterised by abnormal contact between the ball of the hip joint (femoral head) and the socket (acetabulum) during certain movements of the hip. This abnormal contact can result in friction, compression, and damage to the cartilage and soft tissues of the hip joint.

There are three main types of hip impingement:

  1. Cam Impingement: In cam impingement, there is an abnormality in the shape of the femoral head, typically at the junction where the neck meets the head. This abnormality can cause the femoral head to bump against the acetabulum during hip movement, leading to cartilage damage and pain.
  2. Pincer Impingement: In pincer impingement, there is excessive coverage or overgrowth of the acetabulum, resulting in a deeper and more prominent socket. This can cause the femoral head to impinge against the rim of the acetabulum, leading to cartilage damage and pain.
  3. Combined Impingement: Combined impingement involves a combination of cam and pincer abnormalities, where both the femoral head and acetabulum contribute to the impingement.

It’s important to recognise that the variability in symptoms does not necessarily indicate the severity of hip impingement or the need for treatment. However, individuals experiencing hip pain, discomfort, or limitations in hip function should seek a physiotherapy assessment. There are certain symptoms that are commonly associated with hip impingement and serve as key indicators for seeking an assessment.

While the presentation of symptoms may differ, there are several hallmark signs that individuals with hip impingement will often experience:

  1. Groin Pain: Discomfort or pain in the groin area is one of the most common symptoms of hip impingement. The pain may be dull, achy, or sharp and is often exacerbated by certain movements or activities.
  2. Hip Stiffness: Individuals with hip impingement may experience stiffness or limited range of motion in the hip joint, particularly during activities like putting socks on, walking, squatting, or climbing stairs.
  3. Pain with Activity: Hip impingement pain tends to worsen with certain movements or activities that involve flexing the hip joint, such as running, bending, squatting or sitting for prolonged periods.
  4. Clicking or Catching Sensations: Some individuals with hip impingement may experience clicking, popping, or catching sensations in the hip joint, especially during movement or changes in position.
  5. Radiating Pain: In some cases, hip impingement pain may radiate to the buttocks, thigh, or knee, mimicking symptoms of back or knee problems.
  6. Pain at Rest: While hip impingement pain typically worsens with activity, some individuals may experience discomfort or achiness in the hip joint even at rest, especially during periods of prolonged immobilisation or after prolonged activity.
  7. Difficulty Sitting Cross-Legged: Individuals with hip impingement may find it uncomfortable or challenging to sit cross-legged or with their knees bent for extended periods due to hip discomfort or stiffness.

Our top tips for preventing hip and groin pain:

  1. Incorporate Strength Training: Include strength training exercises that target the adductors, hip flexors and glutes as strengthening these muscle groups contributes to better hip stability and reduces the risk of pain.
  2. Avoid Squatting: While squatting is generally a beneficial exercise for strengthening the lower body, there are instances where individuals with certain hip problems may need to avoid squats or at the very least limit range to 90 degree hip flexion. This is often the case with patients who have hip impingement, labral tears or arthritis.
  3. Avoid Prolonged Sitting: When sitting, the hip flexor muscles at the front of the hip can become tight and reduce flexibility in the hip flexors. Sitting also puts constant pressure on the hip joints, particularly the hip sockets. Counteract this by taking lots of breaks or utilise a standing desk.
  4. Wear Supportive Footwear: Choose supportive footwear that provides proper arch support and shock absorption. This helps maintain proper alignment from the feet up, positively impacting hip and groin health.
  5. Address large leg length discrepancies:
    Leg length discrepancies, where one leg is shorter than the other, can contribute to hip pain. The uneven alignment alters the mechanics of the hips and pelvis, potentially increasing stress on the hip joints.
  6. Incorporate Flexibility Training:Regularly engage in flexibility exercises to maintain a full range of motion in the hips and groin. Stretching can help prevent tightness and enhance joint flexibility.
  7. Listen to Your Body:Pay attention to any early signs of discomfort or pain. If you experience persistent pain, tightness or notice changes in your hip range of motion, consult with a physio for timely intervention.

Why We Are Different

We do not just give out exercise sheets.

Many peoples perception of physiotherapy in the UK is that you get given an exercise sheet to do at home and nothing more. We diverge from this, and take a distinct approach to physiotherapy that offers a hands on and more personal approach.

Unlike many physiotherapy providers that merely hand out exercise sheets, we prioritise manual therapy techniques within the session to ensure not just quick, but often instant results for our patients. While our clinic places a strong emphasis on manual therapy for immediate pain relief, we do recognise the important of rehab exercises for long term health and injury prevention.

01

We get to the root of the problem.

We stand out by specialising in identifying the root cause of our patients’ issues rather than solely treating the symptoms. This approach allows us to provide personalised care that ensures long lasting results.

02

We do not try to sell you more appointments than you need.

We take pride in our approach because we don’t believe in recommending more sessions than you need. Unlike some practices, we don’t advocate for more sessions than necessary and our focus is on providing precisely the care you need to achieve the outcome you want, ensuring a cost-effective path to your recovery.

03

Frequently Asked Questions

What is hip arthritis and how is it diagnosed?

Hip arthritis, also known as hip osteoarthritis, is a degenerative joint condition that involves the breakdown of cartilage in the hip joint. Cartilage is the smooth, slippery tissue that covers the ends of the bones in a joint, allowing for smooth movement and cushioning between the bones. When hip arthritis develops, the cartilage in the hip joint wears away over time, leading to pain, stiffness, and decreased mobility in the hip joint

Hip arthritis is typically diagnosed through a combination of clinical examination and confirmed with imaging studies. Here’s how the diagnosis process generally unfolds:

  1. Clinical Examination: During a clinical examination, we will assess the your medical history and perform a physical examination.We will also palpate the hip joint for tenderness, evaluate muscle strength and joint stability, and perform specific tests to assess the joint.
  2. Imaging Studies: While a clinical examination provides valuable information, imaging studies are often necessary to confirm the diagnosis of hip arthritis and evaluate the severity of joint degeneration. The primary imaging modality used to diagnose hip arthritis is X-ray imaging. X-rays can reveal characteristic signs of hip arthritis, including joint space narrowing, osteophyte (bone spur) formation, subchondral sclerosis (hardening of bone beneath cartilage), and joint deformities.

How long does it take to recover from a groin strain?

A groin strain typically refers to a tear or injury to the adductor muscles, which are the muscles located on the inner side of the thigh that help bring the legs together. The severity of a groin strain can vary, ranging from mild disruption of the muscle fibers to partial or complete tears of the muscle tissue.

The time it takes to heal from a groin strain depends on several factors, including:

  1. Severity of the Tear: The severity of the tear, whether it’s a mild strain, moderate tear, or severe rupture, will influence the healing time. Mild strains may heal within a few weeks with conservative treatment, while more severe tears may require several weeks to months of rehabilitation and sometime surgery.
  2. Location of the Tear: The location of the tear within the adductor muscles can also impact healing time. Tears that involve the tendon or the attachment points to the bone will take longer to heal due to decreased blood supply.
  3. Quality of Rehabilitation: The quality and consistency of rehabilitation play a crucial role in the healing process.
  4. Individual Factors: Individual factors such as age, overall health, fitness level, and adherence to treatment and rehabilitation protocols can also influence the healing time for a groin strain.

Why am I getting hip and groin pain at night?

Hip and groin pain that worsens at night can be attributed to several factors. It’s important to note that while we can provide general information, specific cases may vary and it is always worth seeking medical advice when getting night pain. It is relatively common for inflammatory conditions, such as arthritis, tendinitis, labral tears or bursitis, to exhibit worsening symptoms at night. Our body temperature tends to drop at night during sleep, and inflammation does not usually favour  colder conditions.

What is a sportsman's hernia?

A sports hernia, also known as athletic pubalgia or inguinal hernia, is a condition characterised by chronic groin pain that occurs during physical activity. Unlike traditional hernias, sports hernias do not typically involve a visible bulge or protrusion in the groin area. Instead, they involve a weakening or tearing of the soft tissue structures in the lower abdomen and groin region.

An ultrasound scan performed by a hip and groin specialist, is often required to diagnose a sports hernia. Ultrasound imaging can provide detailed real-time images of the soft tissues in the groin and pelvic region, allowing the specialist to assess for abnormalities such as tears or weakening of the muscles and tendons. Additionally, a physical examination by a hip and groin specialist can help identify specific signs and symptoms associated with a sports hernia such as a dilated inguinal ring.

MRI scans can be useful for ruling out other potential causes of groin pain, such as hip labral tears or pelvic bone injuries. However, the subtle nature of sports hernias and the limitations of MRI imaging may result in inconclusive or nonspecific findings. Therefore, ultrasound imaging coupled with a physical examination remains the preferred diagnostic approach for diagnosing sports hernias.

The symptoms of a sports hernia can vary from person to person but commonly include:

  1. Groin Pain: Persistent or recurrent pain in the groin area, which will often worsen during physical activity, especially activities that involve twisting, turning, or sudden changes in direction.
  2. Pain with Movement: Discomfort or sharp pain with movements such as running, jumping, kicking, or cutting motions.
  3. Pain Relief at Rest: Pain may subside or improve with rest, but tends to return during physical activity.
  4. Tenderness: Tenderness or sensitivity to touch in the groin area, particularly over the pubic bone and the inguinal ligament.
  5. Pain Radiation: Pain may radiate to the lower abdomen, inner thigh, or testicles in some cases.
  6. Weakness or Instability: Feeling of weakness or instability in the groin and pelvic region, which may affect balance and coordination during physical activities.

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