The hip joint can be imagined as a ball and socket and is subject to large forces which can sometimes be many times the body weight. This is due to the long, lever-arm mechanism of the lower extremity, with the hip joint being the fulcrum. The hip joint is surrounded first by ligaments that act like ropes to keep the femur (ball) and acetabulum (socket) together. Muscles on the front, back and sides of the joint surround the ligament capsule to move the leg and trunk. These surrounding muscles are subject to increased loads over time. Tendons, which attach muscle directly to bone are especially susceptible to repetitive stress, possibly resulting in tendonitis. Some tendons are protected from the underlying bone by a lubricated cushion called a bursa. A bursa lies underneath two outer hip muscles (the tensor fascia latae and gluteus medius). Any bursa within the body can be inflamed from repetitive stress of the overlying muscle or tendon. This leads to our second source of hip pain, called bursitis of the hip. Both of these conditions fall under the umbrella term called Greater Trochanteric Pain Syndrome.
The tendonous portion of a muscle typically has poor blood flow, making it more susceptible to degenerative changes or tendonitis over time. You can think of tendonitis as:
- unorganized ropes that are pulling the wrong way (disorientation of collagen fibers)
- abnormal amounts of tissue being laid down in an attempt to heal the injured tissues (increased cellularity or scar tissue)
- an area not getting enough of the nutrients it needs to heal if left untreated (lack of blood supply)
Assessment of this type of condition will usually begin with a history and physical exam performed by a knowledgeable health care professional. Treatment may include:
- correcting any postural or muscle imbalances that may have predisposed you to an injury in the first place.
- shockwave therapy, which is used to remove harmful scar tissue, remodel the surrounding tissues, and make new very small blood vessels, called capillaries, in the area to increase its chance to heal properly.
“After a couple of years with a weak muscle in my hip that caused severe pain, I can finally say I am painfree and am now able to increase my daily walking routine. The relief I felt from the RPW shockwave therapy was immediate. My treatment regime is still ongoing, but it has already improved my quality of life.”
We’d like to help you improve your quality of life, too. If these symptoms are familiar to you, book an appointment to get some relief.
by Dr. Brigitte MacPhail, Chiropractor