Bursitis

Hip Bursitis is inflammation of one or more of the hip bursae. In a healthy hip, the bursa (fluid filled sack) functions as a cushion and gliding surface to reduce friction between the muscles, tendons, and bone when in motion. There are two predominant bursa in the hip, one located on the outside of the hip covering the greater trochanter (bony point of the femur) and the other located on the inside of the hip (groin side) called the iliopsoas bursa.

Trochanteric Bursitis

Trochanteric Bursitis is the most common form of Hip Bursitis. Symptoms usually begin with sharp, intense pain on the point of the trochanter of the femur on the outside of the hip joint and may extend down the thigh. Pain symptoms are usually worse at night when sleeping on the affected hip, when standing up after being seated for a while, and with activities such as prolonged walking, stair climbing, and squatting. Causes include repetitive overuse injury (running, stair climbing, cycling, prolonged standing), hip injury, Scoliosis, Arthritis of the lumbar spine (low back), pelvic injury, leg length inequality, Rheumatoid Arthritis, previous hip surgery, bone spurs, and calcium deposits.

Iliopsoas Bursitis

Iliopsoas Bursitis is inflammation of the bursa located under the iliopsoas muscle at the front of the hip joint. Common causes of Iliopsoas Bursitis are irritation produced by repetitive activities (running, swimming, soccer, ballet), muscle imbalance, tight psoas muscles, Rheumatoid Arthritis, Osteoarthritis, and as a secondary condition to Iliopsoas Tendonitis. Increases in activity levels, exercise, and stretching can aggravate the condition, resulting in further irritation and inflammation of the affected area. Symptoms include pain at the front of the hip that may radiate down to the knee or around to the buttocks. Occasionally, a snapping sensation may be felt in the hip. A person may also experience pain and stiffness in the hip when rising in the morning that eases throughout the day.

Hip Sprain

Hip Sprain injury occurs when one or more of the ligaments surrounding the hip joint is overstretched or torn. It is generally caused by a violent impact during contact, like tackling in football. Symptoms include pain in the hip with sudden movement, pain in the front of the hip, pain with leg extension backwards, bruising or swelling of the area, and relief of painful symptoms when flexing the hip toward the chest.

Hip Strain

Hip Strain happens when a muscle or tendon supporting the hip joint is stretched beyond its limit or is torn. The strain can be mild or severe and may involve a muscle, a tendon, or a combination of muscles and tendons with varying degrees of injury. Sudden motions, including running, sprinting, kicking, quick changes in direction while running, the impact from a fall, and a direct blow, can overstretch and tear the hip flexor muscles or tendons. Hip Strains are also overuse injuries caused by muscles or tendons that have become weakened over time by repetitive movement. Other risk factors for Hip Strain include prior injury in the same area, muscle tightness, failure to properly warm-up before participating in sports activity, and unaccustomed level or intensity of exercise. Symptoms of Hip Strain include pain and tenderness in the injured area, increased pain when using the affected muscle, limited range of motion, muscle weakness or inability to use the involved muscle group at all, increased pain when flexing the hip toward your chest, pain when stretching the hip muscles, muscle spasms in the hip and thigh, and swelling or bruising around the area of injury.

Iliopsoas Tendonitis

Iliopsoas Tendonitis is inflammation of the iliopsoas tendons or the area surrounding the tendons. The Iliopsoas muscle group consists of two separate muscles, the Iliacus and the Psoas Major. These muscles converge in the front of the hip and assist with motions such as, lifting the leg to a bent position (climbing stairs, running), rotating the leg outward (ballet, gymnastics), and helping to bend at the waist (sit-ups, crunches). This muscle group is constantly used and is involved (whether directly or as an assistant to the primary muscle group) in most of the body’s movements, making it susceptible to overuse. Iliopsoas Tendonitis is therefore predominantly the result of repetitive hip flexion and overuse of the hip in general that leads to weakening of the Iliopsoas muscles and tendons, irritation of the surrounding area, and inflammation. Symptoms begin gradually at the front of the hip and tend to increase over time. There is typically pain when engaging in movement that activates the Iliopsoas such as running, climbing stairs, sit-ups, squats, and lunges. Pain and discomfort may increase when stretching the hip backward (lunges, Yoga Warrior Poses). Other symptoms are muscle weakness, tenderness of the affected area, swelling, and pain with sudden movement. Additionally, due to it’s location, this condition can often be associated with Iliopsoas Syndrome, Iliopsoas Bursitis, and Snapping Hip Syndrome.

Snapping Hip Syndrome

Snapping Hip Syndrome is also known as Iliopsoas Tendonitis, Coxa Saltans, or Dancer’s Hip. This condition is characterized by a snapping sound or snapping sensation when the hip is engaged in motions such as walking, running, squats, and lunges. The snapping is often caused by a muscle or tendon moving from one side of a boney structure in the hip to the other. As these tendons slide across the boney structures, the tissue can thicken and catch with motion creating inflammation. The Iliotibial Band moving across the thigh bone on the outside of the hip (Greater Trochanter) is the most common site of Snapping Hip Syndrome. Other tendons associated with Snapping Hip Syndrome are the Iliopsoas, Rectus Femoris, Tensor Fascia Latae, and Gluteus Medius. Symptoms include: Pain or discomfort in the front of the hip, sharp sudden pain, pain that worsens with activity, weakness in the muscles and tendons of the hip, and dull or achy pain that can persist for months or years.

Hip Labral Tear

A Labral Tear in the hip involves the band of cartilage, labrum, that surrounds the boney socket of the hip joint. The labrum cushions the joint and acts like a rubber seal or gasket by stabilizing the ball of the thighbone firmly within the hip socket. A Labral Tear occurs when a portion of the labrum is separated or torn away from the hip socket. Most Labral Tears are the result of repetitive trauma to the joint caused by overuse and the extreme ranges of motion required in various sports activities. Athletes who participate in sports such as, ballet, gymnastics, golf, ice hockey, soccer, football, etc., have the greatest risk of developing a Hip Labral Tear. Symptoms can include a deep ache in the front of the hip or groin, sudden painful clicking or catching when moving, a feeling of something stuck inhibiting motion in the hip, increased pain with prolonged sitting or walking, sharp pain in the hip or groin when squatting, stiffness in the hip, and weakness in the muscles surrounding the hip.

Hip Impingement

Hip Impingement, also known as Femoroacetabular Impingement (FAI), is most frequently diagnosed in active adults in their 20s, 30s, and 40s. Abnormal contact between the hip’s bones or between the hip’s bones and cartilage produce pain and a decreased range of motion. Causes of Hip Impingement stem from unusual bone growths that can occur near the femoral head, at the edge of the hip’s socket, or in both locations simultaneously. These excessive bone growths form bumps and malformations which can prevent the femoral head’s full rotation within the hip socket, damage the articular cartilage (cartilage lining the femoral head and hip socket), and pinch the labrum (ring of cartilage surrounding the hip socket). If left untreated, a Hip Impingement can lead to Hip Osteoarthritis and, if the labrum is affected, a Hip Labral Tear. Symptoms include: Intermittent pain of the hip and groin, a sharp pain in the groin that accompanies squatting, twisting, and pivoting movements, a dull ache in the hip or groin after prolonged sitting, walking, or exercise, a feeling of something stuck inhibiting motion in the hip, a limited of range of motion (often inability to flex the hip beyond a sitting right angle position), stiffness in the hip, and muscle weakness.

Arthritis

Arthritis is not a single disease; it is an informal way of referring to joint pain or joint disease. There are more than 100 different types of arthritis and related conditions. Two of the most common types of arthritis diagnosed in the hip are Osteoarthritis (OA) and Rheumatoid Arthritis (RA).

Osteoarthritis (OA) occurs from the prolonged wear and tear on joints. There is a dense protective cartilage covering the ends of the bones, which allows them to slide easily. Over time however, the cartilage becomes worn down and the bones begin to rub against each other, which causes the symptoms of osteoarthritis. Certain individuals are more at risk for developing osteoarthritis. Older, females (twice as likely as men), Caucasian, and/or overweight individuals are more at risk for developing OA. Injuries such as fractures and dislocations can increase the risk of developing OA. The most common symptoms of osteoarthritis of the hip include: Pain, swelling, stiffness, joint weakness, chronic pain, limited mobility, and reduced range of motion.

Rheumatoid Arthritis (RA) is an autoimmune condition where a person’s immune system attacks the lining of the joints. Rheumatoid arthritis will affect joints on both sides of the body, such as both hip joints. This symmetry sets it apart from other types of arthritis. Rheumatoid arthritis can also affect the skin, eyes, lungs, heart, blood, or nerves. Symptoms associated with rheumatoid arthritis in the knee include: Pain, stiffness, a dull ache in the outer thigh, groin, or buttocks, pain that is worse in the morning or after prolonged sitting that lessens with activity, increased pain/stiffness with vigorous activity, fatigue, skin rash, mild fever, loss of appetite, joint weakness, limited mobility, and a loss in range of hip motion. Symptoms of RA can last weeks or months at a time, but overall, RA is a slowly progressing disease. Causes of Hip RA are unknown, but it is believed that factors such as genetics, environmental exposures (bacteria, viruses, secondhand smoke, air pollution, insecticides, etc.), intestinal disorders, and hormone imbalances may contribute to triggering the condition.

Iliotibial band Syndrome

Iliotibial Band Syndrome (ITBS) is a type of tendonitis that occurs in the long tendon (IT Band), which runs down the outside of the thigh from the hip to the knee. When this tendon becomes overly tight, it can rub against the bone (lateral epicondyle of the femur) on the outside of the knee causing friction, pain, and inflammation. ITBS is an overuse injury caused by repetitive flexion and extension of the knee, which makes athletes such as runners, cyclers, and weightlifters particularly susceptible to developing the condition. Other risk factors include tight tensor fascia latae muscles (muscle of the hip), weak gluteus medius muscles, poor foot biomechanics, tight inner thigh muscles, and poor exercise/sports training technique. Symptoms consist of pain on the outside of the knee; soreness or tightness in the IT Band; and pain when bending or straightening the knee. The pain typically comes on as activity begins and gradually worsens. Rest will usually alleviate the symptoms, but will return with continued activity.