Hip Pain causes, symptoms and diagnosis. Laser treatment for Hip Osteonecrosis. Piriformis muscle and running injuries, Quadriceps tears and strains, Hip Bursitis Cold/low level laser therapy, for pain relief and the acceleration of the healing process.
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Hip Anatomy
The hip joint is a ball and socket joint. The ball is formed by the top of the thigh bone (femur) and is called the “head” of the femur. The socket is formed by the bones of the pelvis and is called the acetabulum. Ligaments tendons and muscles hold the head of the femur (the ball) in the acetabulum (the socket).
Articular cartilage is a smooth material that covers the head of the femur and the acetabulum. Articular cartilage covers the bony surfaces wherever they come into contact with each other. Articular cartilage allows the head of the femur to move freely inside the acetabulum as the leg moves. Fluid also aids the head of the femur move freely inside the acetabulum. This fluid is called synovial fluid and provides and lubrication to the hip joint.
The hip joint is surrounded by a “sack” called a joint capsule. Ligaments are like strong fibrous rope like structures that help connect bones and provide stability to joints. Ligaments reinforce the capsule and connect the head of the femur to the acetabulum. These ligaments prevent the head of the femur from coming out of the acetabulum. Larger, stronger ligaments also provide stability to the hip joint.
The acetabulum has a ring of tissue called the labrum (this circles the acetabulum) the labrum also helps provide stability to the hip.
Tendons connect muscles to bone. There are various muscles that surround the hip joint. These muscles and their tendons provide stability to the hip joint when the leg is moved. These muscles are also necessary for activities such as running, jumping and walking.
The hamstring muscles (are at the back of the leg) act with the gluteus maximus (the “buttock muscle”) to move the leg backwards at the hip. The hip flexors (iliopsoas and rectus femoris) move the leg forward at the hip. The groin muscles (adductor magnus and longus) move leg toward the midline of the body. The abductor group (gluteus medius, gluteus minimus and tensor fascia lata) move the leg away from the body and are also stabilize the hip joint.
A bursa or bursa is a small sac of fluid which limits friction between muscles, tendons and bones. The principle bursa of the hip joint is the bursa of the greater trochanter. This bursa is placed outside of the hip joint. An injury can occur by a direct blow or falling directly onto the outside of the hip, or from overuse.
One of the most common causes of hip pain is the inflammation of the bursa called hip bursitis. A bursa is a fluid filled sac that allows extra protection for the tendons on motion between two uneven surfaces. For example, in the hip, a bursa rests between the bony prominence over the outside of the hip (the greater trochanter) and the firm tendon that passed over this bone. When the tendon has to move over the bone and over the inflamed bursa it will result in pain. Because patients with hip bursitis move this tendon with each step, hip bursitis symptoms can be quite painful. Hip bursitis presents as the pain on the outside of the upper thigh. Management of hip bursitis is often directed on balancing the function of hip, knee and pelvis thus eliminating the cause of the pain as well as local application of the cold laser directed on suppression of inflammation and accelerating healing of the soft tissues
Another less common cause of hip pain is Osteonecrosis of the joint.
Hip Osteonecrosis, also called Avascular necrosis, is a condition when the blood supply to the joint gets impaired. An interruption of the blood supply to the head of the femur (the ball, of the ball-and-socket hip joint will cause a decrease in delivery of oxygen and nutrients to the bone, with subsequent necrosis of the bone and collapse of the bone.
Causes of Hip Osteonecrosis?
Exact causes of hip osteonecrosis are unknown. Because the cartilage of hip joint looses the support of the bone underneath itself, the joint surface is quickly worn away, and arthritis quickly progresses.
Most cases of hip Osteonecrosis are associated with either alcoholism or steroid use. Other less common risk factors for developing hip Osteonecrosis include sickle cell disease, trauma to the hip (dislocation or fracture), lupus, and some genetic disorders.
Symptoms of Hip Osteonecrosis
Common symptoms of hip Osteonecrosis include:
Aching pain in the groin
Pain with movement of the hip
Difficulty walking or presence of limp
Diagnosis of Hip Osteonecrosis
Osteonecrosis of the hip is primarily radiological diagnosis. The X-ray may be completely normal, or it may show severe damage to the hip joint. If the X-ray is normal, an MRI will be performed to look for early signs of hip Osteonecrosis.
The Piriformis muscle.
The piriformis muscle is a small muscle in the groin that runs from the sacrum to the outer hip bone. Should the piriformis muscle becomes tight or cramps it can put pressure on the sciatic nerve which passes underneath the piriformis muscle. Typically this pain increases when the muscle contracts, when sitting for an extended time, or direct pressure on the muscle. Gluteal (or buttock) pain is common. Pirformis syndrome is also a common cause of sciatica
Pain can also be caused by prolonged external rotation of the hip so that the piriformis muscle is shortened. If the sciatic nerve is compressed for an long time there may be aching in the leg and pain in the low back.
Shortening of the muscle and compression of the nerve is the most common cause of piriformis Syndrome, but overuse of the gluts and other muscles in the hip can also cause muscle spasms of the piriformis. Other factors in this syndrome include poor body mechanics and posture, gait problems.
The Quadriceps muscles.
The quadriceps muscles group includes four muscles located in the anterior thigh. This muscle group acts to extend the leg while straightening the knee. A pulled or strained quadriceps muscle causes pain in the front of the thigh. A severe pull or muscle tear causes an abrupt, sudden, acute pain that occurs during activity (often while sprinting). It may be accompanied by swelling or bruises on the thigh.
A pulled quadriceps is often the result of a strength imbalance between the quadriceps and the hamstring. Strong hamstring muscles in the back of the leg and weak quadriceps muscles in the front of the leg can result in a pull or a tear. Such a muscle imbalance is not uncommon among runners, since running tends to work out the hamstrings much more than the quadriceps.
The quadriceps is a group of muscles along the front of the thigh. It consists of the quadriceps femoris, the rectus femoris, vastus lateralis, vastus medialis and the vastus intermedius.
A pulled or strained quadriceps muscle can be identified by a pain in the front of the thigh. A severe tear is abrupt, sudden, and results in acute pain during the activity (often sprinting) and may be accompanied by swelling or bruises on the thigh
Cause
Typically, a pulled quad is the result of a strength imbalance between the quadriceps and the hamstring group, where the hamstrings are more powerful. This is a common muscular imbalance in runners, because running tends to use the hamstrings more than the quadriceps.
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Cold/low level laser Therapy
Types of Soft Tissue Pain.
There are two main types of soft tissue injuries: the strain and the sprain.
Muscle Strain is associated with overstitching or tear of the muscle. During muscle strain the actual muscle fibres are damaged. Muscle fibres are muscle cells that are grouped tightly together to form a muscle. In a muscle strain, the muscle fibre links are separated or even broken, causing muscular damage.
Muscle sprains associated with overstretching or tear of the ligaments. The ligaments connect the muscles to their bone attachments. Ligaments are very tough fibrous connecting tissues made of chains of tough cells grouped together to increase their strength. In a muscle sprain, these chains are separated or torn, causing ligament and/or muscle damage.
Cold/Low Level Laser Therapy (LLLT) is a Handheld, non invasive, light-emitting medical device which is used over different areas of the body. It provides an unmatched advantage in the treatment of conditions such as:
Hip Pain, Conditions and Disorders
Sacroiliac joint inflammation
Sports Injuries
Back and Lower Back
Hip, Leg, knee and Foot Conditions
Shoulder Conditions
Arthritic Pain relief.
Muscle Spasm
Relief of Muscle and Joints
Pain Relief and Stiffness and the Promotion of Muscle Relaxation and Cell Restoration
Wound Management including Skin Ulcers, Pressure Sores and Burns
Soft Tissue Injuries including Sprains and Strains, Tendonitis and Haematomas
Joint Disorders and Conditions including Arthritic pain relief and Tenosynovitis
Chronic pain including Trigeminal Neuralgia and Chronic Hip pain.
Hip Pain for further in depth information on Hip pain and injury treatment, please go to top left corner under “Pain” ”Conditions” or “Treatments” for “Cold/low level laser therapy”.
