Hip Conditions

Bursitis

Hip bursitis is caused by inflammation of a small jelly-like sac that usually contains a small amount of fluid. Bursae act as cushions between bones and the overlying soft tissues, and help reduce friction between the gliding muscles and the bone.

The bony point of the hip is called the greater trochanter. It is an attachment point for muscles that move the hip joint. The trochanter has a fairly large bursa overlying it that occasionally becomes irritated, resulting in hip (or trochanteric) bursitis.

The main symptom of hip bursitis is pain at the bony point of the hip. The pain often extends to the outside of the thigh area. The pain is usually described as sharp and intense. Typically, the pain is worse at night, when lying on the affected hip, or after a period of inactivity. Sitting in a deep seated chair or automobile can create increased symptoms. It can make prolonged walking, stair climbing, or squatting difficult and painful to perform.

There are several factors associated with the development of hip bursitis:

Repetitive stress (overuse) injury. Long distance running, frequent stair climbing, bicycling, or standing for long periods of time are examples of the repetitive motion/use that may lead to hip bursitis.

  • Hip injury. An injury to the point of your hip can occur if you have a heavy fall upon your hip or if you incur a sharp bump to your hip. An example of a hard bump would be banging into the edge of a table.
  • Lying on one side of your body for extended periods of time can irritate the bursa.
  • A variety of musculoskeletal factors can contribute to the development of hip bursitis such as poor core strength, unequal leg lengths, gait deviations, and spinal deformities such as scoliosis.

Physical therapy is often recommended to relieve the inflammation, provide customized exercise and stretching instruction, and assist with improved biomechanics to relieve hip strain.

Hip arthritis

Total hip replacement

The hip is one of the body’s largest weight-bearing joints. It consists of two main parts: a ball (femoral head) at the top of your thighbone or femur that fits into a rounded socket which is called the acetabulum in your pelvis. Bands of tissue connect the ball to the socket and provide stability to the joint.

The most common cause of chronic hip pain and disability is arthritis. Osteoarthritis, rheumatoid arthritis, and traumatic arthritis are the most common forms of this disease.

  • Osteoarthritis usually occurs in people above 50 years of age. In this form of the disease, the cartilage cushioning the bones of the hip wears away. The bones then rub against each other, causing hip pain and stiffness.
  • Rheumatoid arthritis is an autoimmune disease which damages the cartilage of the hip, leading to pain and stiffness.
  • Traumatic arthritis can follow a significant hip injury or fracture. The cartilage of the hip ball and socket becomes damaged and, over time, causes hip pain and stiffness.

Exercise is a critical component of recovery following a hip replacement. Physical therapy is a significant resource to assist you to resume most normal light activities of daily living within 3 to 6 weeks following a total hip replacement surgery.

Your physical therapy program will include:

  • A graduated walking program, initially in your home and later outside
  • A cardiovascular conditioning program to slowly increase your mobility and endurance
  • Specific, customized exercises several times a day to restore movement and assist with regaining your leg strength
  • Gait training assisting you to transition from an assistive device such as a walker or crutches, to a cane and ultimately to the most desirable situation which is no assistive device at all!

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