Understanding and Managing Hip Pain in the Active Patient

Hip pain is very common. I see it everyday in my clinic. Previously active patients are finding it harder and harder to do the activities they love because of hip problems. It affects people across all age groups and activity levels. Does running bother you? What about climbing stairs, flexing at the hip, or getting in a low chair? All of these can be the first tell-tale signs of a hip problem. With knee pain there are a multitude of different treatment options; from injections to arthroscopic procedures. However, until recently there have not been the same variety of excellent options to treat hip pain. No longer are our hip patients told to “wait it out” or immediately offered larger surgeries like a hip replacement. There is now a step-wise progression that takes people through a series of treatments designed to reduce pain and return them to an active lifestyle. These include such things as specialized injections, physical therapy, and medications. In many cases, hip arthroscopy can also offer patients an excellent new alternative and provide hope for a return to enjoying an active life.

In order to understand your hip problem, it is important to have a basic grasp of hip anatomy. The hip is a ball and socket joint that is contained in place by bone. A white smooth layer of cartilage covers this bony ball and socket. The loss of cartilage leads the way to arthritis of the hip. The labrum is a cartilage structure that surrounds the socket. It provides both cushion and a barrier to fluid leaving the hip joint. The hip capsule encloses all of these structures and also provides stability. Finally, the muscles and tendons around the hip joint allow the hip to move in different directions with speed and force. Hip pain can result from injury to any of these structures.

How did we previously deal with hip pain? How has this changed? Perhaps two examples illustrate this point best. An 18 year old female and a 45 year old male both come into clinic. The 18 year old loves to dance and has been having terrible hip pain with certain motions. The 45 year old loves to run, but has recently been having some hip pain in the front part of the joint. We used to tell the 18 year old to stop dancing and it would go away, well, it didn’t. Now we have the tools to implement a complete recovery process. We know that certain types of physical therapy can be very beneficial and may help avoid any type of surgery. However, this is not always the case. When therapy doesn’t work, hip arthroscopy can be used to help repair the problem in the joint and get her dancing again. What about the 45 year old with pain when running? Same story, previous medical thought would be that it is best if he stops running and probably has some “cartilage” loss in the hip. For someone that loves running, this isn’t a good solution. With our current treatment plans, we are able to offer many different options that will keep him running. Specialized therapy can help a runner compensate or correct for problems. The pain may also be due to a single incident of inflammation, in these cases, specific injections can sometimes relieve the pain instantaneously. Once again, if all of these treatments fail, all is not lost. The 45 year old has an excellent chance at running again with an arthroscopic hip procedure to repair some of the damage. This creates a new hope for active patients that have previously been told to stop what they love to do.

Dr. Van Thiel treats patients from all over Illinois including Rockford. Schedule an appointment with him today.


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