Physical Therapy for Hip Pain

The hip is a ball and socket joint consisting of the thigh (femur) and the pelvis. There are many ligaments that support the bones, which provide considerable stability to the joint. Numerous muscles also attach around the hip to help move the joint.
Hip pain can be caused by many factors. Often, you may start feeling hip pain for no apparent reason. Sometimes recreation or sports puts repetitive strain on the hip causing pain. Because the hip is a major weight-bearing joint, arthritis of the hip is a common problem. The hip is responsible for such functional activities as walking, running, rising from sitting, and climbing stairs. Pain in the hip can limit these activities.
Where Hip Pain Is Felt The hip is close to the low back, and it can be difficult to determine if your hip pain is truly coming from the hip or coming from your low back. The location of your symptoms can often help to solve this problem.

• Pain in the groin or front of the hip. If you feel pain in the front of the hip, this may due to arthritis in the hip joint. In younger people, anterior hip and groin pain may be caused by hip femoroacetabular impingement (FAI).Muscular strain around the hip can also cause pain here.
• Pain in the side of the hip. Pain in the side of the hip typically indicates a problem with the muscles or structures around the hip. A common problem here is hip bursitis. A bursa is a fluid-filled sac that allows muscles and bones to glide smoothly past one another. Bursitis is irritation of that sac. There is a large bursa on the side of the hip, and this can become irritated with repetitive strain or muscle imbalance. Iliotibial band pain can also arise from the side of your hip.

If hip pain persists for more than two or three weeks or occurs as the result of major trauma, a visit to a physician, physical therapist, or healthcare provider is recommended.
What to Expect From Physical Therapy for Hip Pain Your first visit to physical therapy for hip pain will begin with an initial evaluation. This visit is important to ensure correct diagnosis and proper management. During this visit, the physical therapist will interview you to gather information about the history of your problem, the aggravating and relieving factors, and about any past medical history that may contribute to the overall problem. From the information gathered during the history, a focused examination will be conducted.
The examination may consist of several sections including, but not limited to:

• Gait evaluation. A gait evaluation is an assessment of how you are walking.Physical therapists are trained to notice small changes in the hip during different phases of walking. This can help lead to proper management. Your physical therapist may also perform a video gait analysis to identify nuances in your gait that may be leading to your pain.
• Palpation. This involves using the hands to touch various structures around the hip to feel for abnormalities or to assess if a structure is painful to touch.
• Range of motion measurements. Range of motion refers to how far your hip is bending, straightening, or rotating. The physical therapist may use special instruments to measure how the hip joint is moving to help direct treatment.
• Strength measurements. There are many muscular attachments around the hip and a measurement of strength can help determine if muscular weakness or imbalance is causing your hip pain.
• Functional mobility tests. Your PT may watch you walk, climb stairs, or run to determine how your hip pain affects your overall mobility.
• Special tests. Special tests are specific maneuvers performed around the hip to help determine which structure may be at fault and may be causing the problem. This may include testing of the low back to determine if your hip pain is really coming from your spine.

After the initial evaluation, you and your physical therapist will be able to initiate a plan of treatment for your hip. The therapist may use physical agents like heat or ice help with inflammation.
Passive treatments like heat or ice may feel good, but active engagement in your PT program through exercise has been proven to be the best treatment for hip pain.
Exercises to improve hip strength or mobility may be prescribed by your physical therapist. You also may have to perform exercises at home each day as part of a home exercise program. It is important for you to be an active participant in physical therapy, and ask questions if you have any.
Exercises to improve the mobility or strength of your hip are important to keep your hip healthy. Simple exercises performed once daily are a good way to keep the hips working properly. As your hip pain improves, advanced hip strengthening may be another option to maximize hip function.
Research has also shown that joint mobilization techniques can help improve short and long-term pain in patients with hip osteoarthritis. This improvement in pain may also be accompanied by improved hip mobility.
The hip is a major weight-bearing joint in the body and is responsible for many functional activities such as walking and running, sitting and standing, and climbing stairs. Pain in your hip may limit your normal activities. Research has shown that working with a physical therapist can help improve your pain and overall mobility. By keeping your hips strong and mobile, hip pain can quickly be eliminated and a rapid return to normal activity can occur.