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Hip & Groin Pain

Hip and groin pain is a common cause of dysfunction and activity limitation in the sporting, pediatric and older population. Hip and groin pain is common in athletes competing in tennis, football of all codes, long-distance running and hockey, and is the 3rd most common injury (5-15% of all injuries) reported in Australian Football (1). 

Physiotherapy can have a beneficial impact on the following common hip pathologies ;

Intra-articular:

  • Osteoarthritis (OA)

  • Femoral-acetabular impingement

  • Hip Joint instability

  • Labral and ligamentum teres tears

  • Chondral lesions

Extra-articular:

  • Adductor-related pain

  • Hip flexor related pain

  • Pubic-groin pain

  • Gluteus medius tendinopathy

  • Trochanteric bursitis

  • Rectus abdominis strains

The hip and groin region is a very complex area and is commonly called the Bermuda triangle of sports medicine. OA involves the weakening and eventual degradation of articular cartilage and is a very common articular hip joint pathology in the elderly population. Patients often complain of morning stiffness, pain with prolonged weight bearing and pain at night in the later stages. OA is usually found in patients over 50, however previous lower limb trauma, a family history of early onset OA or congenital conditions at birth can increase the risk of early OA in the younger population.

Femoral-acetabular impingement is a common morphological variant found in 20 percent of the population. Cam impingement is the abnormal growth of bone on the superior aspect of the femoral neck and is commonly symptomatic in young male patients that engage in sports like basketball or football. Pincer impingement is the abnormal growth of the acetabular rim, often superior and anteriorly. Pincer impingement is common in middle aged woman that are involved in yoga and dance-based activities. These conditions can happen together, with a mixed presentation found in 88% of people with FAI. 

 

The labrum is a ring of cartilage that deepens the acetabulum by 21% and increases the joint surface area by 28%. If the labrum wasn’t there,

the articular cartilage would take on up to 92% more contact stress. Repetitive activities that involve twisting/pivoting on a loaded femur have been associated with labral damage such as soccer, hockey, AFL, golf and ballet. 

 

Hip dysplasia refers to a wide variety of pathologies where the bones of the hip are not aligned properly, leading to improper orientation of the acetabulum to the femoral head, and a relatively unstable hip joint. More common in women and is often a common cause of early OA in women under 50.

Groin/hip pain may also be the result of soft tissue dysfunction. The adductors work together with the glutes to stabilise the pelvis and are commonly injured in sports that involve lateral changes in direction or kicking such as; rugby, football and hockey. 

The iliopsoas muscle group is made up of the iliacus, psoas major and in 60% of people, the psoas minor. These muscles flex the hip, provide stability to the lumbar spine and the femoral head during hip extension as you move through the stance phase of gait. Acute iliopsoas lesions are commonly linked to kicking or sprinting movements. Chronic pathology will present with pain on palpation and on stretch, as well as weakness. Pain will also be aggravated by running and speed training. 

 

The adductors and rectus abdominus attached into the pubic symphysis, high up in the groin. Osteitis pubis is a common injury we see in the clinic as it involves a bone stress reaction due to overloading forces through the muscles that attach here. Athletes involved in kicking and sprinting sports like football and AFL may present with this pubic pain that is often worse in the morning. 

 

The gluteus medius abducts the hip and acts as a pelvic stabiliser in stance phase, preventing your knee from dropping in. Gluteus medius tendinopathy and trocanteric bursitis are very common conditions seen in middle aged female distance runners and gym members that are unaccustomed to heavy leg training. Patients often report pain referring into lateral thigh or even into the knee, with symptoms relieved by exercise initially. 

 

These conditions are just a few we see and treat successfully everyday here at Game Time Physiotherapy.

 

If any of these presentations are similar to your pain, book an appointment online now or ask a question in the box below, so as a team, we can rid you of your hip or groin pain to allow you to take control of your health and perform at your best.

Have a question about your hip or groin pain?

Pain should never be accepted as 'normal' as it limits our ability to perform at our best and effects the quality of sleep we get. To take control of your hip pain, book an appointment online now to resolve this common disability for good. 

Contact Information:

Game Time Physiotherapy

1/449Lytton Road, Morningside QLD 4170

info@gametimephysio.com.au

References:

1. Brukner, P. & Khan, K. (2012). Brukner & Khan's Clinical Sports Medicine. NY, USA, McGraw-Hill Australia