Tight Hips and Osteoarthritis

Do you have pain in your groin or thigh that radiates to your buttocks and flares up with vigorous activity?  Or do you have stiffness in the hip joint with occasional “locking” of the joint and a grinding noise during movement? If yes, we are going to discuss with you Osteoarthritis physical therapy and how it works.

Are you a runner or athlete who is struggling with tight hips or hip pain?

If so, you may have osteoarthritis or a possible precursor to what may cause osteoarthritis of the hip.  If you have already been diagnosed with hip osteoarthritis you may be taking anti-inflammatories and custom orthotics but are still experiencing pain.   Unfortunately popping a pill and adding excessive cushion to your shoes will only provide a band aid to the pain and will NOT fix the source of what is causing your issue.  Here is the good news; a diagnosis of hip osteoarthritis does not automatically mean a hip replacement is in your future.  There is a way to prevent this pain from getting worse or even stopping it all together WITHOUT giving up running!  Check out this clip to find out how.

What is hip osteoarthritis?:

Arthritis means “joint inflammation” and causes pain and swelling in the joints such as the hips and knees.  Hip osteoarthritis is a degenerative type of arthritis that occurs most often in those over the age of 65, though it may occur in younger people, too.

In osteoarthritis, the cartilage in the hip joint gradually wears away over time. As the cartilage wears away, it becomes frayed and rough, and the protective joint space between the bones decreases. This can result in bone rubbing on bone. To make up for the lost cartilage, the damaged bones may start to grow outward and form bone spurs (osteophytes).

Symptoms: 

The most common symptom of hip osteoarthritis is pain around the hip joint. Pain and stiffness may be worse in the morning, or after sitting or resting for a while. Over time, painful symptoms may occur more frequently, including during rest or at night. Additional symptoms may include:

1. “Locking” or “sticking” of the joint, and a grinding noise (crepitus) during movement caused by loose fragments of cartilage and other tissue interfering with the smooth motion of the hip
2. Decreased range of motion in the hip that affects the ability to walk and may cause a limp

3. Increased joint pain with rainy weather

4. A sound or feeling (“crunching”) of bone rubbing against bone

Causes: 

There are a few risk factors for developing osteoarthritis including: Increasing age, previous injury to the hip joint, obesity, and improper formation of the hip joint at birth known has developmental hip dysplasia.  Most of these factors are uncontrollable however there are a few mechanical factors that we can control.

For runners, several factors may put you at risk for osteoarthritis as well as other hip and lower extremity pain.  This includes faulty gait and movement patterns, muscles imbalances, and inadequate training.  Muscle imbalances can include muscles of the hip and leg that are elongated and weak as well as muscle groups that are shortened and tight.  These muscle imbalances can cause an improper alignment of the hip in the joint, and even further cause more faulty running mechanics.  When this happens excessive compressive forces in the joints can occur.

We may have a number of issues going on that include mobility, strength/stability, motor control, and dysfunctional running patterns.  It is always wise to address mobility issues first since if you lack the mobility to get into proper positioning strength and motor control components won’t be as beneficial.  Check out the self tests below to see if your mobility may be contributing to your issue.

Self Tests

Try out these self mobility tests on yourself to see if you may have inadequate hip mobility required for running:

1. Figure 4: Lay on a solid surface and rest your foot on the knee of the opposite leg. You should be able to lower your knee to two fist lengths off the ground without lifting up the opposite hip.
2. Hip flexion:  Lay on your back and pull your knees straight up to your chest.  You should be able to touch your abdomen with the top of your thigh without bringing your leg out to the side and the position should be pain free
3. Hip extension: Lay on a table where you can hang your leg off without touching the floor.  Bring one leg straight back to your chest allowing the opposite leg to hang off the table.  If your leg comes off the table or your knee straightens this means you could have tight hip flexors and inadequate hip extension.

Movement Rx Prescription for you: 

1. Perform the preceding tests, and work on the POSITIONS you found were limited.
2. If you are still having trouble, Call us at 1- 877-854-1343.

References: 

Siverling S, O’Sullivan E, Garofalo M, Moley P. Hip osteoarthritis and the active patient: will I run again? Current Reviews in Musculoskeletal Medicine. 2012;5(1):24-31. doi:10.1007/s12178-011-9102-y.

Orthoinfo. http://orthoinfo.aaos.org/topic.cfm?topic=a00213