Hip Pain

August 14, 2017

 

The hip joint consists of a joint formed by the acetabulum and the head of the femur. These structures are covered with cartilage that allows movements to be made. The hip performs the movements of flexion, extension, abduction, adduction, internal and external rotation, in addition to the surrounding movement.

 

Some diseases, such as osteoarthritis, arthritis, circulatory disorders of the femoral head (osteonecrosis), and others can cause injuries to the articular cartilage of the hip and compromise movement. Gradually, the patient presents with pain and the decrease of the movements preventing to carry out activities of the day to day.

 

In some cases the lesions may be treated with physiotherapy, however, when there is irreversible hip wear it may be necessary to perform a hip arthroplasty to restore joint movements and relieve pain. 


Arthroplasty is a surgical procedure that consists of replacing the fermoral head as an acetabulum by a prosthesis, which is formed by a metal rod and a prosthetic head.

Surgery improves the quality of life of the patient who can walk and perform their activities without limitations. 


If the material of the prosthesis is of good quality it can last up to 25 years. 
After the arthroplasty the accompaniment of a physiotherapist is essential for the recovery of the movements. The practitioner will set the limits of the patient to start a treatment plan with the intention of restoring strength and balance. 


Among the exercises used for the rehabilitation of a patient who underwent hip arthroplasty surgery are: active exercises, strengthening, proprioception, gait training and hydrotherapy.

The amount of exercise should be increased according to the patient's ability to perform the movements. 


Physiotherapeutic treatment is indispensable for patient recovery after hip arthroplasty. It is important to seek a professional who understands the mechanisms of surgery so that complications do not occur.

 

Why does the hip ache?

One of the causes is pelvic injury. It is a consequence of micro-injuries and inflammation between the bone of the pelvis, the muscles of the inner thigh and the abdominals. What leads to discomfort is the overload of repetitive efforts and movements during the practice of some sport. The pain can be on one side or both. To make it easier to rest and physiotherapy sessions. If necessary the doctor will recommend the use of anti-inflammatories.

Muscle strain may mimic hip pain

 

Distension is the stretching or rupture of a muscle or tendon, which may occur in the flexor area of ​​the hip. The cause of this discomfort has to do with overuse or jerky movements when the hip is not well heated. Hip distension is common in both athletes and sedentary people. Some of the symptoms are: pain, swelling, bruising, limitation of movement, irradiation of pain to neighbouring muscles and muscle stiffness. One of the physiotherapeutic treatments to deal with the picture is the micro electric current that will stimulate the absorption of inflammatory fluid and lead to relaxation of muscle fibers. This therapy can be associated with laser and ultrasound.

 

Stretching in this case is contraindicated until the patient feels no further discomfort. Women are the ones who most feel this kind of discomfort that starts at the side of the hip and can reach the thigh. At night the pain always worsens. Bursitis is an inflammation of the bursa, which is like a pouch with a small amount of fluid that exists in various parts of the body, such as shoulder and knee.

 

When diagnosing the problem the doctor advises treatment and the role of the physiotherapist is indispensable. It is he who will correct the patient's posture and teach it to lengthen the hip muscles, and, if necessary, use other types of apparatus to relieve pain.

Never ignore the pain

 

Run, climb stairs, crouch or cross legs ... Simple day to day activities can contribute to that recurring hip pain and in some cases even irradiation to the thigh and knee, causing a feeling of discomfort. And that picture may get worse in a few years. Data released by the International Osteoporosis Foundation has shown that the number of hip fractures caused by osteoporosis is expected to increase by 32%. What is already estimated is that currently occur more than 121 thousand fractures in this part of the body every year in Brazil.

Frequently Asked Questions

 

If you have noticed a discomfort in the hips, do not hesitate to seek a physiotherapist or doctor for a dysfunctional diagnosis and start treatment.The causes that most affect men and women are:

  • Bursitis Trocantérica

Corresponds to an inflammation of the pouch which is present lateral to the femur in its proximal part and occurs due to a friction of a fibrous tissue of the thigh on the bone.

  • Tendinopathies

It can be an inflammation or even a degenerative process of some tendons around the hip. This pain caused by tendinopathy limits the patient's movement, which makes it difficult to perform daily tasks.

  • Osteonecrosis

When there is death of bone cells provoked when there is an interruption of the blood supply to the femur. The person may lose his or her movements.

  • Fractures

Fractures are more common in women over 65, with falls being the main reason.

 

When to be suspicious of a hip injury?

You should see a specialist when you experience pain in the hip joint, the groin area, and the inside of the thigh, which may radiate to the knees.

Get medical help as soon as possible!

 

Walking, climbing or descending stairs, crouching, crossing legs, shoe shine, changing clothes ... Simple daily activities can contribute to that recurring hip pain and in some cases even irradiation to the thigh and knee, causing the feeling of discomfort and loss of strength.

This condition may worsen over the years, especially if it is left aside for an extended period of time.

 

In addition, data released by the International Osteoporosis Foundation show that people with osteoporosis or simply osteopenia have a greater chance of developing hip problems. It is noteworthy that many patients of the third age end up evolving to placement of hip prosthesis when the pain is very intense!

 

However, there are many non-surgical options for chronic hip conditions like femoroacetabular impact , osteoarthritis, arthrosis or even arthritis!

 

A person who walks, runs, and exercises normally suddenly begins to feel a pain that begins in the groin radiating to the hip. What can it be? Depending on the age she may have a hip arthrosis , since it is one of the diseases that most affects the hip. The disease affects articular cartilage, being characterized by new bone formation in bone surfaces and margins.

The problem reaches an average of 5 to 10% of the population, preferably women over 55 years. 


Although this pathology is caused by cartilage deterioration, some factors may be involved in the onset of the disease. Among them: advanced age, obesity, joint overload, hip dysplasia (morphological alterations), trauma sequelae, inflammatory joint diseases and infectious processes. 

The first symptoms may be mild discomfort in the thigh or knee area. When the cartilaginous tissue is finally worn, the movement becomes very painful.

Therefore, when you experience severe pain in this region, it is important to seek a doctor or physiotherapist for a thorough examination of the whole body, assessing joint movements and gait quality.

 

BURSITE

 

Feeling pain on the side of the hip and the area of ​​the femur can only be a sign of Bursitis. Bursitis consists of an inflammation in the area of ​​friction between tendons and bones. And when the pain is on the side of the hip, near the bone region it is called trochanteric bursitis.

 

The problem worsens when the person climbs a ladder, running and can still feel a palpitation of the side of the hip, generating a very great nuisance. Generally, this type of bursitis comes accompanied by other inflammations in the tendons, fascias and muscles.

One of the main symptoms of hip bursitis is the lateral pain of the thigh, especially when lying on the affected side. In the early stages, the pain can be acute and intense, preventing the patient from getting around easily. But it is usually at night that the picture worsens. In addition, pain may also appear when the person remains standing for a long time or when climbing stairs.

 

The inflammation of these bursas in the hip occurs due to excessive friction caused by decreased flexibility, muscular weakness, biomechanical dysfunctions or even direct trauma.

Risk factors

 

Patients with trochanteric bursitis often have one or more of the following conditions: 


- Overuse stress or dynamic valgus injury. This injury can be triggered if the patient insists on running, climbing stairs, cycling or standing for a long time; 
- Spinal problems such as scoliosis, arthritis of the lumbar spine, among other problems. 
- Rheumatoid arthritis. This disease makes the bursa more prone to inflammation; 
- Inequality of lower limbs. A person who has one leg shorter than the other leg may cause irritation on the hip bursae.

 

What is the difference between tendinitis and hip bursitis?

When you feel a pain in the hip that prevents the movements you are in doubt if you have tendinitis or bursitis? There is a difference between these two diseases that affect the hip.

Tendonitis, for example, is inflammation in the tendons of the gluteal muscles. Generally, the pain is located in the lateral region of the hip that can radiate to the side of the thigh.

Tendonitis is caused by increased exercise load and over-impact of the tendon against bony prominences. 


The diagnosis of tendinitis is made through physical examination that analyzes pain, sensitivity and loss of function. In addition, the patient does tests such as nuclear magnetic resonance and ultrasound.

The treatment can be divided into stages. The first one consists of pain relief, inflammation and edema using electrothermotherapy techniques such as laser, ultrasound and combined therapy. The second stage is made through strengthening exercises, flexibility, joint mobilization and sensory-motor training.

What about Bursitis?


Bursitis is an inflammatory process that occurs in a pocket (bursa) that has the function of decreasing the friction between the tendons and bones.When occurring in the hip bursitis can affect the subtrochanteric bursa - located laterally to the hip, just below the major or sciatic trochanter.

 

Although bursitis is also an inflammation in the hip it is caused by decreased flexibility, muscle weakness and biomechanical dysfunctions.

Anyone who has bursitis may feel pain in the side of the hip. Examinations such as MRI may be asked to check for inflammation.

 

The treatment can be done with physiotherapy that aims to decrease inflammation, relieve pain and decrease friction on the bursae. Electromo-therapy, manual therapy and biomechanical correction with muscle strengthening exercises and sensory-motor training can be performed by the physiotherapist to recover movement in the hip.

 

THE LABRUM ACETABULAR INJURY

The labrum is characterized by a fibrocartilaginous structure that lines the acetabulum and aims to maintain the intra-articular pressure by aiding the distribution of the synovial fluid. However, when there is injury to the labrum caused by trauma, there is a joint effusion with inflammation and release of chemicals that can cause damage to joint cartilage and pain in the area.

 

Capsular looseness, hypermobility, hip dysplasia and joint degeneration are also among the causes. 


The symptoms are pain in the hip joint, the inguinal region (groin) and the inner side of the thigh, which may even radiate to the knees. It is important not to ignore the pain, as often the lesion of the labrum in the hip is mistaken for extra-articular injury such as muscles and tendons.Therefore, when noticing any pain or discomfort it is recommended to seek a specialist. 


To diagnose the problem, the specialist may request tests such as X-rays and magnetic resonance imaging (MRI). The radiographs can detect the presence of femoroacetabular impact and confirm the presence of lesion of the labrum.

 

The treatment is conservative and must have physiotherapy sessions. Initially sessions can relieve pain and inflammation with electrothermal therapy, manual therapy, biomechanical correction with muscle strengthening and sensory-motor training. Physical activities should be decreased and movements that cause pain should be avoided. Arthroscopic surgery should only be performed in cases in which conservative treatment does not improve.

 

HOW TO TREAT OSTEOARTROSIS OF HIP

When pain is associated with cartilage loss it can be a sign of osteoarthritis - a degenerative joint disease that causes a lot of pain and disability of the movements. This problem can affect any joint, however, when it hits the hip or knees the damage is greater. The person may have difficulty in getting around and practicing limited physical activity.

 

Osteoarthrosis may be a consequence of other diseases, such as congenital hip defects, avascular necrosis of the femoral head, inflammatory diseases, childhood hip diseases, as sequelae of hip fractures and secondary to femoroacetabular Impact. 
Symptoms can be a discomfort in the gluteal or thigh region during physical activity and tend to be progressive and evolve. 

Before starting any treatment, it is important to make the diagnosis of the disease. It is done through a physical examination and based on the patient's medical history. Treatment may be surgical or non-surgical. Depending on the case, the patient can do physiotherapy to ease the pain and recover the movements. The goal of this treatment is to minimize the progression of the lesions, to prevent joint limitations and deformities, and to improve the patient's quality of life.

 

The patient is able to regain muscle strength and movements through therapeutic programs. In addition, he should do targeted physical conditioning exercises that have the effect of improving strength, endurance, and flexibility. The surgical treatment is indicated for the more advanced cases of the disease, being more common the total hip arthroplasty.

 

WHAT IS PYRIFORM SYNDROME?

When pain arises in the hip and radiates to the legs accompanied by numbness and tingling, many people soon seek a doctor because they believe they have inflammation in the sciatic nerve. However, the origin of the problem may not be the spine but in the hip, being a syndrome of the piriforme.In the region of the buttocks, is the piriformis muscle. From the moment that this structure undergoes an overload or a weakness, the sciatic nerve can ignite provoking the piriformis syndrome.

 

This dysfunction occurs in individuals with anatomical changes. In this case, the person may develop the syndrome when running with the toe pointed out, especially in races that have slopes. 


The main symptoms of this syndrome are numbness, tingling and intense pain in the lateral and posterior region of the thigh. When you notice the symptoms, it is important to seek a doctor to make a diagnosis and to identify if the source of the problem is in the spine or the hip. The doctor should examine the back, hip, lower limb and examine if there is any inflammation present in the sciatic nerve. Examinations such as nuclear magnetic resonance of the spine and X-ray can be requested.

 

Treatment is conservative through Physiotherapy. The patient can make ice pack and apply under the spot, keep to rest and start a rehabilitation program as soon as possible. To relieve pain, physiotherapy is indispensable in the treatment of the syndrome. Several techniques of muscle relaxation and myofascial release of piriformis can ease pain and symptoms. In addition, electrothermal therapy equipment, ultrasound and combination therapy can be used during the procedure. 


If you are in doubt whether your pain is a spine or hip problem, do not hesitate to seek a physical therapist or doctor to make a dysfunctional diagnosis.

 

Differentiating the piriformis syndrome from sciatic nerve pathology

Most people who experience pains that radiate to the legs accompanied by burning and numbness believe that it is an inflammation in the sciatic nerve. However, these signs can mean a Piriformis syndrome or simply a piriformis contracture. This problem strikes people who remain seated for a long time, since the region is prone to receive overload in the gluteal region. Diagnosis is necessary to confirm pyriform syndrome and rule out other types of diseases in the spine or hip.

 

CHARACTERISTICS OF IMPACT SYNDROME IN HIP

The pain may sound like an alarm for a hip disease. The hip joint is deep and an anterior impact between the structures of the head of the femur and acetabulum can lead to the femoroacetabular impact or hip impact syndrome. 


This impact may favor the onset of osteoarthritis in young adults. Anatomical changes of the femoral head, hypermobility and muscular imbalance are one cause of the problem. 
Muscle imbalance consists of an exaggerated action of the posterior muscles of the thigh. This occurs in movements involving squats, for example.

Types of impact:


Pincer type - the cause is an excess of acetabular coverage on the anterior border. This change may cause injury to the labrum and the more peripheral range of acetabular cartilage.

Type Cam - is the result of repetitive contact between a femoral neck-to-acetabulum transition. This may cause a degeneration of the articular cartilage due to the shear force transmitted to the anterolateral portion of the acetabulum.

 

Mixed Type - represents more than half of the impact cases and is also associated with the two previous types.

 

Symptoms 
Most of the patients who present the femoroacetabular impact are between the third and fifth decade of life. Pain radiates to the region of the thigh or knee, which may delay the diagnosis, as the syndrome may be mistaken for muscle injuries (thigh or groin strains). Pain may worsen after and during physical activity.

 

Treatment 
The treatment of the syndrome can be done with physiotherapy and guidelines when practicing physical activity. The patient should avoid an overload or exercise and impact sports that require hip flexion or opening. The patient should be evaluated periodically, and may use medications eventually. Physical therapy should be done only as maintenance of joint mobility.

Prevent yourself! 


Check out some tips to avoid bursitis in the hip: 
-Warm up before sports; 
-Avoid carrying excessive weight; 
-Practice physical activity without excess.

 

TENDINITE ILIOPSOAS IS CAUSED BY THE EXCESSIVE USE OF HIP

Simple day to day activities like climbing stairs, sitting, running or walking can cause a pain in the front of the hip due to tendon wear. This condition is characterized as iliopsoas tendinitis . The psoas muscle originates from the lumbar spine and attaches to the iliac muscle in the pelvis and forms the iliopsoas that extends to the front of the thigh. Iliopsoas tendonitis is an inflammation of the iliopsoas tendon that affects the anterior hip movement. This is because of excessive use of muscle.

 

The hip is a joint composed of muscles, tendons, nerves and vessels, these structures are more likely to suffer an injury. Sportspeople like: Soccer players are the ones who suffer most from this type of tendonitis due to the movement of the kick.

 

This pain in the hip region can progress during physical activity and decrease with rest, but symptoms may return to appear. Iliopsoas tendonitis can occur due to : Muscle contraction, strength training, repetitive movements and injuries to the hip that also contribute to the origin of this inflammation. 


The diagnosis of tendinitis is made during the medical appointment and examinations such as X-ray and MRI can be requested to check the lesion. 


Treatment may be conservative including rest, ice and leg elevation. Physical therapy may also contribute to muscle recovery through massage and physiotherapeutic methods to accelerate patient recovery.

 

OSTEOPOROSIS IS ONE OF THE MAIN CAUSES OF FRACTURES IN THE HIP

Osteoporosis is a silent disease that rarely presents symptoms before the person suffers a serious consequence like the fracture. The disease consists of reducing bone mass, which weakens the bones, meaning any trauma that the person suffers may occur a fracture in the spine or hip. 


This problem affects the elderly, especially women.  Women suffer more with the disease because of the fall of the female hormone estrogen after menopause which is important for the fixation of calcium in the bone. With their loss, the woman has a reduction in bone mass which accelerates reaching 25% of the skeleton is as osteoporosis settles. 
The bone affected by osteoporosis suffers porosis - the formation of large pores or gaps between the bone tissue. Early in the disease, the patient shows no symptoms. In advanced stages of the disease may occur fractures that cause pain and limitation. 


HIP FRACTURE IN 
Who has the disease is likely to suffer fractures in the spine or hip. The falls in the elderly can cause fractures, reduce the mobility of the individual and cause a silent complication. Women have up to three times more likely to suffer falls. 
It is noteworthy that osteoporosis is responsible for the excess breakage of the femur and pelvis,It is the main cause of suffering, disability and premature death in the elderly. 

 

HAVE YOU REALIZED A LOCK ON HIP?

Who play any sport complains often of a crash in the hip often accompanied by hooked. This is due to the practice of hip rotation movements.

Athletes who practice martial arts, football and other sports that require contact need to be alert to any locking signal as these cases this problem can indicate a hip injury called femoroacetabular impingement (IFA).

 

This syndrome is a condition in which the bones of the pelvis (acetabulum) and the femur (femoral neck) have a change in their shape causing a deformity. This problem causes an imperfect fit of the bones damaging the joint. In addition to changing bones in the hip, changes in the growth plate in the hip development and biomechanical changes in the lower limbs can also be a cause of the syndrome. Patients with this syndrome may experience muscle pain, joint pain locking and inguinal (groin).

 

It is important to consult a doctor for tests to be done to identify the syndrome. imaging with X-ray, computed tomography, magnetic resonance imaging, among others. Treatment can be conservative or surgical. If conservative treatment, physical therapy may be indicated. Exercises can be done for biomechanical correction, muscle strengthening, balance and proprioception can be associated with electrothermal technology to decrease pain and inflammation. Patients who have undergone surgery can also opt for physical therapy to regain hip postoperative three or four months later.

 

WOMEN ARE THE MOST AFFECTED BY THE DISEASE ON HIP

The female audience is the most affected by diseases of the hip, this because the bowl is wider and muscles tend to be weaker. Women between the ages of 50 and 60 are undergoing hormonal changes in the postmenopausal period also changes occur in tissue elasticity and the loss of calcium. 


The hip injury may arise due to aging and also by repetitive movements of any body part. Those who practice some physical activity such as running, for example, also features more likely to develop a problem in the region. Possible injuries, we can highlight:

 

  • - Injuries of the pubic symphysis: symphysis injury in which is located at the end of the abdomen muscle is considered one of the main departures from physical activities. The problem may arise due to the use of inappropriate shoes, excessive workouts on hard floors.

  • - Osteonecrosis hip: occurs when blood to the bone is broken. The lack of blood causes a failure of bone cells leading to a change in the format and also the functioning of the hip. Osteonecrosis can still cause a arthrosis.

  • - Tendinitis: is the excessive and abnormal use of the tendons around the hip leaving them inflamed. The inflammation can cause pain and limited range of motion in the hip region.

  • - trochanteric bursitis: is caused by friction on the bone of the femur called greater trochanter which is located on the side of the thigh. Women are more affected because the pelvis is wider. The emergence of bursitis is also related to inflammation in the tendons.

 

TRAINING IN EXCESS MAY CAUSE AN TENDONITIS MUSCLE IN MIDDLE GLUTEUS

Exercising the body is good for health, however, overdo the training can trigger various injuries, especially in the hip region. 


The painful sting you feel in the buttock may be an indication that you developed a "trocanterite", ie, inflammation of the insertion of the gluteal hip. The joint overload, is the hip joint, knee and ankle favors the onset of tendon lesions. 


The hip, the tendons of the gluteus muscles (maximum, medium and minimum) tendon ilio-psoas muscle and the adductor muscles are the main affected. Generally, those with inflamed tendons will complain of pain in the hip region side, specifically on the trochanter of the femur which often extends to the lateral aspect of the leg.


In cases of tendinitis cause is related to the increase in exercise load and excess friction in the tendon. Some people may also have biomechanical changes that may favor the overload tendons and accelerate this inflammatory process.

 

Be wary of the symptoms
can be wary of tendonitis in the hip, it is important to pay attention to the limitation of motion in the hip which tends worse at night and the pain up and down stairs. 
By detecting the symptoms is advised to seek an expert to conduct clinical tests or even imaging tests.

 

Treatment can be divided into two stages. The first consists in the control of pain, inflammation and edema Eletrotermofoterapia through laser techniques, ultrasound and combination therapy. The second stage consists in correcting biomechanical dysfunctions through stretching exercises, strengthening and joint mobilization. 
In most cases, conservative treatment can achieve satisfactory results, and essential surgery.

 

HIP REPLACEMENT

 

What is?

It is surgery to replace the hip joint with a prosthesis. The hip is formed by the head of the femur and the acetabulum, these two regions are replaced by a metallic femoral component and the acetabular polyethylene or ceramic fixed with bone cement (total hip arthroplasty - THA).

indications:

The THA is indicated to restore the hip joint in cases of:

  • Osteoarthritis of the hip

  • femoral head necrosis

  • Rheumatoid arthritis

  • Femoral neck fracture

  • Sequelae of Legg-Perthes disease-Calvée

Post-operative care:

The patient underwent THA care must be taken in the placement and performance of daily activities, as some movements of the hips and adduction (close the leg beyond the line of the body), medial rotation (to rotate the leg inward) and bending up 90 ° (approximate pen trunk) can displace the prosthesis.

  • Laying, should keep her legs apart with the aid of a triangular cushion between your knees, avoiding leaving the operated leg round inside;

  • Avoid rotations / twists on the operated leg;

  • When sitting on the toilet or chains, one should keep the torso bent back and the operated leg stretched and slightly opened;

  • Avoid sitting on very low place;

  • Use extender toilet;

  • Not cross the operated leg;

  • When getting off the bed must first turn the body to the operated side and sit with upper body leaning back, keeping the leg straight, you should slip to the edge of the bed;

  • When climbing stairs, first put the leg-op and after the surgery. When descending reverses the order, first puts the operated leg and then not operate.

Hip prosthesis requires physiotherapy before and after surgery 
the hip or femur prosthesis is surgery indicated for patients with poor bone formation, wear or trauma after a serious accident.

 

Usually I hear say that athletes such as marathon runners, had the procedure, but also the elderly are the most affected. With advancing age the low estrogen production and that is the hormone responsible for protecting the bones from decalcification, therefore, increases the risk of osteoporosis and hip wear, leading to surgery. The first sign of the disease is the discomfort and stiffness in the groin, difficulty to move, rotate or flex the hip. When the cartilage wears down completely the deterioration level of pain. Initially, when the picture is not so severe, physical therapy is indicated to strengthen regional muscles and range of motion. But if necessary the patient will be referred for surgery.

 

When we speak of postoperative treatment sessions will help the person to return to their normal activities more quickly and prevent falls or sprains. The physical therapist will perform active exercises ankle and knee to keep the hip mobility. In addition, gait training is also indicated after the medical release. For an anti-inflammatory and analgesic work of the tissues around the hip and knee may be the electrotherapeutic resources as GIC or laser used.

You can practice physical exercises with the hip prosthesis?

 

Many people are away from sports for extremely become unable to perform activities due to certain diseases such as osteoarthritis of the hip. It is characterized by joint wear in the hip and often responsible for early surgical treatment.

 

In the case of young patients, it is caused by intensive trauma sequelae or osteonecrosis, which is the loss of femoral head circulation, which occurs mainly in childhood, and can be triggered by sequelae of infections or severe forms of disease autoimmune. For the elderly, as well as any joint has connected to its cause degeneration genetically determined and developed over the years.

 

Also known as coxarthrosis initially has a symptom that manifests deeply with groin pain. This pain can radiate to the knee from inside and the front of the thigh. After the completion of more intense exercise, pain arises by stitching. These symptoms extend for many years and slowly worsens.

 

In this process of evolution, the pain may appear during routine activities evolving commitment to the sport performance. Actions such as cutting toenails, put on your shoes and get in and out of the car began to be hampered by the loss of joint movement. In the most advanced stage of the disease where the nocturnal pain and morning stiffness arise, begins the actual loss of quality of life.

 

The treatment of osteoarthritis is individualized, ie, according to the degree of the disease and with the expectations and needs of each patient. It is initially done with physical therapy to strengthen the muscles and maintains regional range of motion. impact exercises should be avoided. Since the decision to perform surgery should be made jointly by the patient and the specialist.

 

In the case of surgical treatment is the most appropriate implementation of total hip replacement. There are many prostheses, using as basic material a metal alloy, polyethylene and ceramics. The fixation of the prosthesis can be made with cement or other securing mechanisms. The model to be used for each implant will vary according to the age of the patient, type of disease causing joint destruction, the amount of bone and the surgeon's experience.

 

About 60% of patients with prosthetic hip can return to practice sports and this return is directly linked to the considerable reduction in pain. However, care should be taken when choosing the exercise to be practiced, for example, impact exercises like street racing, football and volleyball are to be avoided, after all, represent the fracture risk of double or failure of components the prosthesis.

 

Damage or release of some prosthetic component reaches about 14.3% of the population only number that reinforces the need for guidance for a return healthy and safe maintenance of physical activity, sport or leisure. correctly follow the guidance of a physical therapist reduces the chances of new lesions or that may damage the prosthesis.

 

PHYSIOTHERAPY TO RELIEVE PAIN IN THE HIP

The hip support around the body and are able to perform a greater range of motion. One of the most common causes of hip pain is bursitis , osteoarthritis, muscle pain and nerve compression. 


In the case of bursitis that are more frequent in women of age 60 35 consists of an inflammation of the bursa on the outside of the hip joint (femoral trochanter), called trochanteric bursitis. It can cause pain to the hip movement.

 

In some cases the pain can is associated with inflammation of the tendons around the hip. This pain may limit the patient finds it difficult to move around and also to do physical activity. 
When you feel severe pain in the hip region it is important to see a doctor for a thorough examination. The diagnosis will evaluate the movements of the joints, the level of pain and gait quality. 


After this thorough assessment, some tests should also be made as X-ray, computed tomography and magnetic resonance imaging.

 

Treatment with physical therapy can be an ally to eliminate pain and restore movement. In the case of bursitis, muscles and tendons compress the bursae affected leaving them irritated and painful. With physical therapy, you can extend these muscles preventing them to press the bursae and the result is a decrease in pain. 


Treatment of physical therapy include myofascial release, strengthening exercises and physical features such as laser and cryotherapy. During the session, the therapist should perform passive movements within the pain threshold. As the session advances, the patient may experience a decrease in pain and swelling. Gradually start moving and resistance exercises in order to rebalance the muscles.The number of therapy sessions will vary according to the stage and severity of the injury, the intensity of treatment and patient compliance.

 

POST-OPERATIVE OF DISEASES ON HIP

Pain that starts in the hip, thigh and radiates to the knee can be signs of arthrosis, the main disease that affects the hips in people after 45 years. Osteoarthritis is the degeneration of the joint between the femur and the acetabulum, generating a very intense pain and unresponsive to treatments such as analgesics and rest. The disease can progress and prevent the patient can walk, drive or perform simple everyday tasks. 


Osteoarthritis may annoy and evolve. It is more common in the elderly, can be treated with medication and physical therapy,but in some cases the pain is so intense that it is necessary to replacement surgery.

 

The hip replacement surgery - called hip replacement arthroplasty consists of replacing the hip joint with a prosthesis. The procedure can be partial, where the femoral head is replaced, or all, when replacing acetabular region (basin). The prostheses last about 15-25 years (depending on the patient's age and activity level.

 

After surgery the patient needs to follow some recommendations to ensure the success of the surgery. Rehabilitation is earlier, with exercises and gait training with the aid of a walker, crutches or canes are quite recommended by physiotherapists. These measures help to prevent complications that occur when the patient is lying much time and property (such as deep vein thrombosis and cardiorespiratory complications). 


Every one or two years, the patient should consult and make an assessment to analyze the functionality of the prosthesis, the positioning of implants and any signs of wear. Surgery is not the only solution. If you notice a different hip pain, see a doctor or physical therapist.

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