Hip Pain Physiotherapy Treatment in Gurgaon

Causes of Hip Pain

Anterior Hip pain may be due to

• Hip Osteoarthritis – It is the most common cause affecting the old age group, resulting in pain with sitting or prolonged standing. Difficulty in hip movements especially external rotation and abduction. The patient may also present with an antalgic gait pattern which often starts gradually. Best revealed in X-Ray.
• Hip Fracture - It can affect any age group but commonly occurs in older age again due to osteoporotic bone which causes fractures even after a minor fall in the bathroom. The patient complains of an inability to bear weight on the affected leg and presents with an abducted and externally rotated leg.
• Avascular Necrosis – It may occur in adults after an accident which results in poor blood circulation in the hip joint and does not allow bone to reunite or heal. It is also presented with an antalgic gait but has a history of accidents. It is misdiagnosed in early stages but can be present in X-Ray in later stages.
• Femoral Neck Stress Fracture – It generally occurs in sportspersons by an overuse injury or improper muscular energy balance of Hip muscles. It is also presented with difficulty in walking or going back to sports activity. The patient will be unable to stand or move his leg freely.
• Spondylolisthesis and Spondylolysis – Scottish dog appearance wearing a collar is a clinical feature in X-ray and MRI for Spondylolysis. Similarly, the head elongated from the neck of the dog is a characteristic feature of his thesis. Spondylolisthesis also shows Step-up deformity on physical examination. It usually restricts backward bending as the body may further slip on bending.
• Labral tears – It is associated with overuse and gradual injury and is presented as a popping, catching, or clicking sound associated with activities such as dance, gymnastics, hockey, basketball, and soccer. It is tested physically by FABER Test and revealed by MRI.

Lateral Hip pain may be due to:-

• Greater Trochanteric Bursitis – It usually affects more in 40-60 years of females. It results from the tight IT band or Gluteus medius tendinopathy causing friction over the greater trochanter. The patient has lateral side pain and tenderness at a Hip joint or GT. Pain is usually affected by sleeping on the same side or after physical activity.
• Piriformis Syndrome – Deep buttock pain which is often associated with no injury, pain usually gets worse after prolonged sitting, especially in a car. It can also cause Sciatic Nerve compression which radiates pain from your buttock to thigh to the lateral side of the leg to the big toe. It can be tested only physically through the Seated Piriformis Stretch test.
• SI Joint Pain – Pain is referred to as hip due to SI Joint dysfunction. Tenderness and pain are present at PSIS or L5 level. Can be tested by X-ray or physical examination by FABER Test or SLR positive above 80degrees. It can also lead to LBP due to a decrease in hip joint mobility.
• Coccyxodynia – It is an uncommon injury that results only after a fall in a sitting position or prolonged sitting on an unpadded surface. It is also termed as tailbone pain due to the same reason. It may also coexist with low back pain.
• Coxa Vara or Valga – It is an abnormality of the neck of the thigh bone (femur) characterized by an increase or decrease in neck-shaft angle. It may result in marked shortening or lengthening of the leg. Trendelenburg gait pattern is noticed in these types. It occurs due to the mal-development of bones during growth. Revealed by measuring the Neck shaft angle in an X-ray of the hip joint.
• Legg-Calve-Perthes disease – It is most common in young age boys of 2-6 years and is characterized by avascular necrosis and malunion of the epiphyseal growth plate. The patient presents with a painless limp, antalgic gait, muscle spasm, and aim in the hip, thigh, or knee. This condition requires early consultation with the doctor in order to prevent further deformity.

Physiotherapy Treatment for Hip Pain in Gurgaon

• Pain, inflammation, and muscle spasms can be reduced by – Cryotherapy in the initial stages and Thermotherapy in later stages. Both the Ice pack and Moist heat pack can be applied for 10-15 minutes.
• Use of cast and avoid external rotations in case of dislocations of the hip.
• Improvement of ROM exercises can be done by Passive ROM exercise, Active assisted ROM to flexors, extensors, abductors, adductors, and rotators is prescribed according to the hip condition.
• Strengthening exercises for Hip muscles can be done by Resistive strengthening exercises, PRE, Active resisted exercises, and isometrics all are done according to the patient's condition and gradually progress.
• Stretching exercises for the Piriformis, gluteus muscle, and hamstring muscles are also required often. Stretching of QL, Iliopsoas, and quadriceps is also required according to the condition.
• Prevention of contractures in the immobilization phase is important by making patients prone to lying, or sustainable slow stretching of the hip joint muscles.
• Thera band exercises in the non-weight bearing phase can be started in a lying position for various groups of muscles.
• Clamshell exercises for abductor weakness are very beneficial exercises.
• Hip mobility exercises like Dead bugs, Cat and camel exercises, Superman exercises, and Pelvic tilting result in greater mobility of the Hip joint in the initial pain phase.
• Weight-bearing and non-weight-bearing with the help of crutches and crutches are taught in certain cases like during post-op rehabilitation of Total hip replacement, or fracture.
• Different Gait patterns can be taught on parallel bars with the help of mirror feedback.
• Wobble board training can be done for balance.
• Once the patient achieves functional balance and gait, our focus shifts towards strengthening Hip muscles to prevent further damage or to maintain the current status.
• Advanced strengthening exercises like wall-supported squatting, side lunges, forward lunges leg presses, one-leg squats, full squats, and sumo squats all are done according to the patient and progress gradually.

Different strategies for the different conditions of the hip according to the patient are applied to avoid any further complications. Therefore, for a better rehabilitation program contact our physiotherapy clinic in Gurgaon, or reach us at our different branches in Gurugram. For further details contact at 8929294515