susceptible to joint compression, tightness, and structural issues. Femoral neck fractures, Osteoarthritis, hip replacement, bursitis, and strains in the quadriceps, abductors, adductors, and hamstrings are treated with a variety of techniques: joint traction/mobilization, stretching, Graston, active release, and modalities.
The hip is
Femoral Neck Fracture
The hip joint, like the shoulder joint, is a “ball-and-socket” joint composed of the femoral head (the “ball”) and the acetabular labrum (the “socket”). The femoral neck is the region of the femur (thigh bone) that sits just below the ball. Femoral neck fractures are very common in the elderly population, which presents unique challenges for healing and as a result there is a high risk for resultant disability. Injury most often occurs as the result of degeneration over time combined with a traumatic incident such as a fall. Signs and symptoms include hip pain, bruising, loss of motion, swelling and weakness. Surgery is indicated to set the fracture in proper alignment and ensure optimal healing. In addition to rest, ice, and medications to reduce pain and inflammation, post-surgical physical therapy is indicated to regain strength and mobility in the hip, as well as to maximize overall patient function to decrease risk of permanent disability.
Hip Osteoarthritis/Hip Replacement
Osteoarthritis is a degenerative process in which joints wear down over time, causing inflammation and a change in the shape of the joint surfaces. Signs and symptoms include pain extending from the groin to the knee, limited motion, difficulty walking, and loss of muscle surrounding the hip (atrophy). In addition to rest, ice, and medications to reduce pain and inflammation, physical therapy is indicated to strengthen hip muscles and perform hip joint mobilizations to improve mobility. Because osteoarthritis causes irreversible changes to occur in the joint surfaces, hip replacement surgery may be indicated in patients who don’t respond to conservative therapy. Both the ball and socket of the joint are replaced, creating correctly shaped surfaces for proper articulation of the joint. In addition to rest, ice, and medications to reduce pain and inflammation, post-surgical physical therapy is indicated to regain strength and mobility in the hip.
Muscle Strain (Quadriceps, Groin/Adductors, Hamstrings)
A muscle strain is a small tear that occurs when a muscle or tendon is stretched beyond its limits. Common sites of muscle strains in the thigh include the quadriceps (front of thigh), adductors (groin/medial thigh), and hamstrings (back of thigh). Any sudden movement that causes a quick stretch to an unprepared muscle can cause a muscle strain. Signs and symptoms include pain and tenderness over the site of the strain, limited movement with pain, reported feeling of a “pop” during injury, bruising, and swelling. In addition to rest, ice, and medications to reduce pain and inflammation, physical therapy is indicated to introduce strengthening and mobility activities as tolerated.
A bursa is a fluid filled sac found in many joints that provides cushion between muscles or tendons and bones. This bursa can become irritated or inflamed due to friction, resulting in a condition called bursitis. Trochanteric bursitis is inflammation of the bursa located over the greater trochanter, a prominence on the lateral aspect of the femur (thigh bone). Injury most commonly results from repetitive hip flexion and external rotation, tightness of the iliotibial (IT) band as it passes over the bursa, or direction trauma. Signs and symptoms include pain and tenderness on the outside of the hip, as well as pain with standing, walking, sitting, climbing stairs, or bringing the leg across the body (adduction). In addition to rest, ice, and medications to reduce pain and inflammation, physical therapy is indicated to introduce strengthening and mobility activities as tolerated.