The hip provides support and shock absorption as well as balancing the body. This process requires mobility and stability. The hip moves in flexion, extension, abduction, adduction, internal and external rotation. Because of the high level of mobility in the hip, there is an increased chance of injury. The hip is stabilized above by the lower back and core as well as below by the knee. The hip consists of the pelvis bones and the femur (leg bone). The hip is a ball and socket joint that is held in place with a capsule, ligaments, and muscles.
Our initial goal is to assess the region and type of pain, the biomechanics and gait, and the history of the injury. In most cases, the injury is actually a tear in either the muscle or the tendon of the hip. Sometimes there is a lot of tearing and sometimes there is just a little tearing (microtears) that adds up over time. This tearing leads to inflammation (tendonitis), weakness, soreness, swelling, bleeding and eventually scarring (adhesion / fibrosis). The key to fixing hip pain, though, is to reduce or eliminate all of the above symptoms plus the adhesions and fibrosis that comes from the tearing process.
This causes decreased circulation and tightening of the muscle resulting in inflammation and lack of oxygen to tissues, creating biochemical changes, increasing fibroblasts and resulting in fibrosis and adhesions. More and more fibrosis and adhesions develop within the muscles causing the muscle to become less elastic (like a rubber band) and more leathery (like a belt). The more leathery the muscle becomes the more stress is placed at the tendon (where muscles inserts into bone). Too much load or force can create tearing of the tendon!