All things exercise, injuries, treatment & rehab!
Hip joint anatomy
The hip is a ball and socket joint which is inherently very stable. The femur (thigh bone) being the ball and the acetabulum (pelvis) the socket. It also has a ring of cartilage, called the labrum, which increases the depth of the joint and therefore makes it more stable.
Hip joint injuries
As with any joint, the hip can suffer from a number of different injuries.
Arthritis of the hip is fairly common, affecting around 1 in 9 adults over the age of 45 in the UK (1). It is a condition that can be managed in a number of ways but is likely to gradually worsen over time.
Hip impingement, known as femoracetabular impingement or FAI, is a common condition in sports people and is often considered to be a condition pre-disposing individuals to arthritis. Those suffering with FAI will often complain of a pinching sensation and pain deep in the groin.
There are two types of FAI; cam impingement and pincer impingement. Cam impingement occurs when the head of the femur isn’t perfectly round and this prevents the femur from moving smoothly in he acetabulum. Pincer impingement when the acetabulum covers the head of femur excessivley, often due to osteophytes, causing the neck of the femur to impinge on the acetabulum . This often causes pinching and can indeed lead to tearing of the labrum.
A torn labrum has recently gained notoriety as the most likely diagnosis for Andy Murray’s ongoing hip issues (2). A torn lbraum can cause significant pain and disability, particularly during sports and activities that involve twisting and turning movements.
Treatment of hip injuries
Rheabilitation of hip injuries involves considering a number of possible causative factors such as:
- training loads
- previous injury
It is possible that more than one of these factors combined is the root cause of hip issues and it requires evaluation from a qualified healthcare professional. Radiological investigations may also be useful in identifying the cause.
Rehabilitation should consider the causative factors and aim to address them in order to alleviate the symptoms, although it may not fix the problem. Treatments may include massage, manual therapy, stretches and strengthening exercises with r pharmacological interventions. Dealing with hip and groin problems can be difficult as can be seen with Andy Murray’s struggles over the past 9 months. Other high profile athletes to have hip issues include Leyton Hewitt and Steven Gerrard. Even Lady Gaga cancelled a tour due to a torn labrum!
Surgery of the hip, or any joint, is usually a last resort after conservative treatment and rehabilitation has failed.
Keyhole surgery to treat labrum related problems is usually successful in allowing return to sport and exercise. Obviously rehabilitation is extensive and hugely important for long-term joint health.
For serious arthritis problems, a full joint replacement may be necessary. This is now a relatively common and successful operation but does have its limitations. Exercise for example, will be limited to activities such as cycling, walking and running (with some restrictions) once recovery is complete.
Overall, you should never suffer with hip pain in silence and seek appropriate advice as soon as possible.
In a series of blogs, the PLPR team will each be looking forward to 2018 over the coming weeks. First up is one of our Directors, Allan Munro.
What are your aims for PLPR in 2018?
We would obviously like to continue with the encouraging start the we have made since opening in June with the injury treatment and rehab side of things and we've got some exciting plans for PLPR this year.
Firstly, Chloe is starting some post-natal exercise classes; this is an area Chloe is really keen to work on and with my wife giving birth fairly recently I have seen first-hand how little support there is locally for new Mum's who want to get back to exercising.
We are also looking to expand our Personal Training and Exercise provision. Chris has been really successful with the Strength & Conditioning classes, so we would like to build on that and create more opportunities for people to experience the benefits of exercise. In particular, I would really like to see more group training classes and classes for those with particular problems, such as knee or back pain.
Having taken over running the medical provision for the whole club (Sedgely Park) last year, I really want to see that develop further into the performance and development side of things for the younger guys. We started some S&C (Strength & Conditioning) sessions for the Colts at the back end of last year and I would like to see that roll out across the Junior teams in the coming months. I have just been appointed the Lead Sport Rehabilitator for the North of England Counties u20s and I would love to be able to help develop more of the Sedge youngsters to progress to those type of representative teams.
What are your personal aims for the year?
Personally, I am aiming to complete a marathon this year. It is something that has been on my bucket list for a long while so I thought I better get to it as I'm not getting any younger! I am really hoping the training will help my own practice as although I have been running on and off for most of my life I have never committed to training for anything more than a half-marathon. I think I will get a better understanding of what it is like to run such a distance which will help me when seeing patients who compete in these types of events.
Having had some Achilles issues in the middle of last year, I don't plan on pushing it too quickly, so I am looking at the Yorkshire Marathon in October - as a Yorkshireman theres no better place to run my first marathon. There will be a few events thrown in for preparation during the year and I really can't wait. I will be aiming to keep some kind of a diary of the training - so watch this space!
I am also looking forward to seeing my little boy Billy grow up, he is 3 months old so lots of fun times to come - my wife will be at the new postnatal exercise classes!
2018 promises to be a great year on a number of fronts, and I for one cannot wait.
You can come up with so many reasons not to exercise after having a baby... You’re too tired, you don’t have time, you’re too overweight, you can’t find childcare etc. You can then have further worries; is your body ready? Will it hurt? Can it cause more damage to your body? And finally if you manage to wrap your head round actually doing it, you have the confusion surrounding how, what and where to do it! In the end it can seem easier not to do anything!
Exercise is actually great for you after having a baby and it can be really easy... You’ll even most likely find the benefits out way all the negatives. Some of the benefits of ante-natal exercise include:
These are just a few of the benefits there are so many more! Our new mum and baby exercise classes are starting soon to help you overcome the barriers to exercise and enjoy all the benefits exercise can bring. All you need to do is make the time and come on down! It will be a really relaxed setting that allows you to exercise with your baby alongside lots of other people going through similar experiences as you.
For more information on our Mummy & Me exercise classes visit www.parklaneperformance.com/postnatal. If you’re interested email firstname.lastname@example.org with a subject of “Mummy & Me class” or ring 07976676372 and Danielle will get back to you with more details.