How to Relieve Hip Pain: Effective Strategies and Exercises

Hip Dysplasia an undiagnosed but surprisingly common cause of Hip Pain

Anatomy 

Our Hip is a ball and socket joint (the same as our shoulder) where the femoral head (the ball) articulates with the acetabulum of our pelvis (which is the socket) this type of joint allows movement in all directions, which makes our hip one of the most mobile joints in our body. 

Hip dysplasia refers to a socket (the femoral acetabulum) that is shallower than most hip and this can lead to issues for the acetabulum supporting the hip. This is defined by the Lateral edge center angle (LECA, shown below) which refers to acetabular coverage of the femoral head. People with borderline LECA can still display signs of instability that may be the cause of their symptoms when couples with other factors such as decreased motor control and generalized hypermobility, these patients will still have hypermobile hips particularly in one direction, but do not show ‘true’ hip dysplasia on imaging. 

Signs and symptoms

The average person with hip dysplasia waits 61.5 months from the onset of symptoms to a diagnosis and has normally seen over 3 healthcare providers before a definitive diagnosis is made. This is far too long and goes to show that this is an underappreciated cause of pain in physiotherapy and medicine.

The pain associated with hip dysplasia is with a slow onset of pain in 97% of cases that most often presents in the groin, front of the hip or side of the hip, this depends on the direction of the instability. 80% of people with hip dysplasia also present with mechanical symptoms of clicking catching and locking. 

Aggravating factors include walking, running and impact exercises, for those with posterior instability sitting and squatting are likely to cause an increase in pain and for those with anterior inability activities such as standing for long periods and striding out whilst walking are likely to cause an increase in pain. 

SO WHAT DO WE DO ABOUT IT? 

Early-Stage Management 

Initial management starts with conservative treatment that aims to stabilize the hip by increasing motor control, strengthening the hip and improving moving patterns. 

Decrease Sway Back Posture (if relevant)

Patients with hip dysplasia often have a sway-back posture where the hips sit forward and restore to the shoulders and foot this puts extra stress on the anterior hip and therefore should be corrected to help reduce symptoms. 

This correction is first done in standing where you will try and correct this posture 2 mins per day focusing on getting proper alignment, this is then progressed to weight shifts and transitioning from one leg to another, 

Hip Strength and Control 

These exercises aim to help you increase strength and control at you hip and pelvis this helps control the head of the femur and your pelvis.  Examples of these exercises include. 

Banded external rotation in prone: 

From here exercises are progressed to standing exercises, multi-directional exercises and then sports-specific exercises, with increasing attention given to the entire kinetic chain. 

Progress to more Functional Movements

STEP-UPS

STEP UP TRIPLE EXTENSION

HIP HINGE & Progressing to triple extension

If you are living with hip pain, let's do something about it!

1. Take Control: Remember, you play an active role in your healing. See how you go with these movements.

2. Seek Expert Help: Don't wait for the pain to worsen, have a chat with your physio, and we can do something about it.

Reach out if you need a hand to progress or make sure they are the right ones for you. Joseph is extremely passionate about this subject, contact MOVE Sports Physio info@movesportsphysio.com.au or joseph@movesportsphysio.com.au to discuss your hip pain and get expert guidance.

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