Hip Pain髋部疼痛

Greater Trochanteric Pain Syndrome (GTPS)

Greater Trochanteric Pain Syndrome (GTPS), also known as trochanteric bursitis or hip bursitis, is a condition characterised by pain and tenderness over the greater trochanter, which is the bony prominence on the side of the hip.

Causes

• The structures involved on the outer side of the hip include the gluteus medius and minimus tendons and the greater trochanteric bursa, a fluid-filled sac that helps reduce friction between the greater trochanter and the overlying muscles and tendons.
• Muscle imbalance, overuse and abnormal hip biomechanics can result in the impingement of the gluteus medius and minimus tendons and bursa onto the greater trochanter of the hip. This results in inflammation of the trochanteric bursa and tendinopathy of the gluteal muscles, which causes pain over the lateral hip.

Common Signs and Symptoms

• Pain: Typically, individuals with GTPS experience pain on the outer side of the hip. The pain may radiate down the thigh and is often exacerbated by activities such as walking, climbing stairs, or lying on the affected side.
• Tenderness: The area around the greater trochanter may be tender to the touch.
• Swelling: Some individuals may experience swelling around the hip.

How Can Physiotherapy Help?

Assessment and diagnosis: Physiotherapists perform a thorough assessment to identify the factors contributing to hip pain. This may include evaluating muscle strength, flexibility, joint mobility and the biomechanics of specific activities.

Gait and biomechanical analysis: Physiotherapists may analyse the individual’s gait (walking pattern) and biomechanics to identify abnormalities that could contribute to hip pain. Corrections and modifications can then be suggested.

Education: Physiotherapists can explain GTPS, its causes and symptom-management strategies. This may include advice on modifying activities, improving posture and adopting proper body mechanics to reduce stress on the hip.

Manual therapy: Soft-tissue release for tight muscles, cryotherapy, therapeutic ultrasound and joint mobilisation may reduce pain, relieve muscle tension and improve mobility.

Exercise prescription: Tailored exercise programmes can address muscle imbalances, strengthen weak muscles and improve flexibility. Exercises may target the gluteal muscles, hip abductors and core muscles.

Femoroacetabular Impingement (FAI)

Femoroacetabular impingement (FAI) is a hip-joint disorder characterised by abnormal contact between the femoral head (the ball-shaped top of the thigh bone) and the acetabulum (the hip socket). This contact can lead to friction, pain and potential damage to the hip joint. FAI is classified into three main types: cam impingement (excess bone on the femoral head), pincer impingement (extra bone extending over the normal rim of the acetabulum) and combined impingement (both cam and pincer).

Causes

• Structural Abnormalities: FAI is commonly associated with structural abnormalities in the hip joint, such as a misshapen femoral head or acetabulum, leading to improper joint mechanics.

• Genetics: There may be a genetic predisposition to FAI, where certain individuals are more prone to developing abnormal hip anatomy.

• Repetitive hip movements: Activities that involve repetitive hip motion or excessive hip flexion, such as certain sports or occupations, may contribute to the development of FAI.

Common Signs and Symptoms

• Hip pain: individuals may experience persistent pain in the groin or outer hip. Pain may be exacerbated by activities that involve hip flexion, rotation, or prolonged sitting.

• Limited range of motion: Individuals with FAI may experience stiffness and a reduced range of motion in the hip joint.

• Painful clicking or catching sensation: some individuals may also complain of a clicking or catching sensation in the hip joint, especially during certain movements.

How Can Physiotherapy Help?

Patient education and activity modification: A physiotherapist can advise you to modify or avoid activities and positions that aggravate symptoms, helping to promote healing and prevent further damage.

Pain management: Heat therapy and hip-joint mobilisation may alleviate discomfort. Specific stretching exercises can also reduce stiffness.

Gait analysis: Your physiotherapist may assess and correct gait abnormalities that contribute to hip pain in people with FAI.

Individualised exercise programme: Your physiotherapist can design a personalised programme to address muscle imbalances and improve hip-joint stability through strengthening exercises targeting the hip muscles.

Frequently Asked Questions on Hip Pain