Femoral Acetabular Impingement (FAI) Treatment
Also known as femoroacetabular or FA impingement, hip impingement is an abnormality in the way the ball of the femur (thighbone) and the acetabulum (hip socket) fit together. It is a fairly common condition that affects more men than women. An improper shape of both the ball and the socket creates excess friction in the joint and may cause the hip to "jam" in front when bending forward. Over the years, hip impingement can tear or wear down hip cartilage (osteoarthritis), causing pain, swelling, stiffness and loss of mobility. The condition may be present at birth but cause no symptoms until later in life. Athletic activity-particularly soccer, football, hockey and running-may exacerbate the problem. If left untreated, the person may require total hip replacement.
Hip Bursitis Treatment
Bursitis is the painful swelling of the bursae, fluid filled sacs on the cushion areas where tendons and muscles slide across bone. Specific to the hip is trochanteric bursitis (also known as greater trochanteric pain syndrome or GTPS), which refers to the bursa by the head of the femur. This shock absorbing sac can become agitated and swollen for unknown reasons or as a symptom of other issues such as gluteal tendon infections, uneven leg length or Iliotibial Band Syndrome. Steps can be taken to prevent bursitis by strengthening the core and hips through a moderate training program. Orthotic inserts for people with flat feet can also help. The condition can be treated by:
- Rest
- NSAIDs or steroids to reduce swelling
- Physical therapy
- Surgical removal of the bursa (bursectomy)
Hip Osteoarthritis Treatment
The most common type of arthritis of the hip is osteoarthritis. In this disease, the cartilage in the hip, especially the acetabular labrum, gradually wears away with use and time. Treatments for osteoarthritis include:
- Medication to reduce pain, such as aspirin and acetaminophen
- Medication to reduce swelling and inflammation, such as ibuprofen and nonsteroidal anti-inflammatory drugs (NSAIDs)
- Exercises to improve flexibility and strength
- Maintaining healthy body weight
Hip Replacement
The hip is a "ball-and-socket"" joint where the "ball" at the top of the thigh bone (femur) fits inside the "socket" in the pelvis (acetabulum). A natural substance in the body called cartilage lubricates the joint. When the bone and/or cartilage of the hip becomes diseased or damaged from arthritis, hip fractures, bone death or other causes, the joint can stiffen and be very painful. A total hip replacement may be recommended for patients who experience severe, chronic hip pain and can't do what they want or need to do in daily life.
Labral Tears
The hip socket, or acetabulum, is covered with a layer of cartilage called the labrum that cushions and deepens the socket to help stabilize the joint. The labrum may tear due to a traumatic injury (e.g. hip dislocation), repetitive movement (e.g. twisting or pivoting, such as in golf) or tissue degeneration (e.g. osteoarthritis or hip impingement). Sometimes, a labral tear causes no symptoms and doesn't require treatment. However, tears may cause pain in the hip as well as stiffness, limited motion, and a sense that the joint is locking, clicking or catching.
Hamstring InjuryÂ
An injury to the hamstring muscle is a painful problem, frequent among athletes, especially those who sprint, or run and stop suddenly. The hamstring is not a single muscle, but three muscles located at the back of the thigh. A hamstring injury may involve a strain, which is a stretching or partial tearing of the muscle, or an avulsion injury, which is a complete tear of the muscle, pulling it away from the bone. Because hamstring injuries are usually the result of one of the muscles being stretched beyond capacity, such injuries are commonly referred to as "pulled hamstrings."
Risk Factors for a Hamstring Injury
While a hamstring injury can happen to anyone, individuals are at greater risk of suffering such an injury if they:
Participate in running, soccer, tennis, football, basketball or dance
Have had a previous hamstring injury
Are not flexible or have not stretched prior to exercise
Have a muscle imbalance between the quadriceps and hamstrings
Are adolescents in the midst of a growth spurt
Symptoms of a Hamstring Injury
Patients with a hamstring injury may experience any of all of the following symptoms, depending on the severity of the tear:
Sudden pain during exercise
Snapping or popping sensation
Pain in back of thigh or lower buttock
Tenderness and bruising at the site
Weakness in the hip or knee
Tingling sensation at the back of the thigh
Since the hamstring muscles make it possible to extend the leg straight behind the body and to bend the knee, pain during these movements may be a sign of a hamstring injury.
Diagnosis of a Hamstring Injury
To determine whether the hamstring has been injured and to what extent, the doctor will take a medical history and perform a physical examination of the area. With the patient lying face down, the doctor will look for any sign of tenderness, bruising or muscle spasm on the back of the thigh and will move the leg into different positions to try to pinpoint the region of the damage. If the patient has difficulty putting weight on the affected limb, further diagnostic testing will likely be required, first X-rays to rule out any possible fracture, and then an MRI scan or ultrasound to view the hamstring tear itself.
Hamstring Injury Treatment
Treatment for a hamstring injury depends on the severity of the damage, but many cases will heal with minimal care. Patients can relieve symptoms and facilitate the healing process through home remedies such as resting, applying ice and taking anti-inflammatory medications to diminish pain and swelling. Physical therapy is also typically very beneficial, as it works to gently stretch and strengthen the hamstring muscle. As the symptoms improve, gradually increasing exercise may prevent a recurrence of the injury. Generally, most patients can resume normal activities and sports participation in 4 to 6 weeks when the symptoms are gone.
If these conservative measures are not effective for a partial tear, an injection of either corticosteroids or platelet rich plasma may be recommended. These treatments can provide significant relief from pain and assist in the healing of damaged tissue. Severe hamstring injuries may require surgery to repair the torn muscle, especially in athletic patients, who may otherwise experience weakened muscles or other limitations in their ability to fully engage in the sports of their choice.