The hip joint is where the leg meets the pelvis. The joint itself it made up from the bones of the pelvis and the head of the femur. There are many problems that can affect the hip from congenital anomalies to smaller irritations.
Tendinitis
A tendon is made up of tissue that connects muscle to bone. Traumas to the area, muscle pulls, or repetitive overuse trauma can lead to the tendon becoming inflamed and causing pain. Symptoms of this problem include pain with movement at the area of the tendon insertion and pain that increases with touch. A more-serious problem with tendinitis is when the tendon snaps in half completely or pulls away from the bone (avulses). When the tendon completely breaks, it will need to be surgically fixed; when the tendon pulls away from the bone it can cause deep and extensive bruising. A common area of the hip to be affected by this in contact sports is the crest of the hip, or the bones that we can feel when we push in on our waist.
Bursitis
The bursa is a fibrous sac that is lined and filled with a slippery fluid called synovial fluid. These bursa are a way to decrease friction between different structures around the joints and allow for smoother movement. Around the hip there are 18 bursa. Any one of these bursa can become inflamed. Of the 18 bursa there are three main ones that cause problems; the ischiogluteal bursa located on our tailbone when we sit, iliopsoas bursa located deep in the crease of our leg when we sit, and the trochanteric bursa located on the hip bone itself on the side of our leg. Friction trauma from tight muscles or repetitive overuse of the muscles leads to the initial swelling and pain.
Degeneration/Arthritis
Degeneration in the hip joint happens when the cartilage within the joint starts to break down. This will eventually lead to bone remodeling and bone spurs. This is a long-term problem that starts with some type of minor trauma; i.e. a misstep off a curb. The major symptoms of degeneration are a deep gnawing pain within the hip joint that is relieved by rest, morning stiffness in the joint that gets better with movement and sore again with prolonged movement, and increased pain in cold weather or changes in barometric pressure. The severity of pain is not related to the amount of degeneration. The best way to know if there is degeneration is to get imaging done. MRI offers the best picture of the joint. X-ray is commonly used, but won't show early signs of degeneration.
Necrosis/Legg-Calve-Perthes Disease
Necrosis is a condition in which the blood supply to the bone decreases and the bone starts to decompose. This problem is more common in children who have Legg-Calve-Perthes disease. The actual reason for the decreased blood supply is unknown. Many times these children do not have long-term side effects if the condition is noticed early. When the blood supply increases or returns, the bone will strengthen again. As long as there was not too much damage to the bones and the joints surrounding the bones, the area can heal.
References
- "Quick Reverence Clinical Chiropractic Conditions Manual;" Nikita Vizniak and Michael Carnes; 2004.
- Mayo Clinic
