A hip subluxation is uncomfortable and often painful. The injury occurs when the hip joint is partially dislocated but not fully disconnected. The femur is connected at the hip joint, and the problem is common in people with a hip replacement or many years of wear and tear on the hip. It can, however, also occur in infants and younger populations.
Hip subluxation is treated by stretching, physical therapy programs or a professional capable of popping your thigh bone back into the hip socket.
How the Hip Joint Works
The hip has a socket that receives the head of the thigh bone. The socket allows the bone to rotate, allowing your hips and thighs to move normally. The entire function of the socket to bone connection is mechanical in nature.
The head of the thigh bone is a perfect fit for the socket. If that head is pulled out of the socket completely, mobility and hip function is lost. When the head is pulled out partially, the hip and leg still function, but they lose that complete connection for normal mobility. This creates the hip subluxation that causes a range of negative symptoms.
The hip joint is a major connection and the subluxation is not a problem isolated only to the hip itself. When a hip subluxation occurs, it affects major muscle groups, and the pain and discomfort can reach the lower back and spine. It ultimately becomes an alignment issue that can make your body uncomfortable so pay attention to the hip dislocation signs to work on an immediate solution.
Read more: Hip Alignment Stretches
Subluxation From Trauma and Stretching
The partial dislocation of the bone from the joint can occur from several different causes. The ball on the thigh bone has a perfect fit for the joint. If the joint or the ball experiences enough wear to lose that perfect connection, a subluxation becomes more likely to occur.
A major trauma can also cause the hip and thigh bone to separate. If the leg bone and hip are pulled in opposite directions with enough force, they can separate partially or completely. For example, a car accident or other traumatic event that involves extreme force to the hip and thigh can cause the subluxation.
Pushing the limits of stretching can also lead to a subluxation of the hip. Repetitive stretching beyond the natural limits of your body can slowly work the hip into a partially dislocated position. This happens in yoga and athletics like gymnastics and dance where overstretching and pressure placed on the joint are repetitive in nature.
Proprioception vs. Wear and Tear
According to the Ehlers Danlos Society, impaired proprioception is also a cause of subluxation, not just in the hip but in other major joints too. The body, like a bad sensor in a vehicle that affects timing and recognition of motion, can't recognize the proper motion of joints.
Impaired proprioception is unlikely to affect only the hip, however. When the body isn't sensing the joint placements and motions properly, every joint is a potential candidate for subluxation, creating an issue that requires specialized treatment.
Finally, the hip subluxation can occur because the connective tissue and ligaments around the hip aren't tight. This may occur from extreme stretching, but it also can simply happen over time. Wear and tear on the ligaments around the hip is often part of an aging hip.
Identifying a Hip Subluxation
Pain in the hip area can involve the thigh muscle, gluteal muscle or hamstring. Muscle strains in any of these groups can cause discomfort in the hip.
Especially among athletes, a common point for injuries is the hip flexor. When strained, the hip flexor causes pain and discomfort in the general hip region, which is often acute. A hip subluxation affects a wider area, and the discomfort is widespread.
Partial vs. Full Dislocation
According to the specialists at Aurora Health Care, hip subluxation will involve snapping and popping in the socket while walking and moving. Another is the inability to place weight on the leg.
When the partial dislocation is close to a full dislocation, placing weight on the leg is especially difficult. The hip socket supports the weight placed on your leg, and a separation essentially removes this functionality. If your hip no longer supports weight, your dislocation is extreme and may require immediate action to reset the bone into the joint.
Other dislocated hip symptoms include pain in the thigh and groin along with the feeling that your hips are generally misaligned. If you're really tuned into your body, the displacement is physically noticeable.
Passive Treatment Options
A very limited hip subluxation can call for more passive treatment options before visiting a doctor. Simple stretches and lifestyle changes can help work the hip back into the socket. An extreme case will, however, require professional help. When the hip no longer supports weight, you're beyond the help of passive treatment.
Stretching creates a foundation for your passive treatment, but overstretching can worsen a subluxation, so light stretching is critical. The idea is to loosen the supporting muscles while lightly moving the femur head until it resets properly into the hip joint.
Home stretching programs are not uncommon, but physical therapy is also an option to ensure you're not overextending the hip. The idea is to limit the range of motion somewhat while lightly exercising and moving the hip and leg. Stretching the lower back, thighs and hamstrings is also a useful practice to help maintain the supporting muscles while your hip and leg work back into place.
Read more: Hip Dislocation Exercises
Involving the Orthopedic Doctor
Passive stretching is not always enough, especially when the hip subluxation is chronic. This occurs when the dislocation happens with any regularity. In some cases, it can mean the socket or the femur head is distorted enough that it no longer fits properly.
A hip replacement is the primary surgical solution when the hip itself is worn out. The surgeon must perfectly fit the new hip socket to the femur head to prevent future subluxation issues. If the fit is not perfect, subluxation can occur after the replacement is complete.
Resetting the Hip
An orthopedic surgeon or even a physical therapy specialist can reset the hip. They'll do it only when no bones are broken, though. In many cases, the reset is painful and sedation is used. They basically position the leg in a manner that aligns the femur head with the socket before forcefully pushing it back into place.
If broken bones are involved, manually resetting the hip is not possible. At this point, the reset is done surgically while also resetting and casting the broken points. This scenario is more likely after an accident that has traumatically separated the hip and caused other damage to the body simultaneously.
Long-Term Care for Subluxation
Subluxation is a nuisance for many people. The hip and femur separate just enough to cause discomfort, and it throws off the spine alignment in the process. Unfortunately, there is no magic remedy for an instant fix.
Lifestyle changes are the key to living with subluxation while also minimizing the effects and impact on your body. Light stretching helps, but dietary changes and muscle-building exercises are also useful.
Overweight individuals experiencing hip subluxation can tweak their eating habits to lose weight. Less weight on the hip means less stress is placed on the joint and femur. The outcome is a reduced risk of subluxation by simply making a healthy dietary change.
Strengthen the Supporting Muscles
Incorporating strength exercises can also help the supporting muscles. This can tighten down the ligaments and help hold the femur more securely in the socket. Physical therapy programs use muscle-building exercises, but you can easily bring them home after your required therapy ends.
Knees raises, for example, are a low-impact standing exercise that can be done anywhere. This works the hip socket without adding exceptional strain. Adding them to your daily morning routine will warm up the hip before beginning activity for the day.
Many exercises also take place from a lying position. Leg lifts while lying flat on your back will build strength. Lie on your side and lift the upright leg to work the hip abductors. Strengthening the abductors can really tighten down the hip area and help prevent subluxation.
Training and Diet Tips
The key to an effective exercise and diet program is consistency. Do the exercises daily, preferably in the morning to lubricate the joint and prepare for your day. Also, avoid doing anything that will contribute to the subluxation.
Squatting with exceptionally heavy weights will, for example, stress the joint and can lead to subluxation. Focus on using less weight and perfect your form to reinforce the muscles without stressing the hip.
Use this mentality in all exercises that involve the hips and legs. You can still push on workouts and go hard, but avoid overextending the hip in a repetitive fashion while carrying weight.
Cases Requiring Custom Treatments
The basic premise of subluxation involves the simple full or partial dislocation of the femur head from the hip socket. As covered to this point, the hip is either manually reset, surgically reset or the hip is entirely replaced.
In some cases, though, the body surrounding the hip socket requires a custom treatment plan. For example, Healio Orthopedics references specific treatment for patients with cerebral palsy. Patients with immobility that requires a wheelchair will experience a hip subluxation as a result of their circumstance.
In this case, treating the patient is a matter of special care because the leg is not supporting a heavy weight load, but the socket and femur connection is delicate. Repositioning the femur head in the hip socket is done with light pressure to increase comfort and spinal alignment without strengthening the surrounding ligaments and tissues.
Other unique-case scenarios include those of patients with an immature skeleton. Basically, this means hip subluxation in children and even in infants. Pediatric orthopedic specialists are required to address the dislocation in a skeleton that is continuing to grow. Always seek treatment from a specialist when a unique case of hip subluxation exists.
Is This an Emergency?
- Ehlers Danlos Society: Dislocation/Subluxation Management
- Healio Orthopedics: Treatment of Hip Subluxation in Skeletally Mature Patients With Cerebral Palsey
- Aurora Health Care: Hip Dislocation and Instability
- ADA: Subluxation and Dislocation of the Hip
- Centers for Advanced Orthopaedics: Physical Therapy for Hip Dislocation
- American Academy of Orthopaedic Surgeons: Hip Dislocation