Category Archives: Hip Health

Iliotibial Band Tendonitis/ITBand Tendonitis/Hip Tendonitis

The ITBand attaches at the hip-joint, one of the largest joints in the body. The ITBand is part of the Tensor Fascia Latae (TFL) which runs from the pelvis, to the knee, attached at the tibia and lateral part of the pelvis. This band stabilizes the hip and knee during walking, standing, and running. tendonitis to this bands means it is irritated with swelling and inflammation around the hip.

Causes

-Repetitive overuse injuries, such as running, bike riding or rowers. As these types of athletes train and increase their mileage overtime it can lead to irritation of the hip.
-The type of footwear you wear, causing bad alignment in the lower extremity
-Uneven leg length
-Excessive tightness to the lower extremity

Symptoms
Tenderness and pain to the outside of the hip in knee. In extreme cases the pain will radiate down to the calf.
Pain when running, bike riding, rowing or prolonged riding..
Pain with going up and down stairs

Treatment of Hip Tendonitis

RICE.
Rest: avoid the activities that cause the pain, yes that means you runners!
Ice: This will help the pain and inflammation. Place ice directly over the pain (but not direct skin contact) For about 15-20 minutes at a time. This is the fastest way to reduce the inflammation.
Compression: Especially something to put over the ice while you’re icing. This will help reduce overall inflammation.
Elevation: Elevate when icing to above the level of the heart to help move out the swelling.

How Physical Therapy Can Help

Physical therapy for hip tendonitis MUST be conservative. Your physical therapist will heavily enforce rest and icing to help heal the tendon. If you decide to go against this advice this will be a recurring problem OR the pain will never reduce. Once the swelling and pain has reduced your physical therapist will prescribe a series of stretching and strengthening exercises for the hip-joint based on their evaluation with you. Your therapist may also tape the area to help keep the tendon lengthened and to reduce stress on the joint to reduce pain. You may also need to change the type of footwear you are wearing for your activities, which will again be advised by your therapist.

Prognosis
Particularly for the stubborn athletes, you MUST rest the area and avoid the repetitive activity that is causing the stress on the hip in order for the inflammation to decrease. If you follow the orders by your MD and physical therapist there is a very GOOD prognosis for this condition. Depending on if your care is mild or severe you can return to your full activities in 2-6 weeks. It is important to remember that your return is GRADUAL to prevent re-inflammation.

Total Hip Replacement (THR)

As the baby boomer population continues to get older we are seeing a rise in the number of total hip replacements. The hip is one of the largest joints in the body and is built for weight-bearing. This joint is considered a ball and socket joint which allows for more mobility than other joints.

What leads to a THR? The usual culprit for a THR is a result of moderate to severe arthritis. There are three different types of arthritis that can affect you. They are: osteoarthritis, rheumatoid arthritis, and traumatic arthritis. All of the three types result in a degeneration or loss of cartilage in the hip-joint. This results in excessive rubbing of the joint onto itself which can cause intense pain and poor function of the hip-joint.

Depending on the amount of cartilage degeneration before a THR you can experience the following symptoms

  • A sensation of clicking or popping in the hip-joint
  • Moderate to severe pain on the outside (lateral) part of the hip or groin
  • Loss of motion to the hip/stiffness
  • Weakness noticed to the affected leg when trying to walk

The surgery – When performing a THR your surgeon will either resurface the hip or the joint will be completely removed and replaced. Depending on your needs they will do the following in surgery: they will replace the ball of the hip with a metal or ceramic material, or they will replace the socket of the joint with ceramic or metal material. Your surgeon may also decide to use plastic for the socket.

Physical Therapy after surgery – Depending on the severity of your condition you may have inpatient physical therapy in the hospital or at home physical therapy before transitioning to outpatient physical therapy. Physical therapy will help you regain strength, flexibility and mobility within the joint. There is usually a good outcome with physical therapy to help you return to your everyday activities. A patient can expect 3-4 months of outpatient physical therapy following this procedure.