The Athletic Hip

 

The Athletic Hip Series: The Various Hamstring Injuries

By: Maggie Gebhardt PT, DPT, OCS Adjunct Clinical Professor- Mercer University, Division of Physical Therapy Anyone who has had, or knows someone who has had, a hamstring tear knows it can look pretty bad. Typically people will report pain, hearing a pop, and a deep, ugly bruise that shows up a couple of days later that can extend past the knee. Even though this sounds really dramatic those are the kinds of injuries you actually want to have, because after the initial inflammation they tend to heal fairly quickly. Then there are the more common and much less talked about tendiopathies. These are the injuries that come on slowly and you do not notice until it’s almost too late. They are…

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The Athletic Hip Series-Athletic Pubalgia

By: Maggie Gebhardt PT, DPT, OCS Adjunct Clinical Professor- Mercer University, Division of Physical Therapy Athletic Pubalgia is more commonly known as a Sports Hernia. People with a Sports Hernia will initially complain of groin pain that spreads to the inner thigh as the condition progresses. With the possible involvement of the genitor-femoral nerve, it can also present with numbness or other nerve-related symptoms in the thigh, the scrotum in males, and  the pubis in females. Most often the pain is aggravated by extreme and repetitive twisting, turning, or extending the affected hip and primarily affects football, hockey, tennis and soccer players. This diagnosis can be a frustrating one for the patient and clinician alike due to the fact that it…

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The Athletic Hip Series: Snapping Hip

By: Maggie Gebhardt PT, DPT, OCS Adjunct Clinical Professor- Mercer University, Division of Physical Therapy As odd as it may sound, have you ever heard a strange noise coming from your hip? A rare condition, Snapping Hip can create a sense of alarm, not because of the pain, but because of the loud snapping noise referred to in its name.  The sound is created by one of two things: The IT Band snapping over the head of the femur. The Iliopsoas Tendon (hip flexor muscle) ineffectively stabilizing the joint, causing it to click as it moves through its range of motion. Both of these scenarios are not cause for immediate concern, but reflect incorrect biomechanics occurring at the hip. If you…

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The Athletic Hip Series: Ischiofemoral Impingement and Tendinopathies

Post by Maggie Gebhardt, PT, DPT, OCS In the clinic, therapists tend to see injuries happen in waves. One month its shoulders and the next it’s a completely different body part. Recently, I have had a rash of patients coming in with the diagnosis of ischiofemoral impingement. As the time for my monthly blog approached, I thought it would be the perfect opportunity to delve into this diagnosis a little bit more. What is it you ask? Ischiofemoral impingement is the result of contact between the lesser trochanter of the femur and the ischium (or lower part of the pelvis.) Patients usually report buttocks or groin pain and this can often mimic symptoms of a hip flexor or hamstring tendinopathy….

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The Athletic Hip Series: Labral Tears

Post by Maggie Gebhardt, PT, DPT, OCS For all of you clinicians out there who participated in our journal club in June you were able to hear from one of Atlanta’s preeminent hip surgeons, Dr. Cliff Willimon. He addressed the assessment and treatment of hip pathologies primarily related to labral tears. So, it is only natural that I follow my last blog on hip impingement with a discussion on hip labral tears. For the layperson out there, you may be asking, “What is a labral tear and could I have this tear?” Well, the labrum of your hip is a cartilaginous ring that runs around the perimeter of your hip socket. This allows the ball to sit deeper in the…

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The Athletic Hip Series: Impingement

Post by Maggie Gebhardt, PT, DPT, OCS “Runner’s take your mark!” It’s that time of year again when hundreds and thousands of runners line Peachtree to run Atlanta’s annual July 4th Peachtree Roadrace. It is a day of celebration and festivities that culminate with the highly coveted and secretive t-shirt. From a physical therapy perspective it is the time of year that runners flood your clinic trying to get a couple of appointments in to get themselves bandaged up and to the Peachtree Road starting line. Sometimes the stars align and a little TLC from your favorite therapist gets you back out on the road, but unfortunately that is not always the case. One of those instances is the elusive…

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The Athletic Hip Series: Trochanteric Bursitis

Post by Maggie Gebhardt, PT, DPT, OCS Do you have lateral hip pain that is painful to lay on? If so, then you may have trochanteric bursitis. “What is bursitis,” you ask? Well bursitis is inflammation of the bursa that lies between the IT band and greater trochanter. When the IT band it too tight, it can rub on the bursa causing inflammation and irritation. As we discussed in my previous post, the IT band can get tight from a number of factors but most primarily from decreased strength of the hip abductors/glutes. When the bursa is inflammed it can get swollen and be painful to the touch or even to lie on it. Some people will experience pain when…

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What is Piriformis Syndrome?

Post by Maggie Gebhardt PT, DPT, OCS If a patient comes in with posterior hip pain or radiating pain down their leg, a lot of times they have already self-diagnosed themselves with Piriformis Syndrome. However, Piriformis Syndrome is not as common as most people think. So, what actually is Piriformis Syndrome? Piriformis Syndrome is when the pirifomis muscle is irritated because it is being overutilized. This is usually secondary to weak lateral hip musculature i.e. your glutes… sensing a theme?? The piriformis muscle extends along the back and lateral side of your hip. When it is aggravated it can cause a deep achey sensation in sitting, walking, or running. Sometimes the muscle becomes tight from overuse and can compress the…

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The Athletic Hip Series: What is IT Band Syndrome?

Post by Maggie Gebhardt, PT, DPT, OCS IT, otherwise known as the Iliotibial Band, is a common source of lateral knee pain in runners. However, most people do not realize that this is an issue oftentimes stemming from the hip. Pain generated from disorders of the IT band can be present at its origination along the lateral pelvis all the way to the lateral knee. The IT band is usually over-utilized due to poor lower extremity mechanics. Weak hip musculature, primarily the glutes, cause increased reliance on the IT band to stabilize the knee. This scenario can cause the IT band to get caught in a “catch-22”: overuse of the IT band causes increased tightness of the TFL (Tensor Fascia…

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The Athletic Hip and its Injuries

Post by Maggie Gebhardt, PT, DPT, OCS You may be asking yourself, “What IS the Athletic Hip?” It is a joint that serves as a junction zone for the leg and the pelvis or low back. It is a hip that is often painful and injured as a result of overuse or traumatic activities. It is a joint that is not arthritic and in need of a replacement, but is very painful and can interfere in a person’s ability to participate in all kinds of physical activity. It is an area that is often hard to diagnose, which results in many trips to physicians, multiple xrays and MRIs, and many bouts of unsuccessful physical therapy. It is a joint that…

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Motion Stability