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Anterior Hip Pain
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Anterior Hip Pain - September 7, 2007 1:28:18 PM
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threewhitelights
Posts: 6
Joined: September 7, 2007
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This is my first post, so I should probably introduce myself first... I'm a student studying PT, but I haven't gotten into movement impairments, etc yet. I hope to learn lots from this site from those who have the experiance.
That said, I also suffer from anterior hip pain in the right hip. I am a competitive powerlifter and this pain comes often from doing wide stance squats, but can occasionally be off and on again random.
I believe myself to have tight adductors, but that has been improving. My left illiac crest sits slightly higher than the right, and when standing relaxed my torso rotates counterclockwise (to the left) with respect to my feet. Slight anterior pelvic tilt.
Any ideas of what it is and how to fix it, or how to go about diagnosing it?
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RE: Anterior Hip Pain - September 7, 2007 9:45:25 PM
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bonez
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A little more hx might help. Like the location and nature of the discomfort. Is it deep, localized to a muscle, sharp achey. Is it provoked by other movements, when you scour the acetabulm or ADDuct and flex? Is it agged by spinal positions or raised ITP? These are by no means a complete list by will get the ball started.
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RE: Anterior Hip Pain - September 7, 2007 11:45:02 PM
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threewhitelights
Posts: 6
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I can add that I have limited range of motion with rotating my foot inward (right counterclockwise) in relation to my left foot.
Pain feels like a hip flexor, almost like something that needs to pop or a cramp. It is provoked by sumo stance tdeadlifts or wide stance squats (I'm a powerlifter). I don't believe spinal position has much of an effect on the pain.
I get a positive test (hip clicking) during a scour test. Adduction and flexion hurts but not significantly (as in not more than other movements).
You'll have to forgive me. Like I said I'm still a student and since I'm a double major, I am pretty much self taught so far with regards to PT.
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RE: Anterior Hip Pain - September 8, 2007 4:03:04 AM
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bonez
Posts: 232
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Some concerns for the loss of int rot clicking pain on the scour test include a labral tear. This should be something to review further. Less serious problems can relate to impingement.
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RE: Anterior Hip Pain - September 8, 2007 11:19:12 AM
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threewhitelights
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hmmm... it's been occuring on and off for over a year, so I had discarded the possibility of a labral tear. Wouldn't there also be groin pain?
Imingement was one of the possibilities I was considering, but I wasn't sure if there was anything I could do besides surgery?
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RE: Anterior Hip Pain - September 8, 2007 4:51:05 PM
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bonez
Posts: 232
Joined: August 29, 2007
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It is not uncommon for labral issues to run over long periods. The exact dx and causes time of injury can wash together. 10 years ago who new they existed. The management conservative/surgical is still quite contraversial.
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RE: Anterior Hip Pain - September 8, 2007 7:18:12 PM
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jlharris
Posts: 477
Joined: April 12, 2006
From: Nebraska
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As an example, I just had a lady that I referred to an orthopod because of c/o "catching" and a "need to pop" her hip intermittently. Hip flexor is close to the groin. Pain is weird and not always textbook. Just saw her back s/p arthroscopic hip labral debriedment. She did amazing btw ( despite catching me as her PT, lol).
The obvious recommendation is to quit doing wide base squats (the aggravating factor). However, like other high level athletes, I'm sure that's not something you're ready to do yet.
_____________________________
Jason L. Harris, PT, DPT
My PT Blog
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RE: Anterior Hip Pain - September 9, 2007 3:16:36 AM
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threewhitelights
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Thanks for the help everyone.
What would be treatment other than surgery consist of if it was the labrum? How would I be able to tell? I just looked it up in my text and it seems I have all the symptoms of femoroacetabular impingement (the most striking being that it hurts following sititng for more than 15 minutes). I realize I should be seeing a health care provider, but I am learning this stuff anyways, and do not have health insurance.
As for giving up wide stance squats, I squat close stance most of the time, so dropping them isn't a problem, but it DOES hurt other times as well. And if I AM going to have to go under the knife, I want to do it soon and cheap (need to be 110% in 26 months for world cup).
< Message edited by threewhitelights -- September 9, 2007 3:26:41 AM >
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RE: Anterior Hip Pain - September 10, 2007 2:28:10 PM
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Shill
Posts: 1096
Joined: February 13, 2003
From: Madison WI USA
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Plain films would show if you have the femoral neck changes that can lead to femoroacetabular impingement, there was a good paper on it recently, but I cant remember where, which probably isnt too helpful. And as you dont have insurance, X rays probably would be a bit expensive too. However, there may be a university near you doing a study, and it never hurts to look.
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RE: Anterior Hip Pain - September 10, 2007 9:37:42 PM
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bonez
Posts: 232
Joined: August 29, 2007
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An MRI while expensive would likely be the diagnostic route of choice esp. for the labrum. There are some who report some success with conservative tx BUT there are some that look at labral issues as a factor in DJD.
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RE: Anterior Hip Pain - September 11, 2007 11:07:23 PM
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rwillcott
Posts: 435
Joined: March 20, 2006
From: Canada
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threewhitelights,
It wouldn't hurt to take a look at Shirley Sahrmann's text of Movement Impairment Syndromes. I'm sure one of your classmates or professors can lend you a copy if you don't already have it. I find her section on the hip to be very helpful. You might find you fit into one of her impairment syndromes after reading the hip section. If so, this gives you a cheap and conservative place to start rehabing your hip.
Rob
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RE: Anterior Hip Pain - September 12, 2007 10:34:57 PM
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threewhitelights
Posts: 6
Joined: September 7, 2007
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I actually do have Sahrmanns text, got it this summer, although it is kind of complicated for someone not used to the terminology. I'm reading it kind of as a self teaching type thing, but I just started the lumbar spine section, and won't have time to read much into it, since classes just resumed.
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