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Hip & Groin

The hip and groin area is a complex area to treat. We regularly successfully treat patients who come to us with undiagnosed hip or groin pain that has lasted for months or even years, despite scans, tests and various forms of treatment. A key component of this treatment is the correction of hip biomechanics along with hands on treatment.

Unfortunately hands on treatment for the hip and groin can often be sparse or non existent or, on the other end of the spectrum, be carried out without addressing the underlying biomechanical issues using targeted exercises. Hands on treatment is often essential to reduce pain, release tight, stiff or overactive structures and improve sensory feedback to the brain. This enables the muscles to be switched on more effectively, resulting in more sustainable improvements. Hands on treatment is always tailored to the individual patient.

 

Common conditions

Common conditions that give hip or groin pain include those listed below. Some are local and some are referred from structures elsewhere, which is sometimes why they are missed in diagnosis. Almost always there are a combination of the following things going on and often treatment or surgery has only addressed one or some of the structures involved. We assess and treat all of the contributing factors and it is this thorough approach that gets people better. This means we work closely with leading hip surgeons and consultant physicians who give their input where required to ensure optimal management.

 

Common Causes of Hip Pain

FAI – Femoral acetabular impingement or hip impingement
Tendinopathy – most commonly of the gluteus medius tendon, hip flexor tendon and the hamstring tendon
Trochanteric bursitis
Hernia
Hip arthritis
Cartilage damage
Labral tear
Lumbar spine injury or pain (e.g. disc, facet problem, arthritis)
Adductor, or hip flexor muscle strain or tear
Symphysis pubis dysfunction

 

Treatment

Treatment will vary depending on the specific diagnosis, but any biomechanical inefficiencies which may have caused or resulted from the original injury will need to be addressed thoroughly; this is often the aspect of treatment that is neglected. These often include imbalances and weaknesses in the muscles of the hip, pelvis and lower back and incorrect alignment of the leg, particularly when walking or running. It will also include hands on treatment including mobilisation of stiff joints and release of tight or overactive musculature. Our top five most useful hands on techniques for the hip are as follows:

Deep soft tissue massage of the lateral hip muscles, hip flexors and hip adductors (extending down the anterolateral aspect of the thigh)
Acupuncture to the posterolateral hip musculature
Mobilisation with movement into hip flexion (often with a belt) although care must be taken because this can be an aggravating movement
Hold relax techniques to the adductors and abductors
Thoracic mobilisation

Scroll down for further information on common conditions and exercise ideas. 

Please note that although the advice and exercises provided are designed to assist your recovery they are not a replacement for seeing a Physiotherapist or Osteopath! It is essential that you ALWAYS make sure you see your Osteopath, Doctor or Physiotherapist to diagnose your injury and guide you through recovery.

    Common Injuries

  • Stiff Thoracic Spine

    The thoracic spine – middle and upper part of the back - is the stiffest part of the spine due to the ribs attaching here, but it commonly becomes too stiff as a result of poor postures. Please click here to learn correct sitting posture. Thoracic spine stiffness puts more...

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  • Clicking Back

    Clicking or crunching in the back can be caused by a number of things.Most people fear that the clicking is caused by bone hitting bone. However, thankfully nowadays this is rare. If you have this, it is likely that for many years you have been suffering severe pain and movement...

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  • Facet Joint Problems

    Facet joint pain is normally localized: centrally over your spine or to one side. It may feel like a "catching pain" during certain movements like bending backwards, or turning. It is associated with poor posture, repetitive strain (e.g. horse riding) or injury (e.g. snowboarding falls)The common factors that contribute to...

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  • Disc Problems

    Disc injuries cover a whole spectrum of problems including disc degeneration, disc prolapse and a disc bulge, all in varying levels of severity. Minor injuries will feel like a localized ache over the spine; more severe injuries cause intense pain and immobility, with pain, pins and needles, numbness and/or weakness...

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  • Hip Clicking

    Clicking or crunching in the hip can be caused by a number of things. Most people fear that the clicking is caused by bone hitting bone. However, thankfully nowadays this is rare. If you have this, it is likely that for many years you have been suffering severe pain and...

    Read More
  • Sacroiliac Joint ‘SIJ’

    Problems in the joint that joins your spine to your pelvis are still hotly debated in the physio, osteo and medical worlds. Strains can occur when the ligaments supporting the joint are loose (e.g. during pregnancy or with hypermobility) and we have seen many patients with SIJ pain following a...

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  • Proprioception exercise

    Please click here to learn about lateral ligament strains before reading the following. Proprioception is the body's positional sense. In other words it is what enables your brain to know where your arms and legs are positioned without needing to look at them. If there is a significant difference in...

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  • Thoracic spine exercises

    Please ask your Physiotherapist or Osteopath to show you how!

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  • Train deep core muscles

    The following exercise should be performed under the guidance of your Physiotherapist or Osteopath to ensure you are doing it correctly and prevent aggravation of your condition. Please click here to learn how the back works before reading the following.

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  • Hip, pelvis, back wiggle exercise video – dancing physio

      Wiggle away your back pain, hip pain or groin pain with this dance or Zumba based physio exercise video. Hope you enjoy watching it as much as I enjoyed making it. Make sure you see a physio to properly diagnose and treat any pain or injury.  Get in touch...

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  • Glut/ VMO/ leg alignment exercise

    Please click here to read 'how the knee works' before reading the following. This exercise trains the lateral glute muscle fibres, lower limb alignment, VMO (the inside part of the quads muscle) and stretches the calf so is a big hitter – if you can get it right! You will...

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  • ITB and TFL release

    Please click here to read how the knee works before reading the following.

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