Tag Archive for: Hip pain

Hip Dislocations 101: What You Should Know

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It usually takes a traumatic injury – like being in a car accident or falling from a significant height – to cause a hip dislocation. And if or when it happens, it’s a serious medical emergency requiring immediate treatment. While the initial treatment is quick, it isn’t without pain, and there is often a long recovery time.

A hip dislocation occurs when the head of the thighbone (the femur) is forced out of its socket in the pelvis (or hip bone). The hip itself is a ball-and-socket joint. The ball is the femoral head at the upper end of the femur, and the socket is formed by the acetabulum, which is part of the large pelvis bone.

A Painful Experience

When there is a hip dislocation, the femoral head is pushed either backward out of the socket, or forward. In approximately 90 percent of hip dislocation cases, the thighbone is pushed out of the socket in a backwards direction. That’s called a posterior dislocation. It leaves the lower leg in a fixed position, with the knee and foot rotated in toward the middle of the body. 

When the thighbone slips out of its socket in a forward direction – what is known as an anterior dislocation – the hip is bent only slightly, and the leg will rotate out and away from the middle of the body.

In either case, a hip dislocation is extremely painful because the ligaments, labrum, muscles, and other soft tissues holding the bones in place are often torn and damaged. Also, nerves around the hip may be injured. You are unable to move your leg and, if there’s nerve damage, you may not have feeling in your foot or ankle.

The most common cause of traumatic hip dislocations are motor vehicle collisions in which the knee is forced against the dashboard. That drives the thigh backwards, which pops the ball head of the femur out of the hip socket. You can reduce your risk of hip dislocation during a collision by wearing a seatbelt at all times. 

How Hip Dislocations Are Treated

An orthopedic surgeon can usually diagnose a hip dislocation simply by looking at the position of the leg. However, the doctor will conduct a thorough physical evaluation since hip dislocations often involve additional injuries. The doctor may order X-rays or other imaging tests to pinpoint the exact position of the dislocated bones and identify any additional fractures in the hip or thighbone.

If there aren’t other injuries, the doctor will administer an anesthetic or sedative, then manipulate the bones back into their proper position. This procedure is called a reduction. A hip reduction takes a lot of force, combined with just the right movement and positioning.

If torn soft tissue or small bone fragments block the bone from going back into the socket, surgery may be necessary to remove the loose tissues and fragments and correctly position the bones. Once the reduction is complete, the doctor will order another set of X-rays and possibly a CT scan to be sure the bones are in proper position.

It can take up to three months for a hip to heal after a dislocation. And if there are additional fractures, the rehabilitation period could be longer. In the meantime, your doctor may recommend limiting your hip motion for several weeks to prevent another dislocation. Also, physical therapy is often recommended.

Within a short time, patients often start walking again with the aid of crutches. Also, walkers and canes can help patients regain their mobility.

The Colorado Center for Orthopaedic Excellence in Colorado Springs provides treatment for patients with hip dislocations and other needs. From sports injuries to car accidents, our board-certified orthopedic surgeons can diagnose your condition and explain your treatment options. Call us today at (719) 623-1050 for an appointment.

Proper Sports Techniques to Prevent Hip Pain

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The hip joint is one the large joints of the body that helps the thigh move forward and backward. The hip joint also rotates when sitting and with changes of direction when walking. The hip joint is where the ball of the thigh bone (femur) joins the pelvis at a socket called the acetabulum. There is cartilage covering both the bone of the femur and the acetabulum of the pelvis in the hip joint. A joint lining tissue, called synovium, surrounds the hip joint. The synovium tissue produces fluid that lubricates the joint and provides nutrients to the cartilage of the joint. 

The singer Shakira had it right when she says “Hips Don’t Lie” in her hit song. It seems that until our hips are in pain, we don’t give them much thought. We use our hips every day, when we walk, stand, sit and workout. In fact, there are few times when we are not using our hips, especially when playing sports or exercising.

If your hips are not working properly, other movements and muscles will suffer. Your hips are able to withstand a great amount of stress, but if they are used improperly, an uneven amount of stress can be transferred elsewhere in the body where it is not meant to go. Over time, the muscle that is compensating for the weakened hip muscles will begin to feel tight, decreasing agility and speed, as well as taking longer to recover. Reducing participation in painful activities is the most important step a patient can take. Here are some other tips to help reduce pain:

Modifying activity: Athletes who must perform repetitive movements will need to avoid painful activities and modify their training during the rehabilitation process.

Icing: Applying ice after exercise may diminish the pain and other symptoms, such as swelling.

Medication: Physicians frequently prescribe ibuprofen or acetaminophen to help reduce inflammation and pain. Physicians also may prescribe injections of steroids or anesthetic to both diagnose the source and treat the pain.

Rehabilitation: Physical therapy is often needed to reduce pain and improve function. Therapy will include heat and/or ice to decrease inflammation and stretching/strengthening exercises for specific hip muscles. The therapy will progress to more functional activities, simulating sport-specific motions. As the symptoms improve, a specific training program will allow proper, incremental return to full activity.

To learn more about hip pain and how to treat it, call the Colorado Center of Orthopaedic Excellence at (719) 623-1050 to request an appointment, or request one online.

Hip Pain, Shoulder Pain and Fibromyalgia

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Fibromyalgia is a disorder that causes aches and pain all over the body. People with fibromyalgia also have “tender points” throughout their bodies. Tender points are specific places on the neck, shoulders, back, hips, arms, and legs that hurt when pressure is put on them.

Fibromyalgia affects as many as five million Americans ages 18 and older. Most people with fibromyalgia are women (about 80 – 90 percent). However, men and children also can have the disorder. Most people are diagnosed during middle age. Fibromyalgia can occur by itself, but people with certain other diseases, such as rheumatoid arthritis, lupus, and other types of arthritis, may be more likely to have it. Individuals who have a close relative with fibromyalgia are also more likely to develop it themselves.

What Causes Fibromyalgia?

  • The causes of fibromyalgia are not yet known. Researchers think a number of factors might be involved. Fibromyalgia can occur on its own, but has also been linked to:
  • Having a family history of fibromyalgia
  • Being exposed to stressful or traumatic events, such as:
  • Car accidents
  • Injuries to the body caused by performing the same action over and over again (called “repetitive” injuries)
  • Infections or illnesses

How is fibromyalgia diagnosed?

People with fibromyalgia often see many doctors before being diagnosed. One reason for this may be that pain and fatigue, the main symptoms of fibromyalgia, also are symptoms of many other conditions. Therefore, doctors often must rule out other possible causes of these symptoms before diagnosing fibromyalgia. Fibromyalgia cannot be found by a lab test. A doctor who knows about fibromyalgia, however, can make a diagnosis based upon two criteria:

  1. A history of widespread pain lasting more than 3 months. Pain must be present in both the right and left sides of the body as well as above and below the waist.
  2. Presence of tender points. The body has 18 sites that are possible tender points. For fibromyalgia diagnosis, a person must have 11 or more tender points. For a point to be “tender,” the patient must feel pain when pressure is put on the site. People who have fibromyalgia may feel pain at other sites, too, but those 18 sites on the body are used for diagnosis.

How is Fibromyalgia Treated?

Fibromyalgia can be hard to treat. It’s important to find a doctor who has treated others with fibromyalgia. Many family doctors, general internists, or rheumatologists can treat fibromyalgia. Rheumatologists are doctors who treat arthritis and other conditions that affect the joints and soft tissues.

Treatment often requires a team approach. The team may include your doctor, a physical therapist, and possibly other health care providers. A pain or rheumatology clinic can be a good place to get treatment. Treatment for fibromyalgia may include the following:

Getting enough sleep: Getting enough sleep and the right kind of sleep can help ease the pain and fatigue of fibromyalgia. Most adults need seven to eight hours of “restorative” sleep per night. Restorative sleep leaves you feeling well-rested and ready for your day to start when you wake up. It is hard for people with fibromyalgia to get a good night’s sleep. It is important to discuss any sleep problems with your doctor, who can then recommend proper treatment.

Exercising: Although pain and fatigue may make exercise and daily activities difficult, it is crucial to be as physically active as possible. Research has repeatedly shown that regular exercise is one of the most effective treatments for fibromyalgia. People who have too much pain or fatigue to do hard exercise should just begin to move more and become more active in routine daily activities. They can begin with walking (or other gentle exercise) and build their endurance and intensity slowly.

Eating well: Although some people with fibromyalgia report feeling better when they eat or avoid certain foods, no specific diet has been proven to influence fibromyalgia. Of course, it is important to have a healthy, balanced diet. Not only will proper nutrition give you more energy and make you generally feel better, it will also help you avoid other health problems.

Pain management: Three medicines have been approved by the U.S. Food and Drug Administration (FDA) to treat fibromyalgia. These are pregabalin (Lyrica), duloxetine (Cymbalta), and milnacipran (Savella). Other medications are being developed and may also receive FDA approval in the future. Your doctor may also suggest non-narcotic pain relievers, low-dose antidepressants, or other classes of medications that might help improve certain symptoms.

Other treatments: Complementary therapies may help you. Talk to your physician before trying any alternative treatments. These include:

  • Physical therapy
  • Massage
  • Myofascial release therapy
  • Water therapy
  • Light aerobics
  • Acupressure
  • Applying heat or cold
  • Acupuncture
  • Yoga
  • Relaxation exercises
  • Breathing techniques
  • Aromatherapy
  • Cognitive therapy
  • Nutritional supplements

To learn more information about fibromyalgia, and if you may have it, call Colorado Center of Orthopaedic Excellence at (719) 623-1050, or request an appointment online.

Hip Dislocation

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The hip joint is one of the most important joints in the human body. It allows us to walk, run, and jump. It bears our body’s weight and the force of the strong muscles of the hip and leg. Our hips are also one of our most flexible joints, which allows a greater range of motion than all other joints in the body, except for the shoulder.

The hip is considered one of the more complex regions of our body due to its multiaxial arrangement, meaning it can move in many different directions. When they are healthy, it takes great force to hurt them. However, playing sports, running, overuse or falling can all sometimes lead to hip injuries. These include strains, bursitis, dislocations, and fractures. Certain diseases also lead to hip injuries or problems. Osteoarthritis can cause pain and limited motion. Osteoporosis of the hip causes weak bones that break easily, both of which are more common in older people.

Hip Dislocation:

Your hip is the joint where your thigh bone meets your pelvis bone. Hips are called ball-and-socket joints because the ball-like top of your femur moves within a cup-like space in your pelvis. The socket is formed by the acetabulum, which is part of the large pelvis bone. The ball is the femoral head, which is the upper end of the femur (thighbone). A smooth tissue called articular cartilage covers the surface of the ball and the socket. It creates a low friction surface that helps the bones glide easily across each other. The acetabulum is surrounded by strong fibrocartilage called labrum. The labrum forms a lining around the socket, creating a tight seal, helping to provide stability to the hip joint.

A traumatic hip dislocation occurs when the head of the thighbone (femur) is forced out of its socket in the hip bone (pelvis). When there is a hip dislocation, the femoral head is pushed either backward out of the socket, or forward. It typically takes a major force to dislocate the hip. Car collisions and falls from significant heights are common causes and, as a result, other injuries like broken bones often occur with the dislocation. In rare cases, a hip dislocation can occur during impact sports like football. A hip dislocation is a very painful and serious medical emergency, where immediate treatment is necessary.

Treatment and Recovery:

In cases in which hip dislocation is the only injury, an orthopedic surgeon can often diagnose it simply by looking at the position of the leg. Because hip dislocations often occur with additional injuries, your doctor will complete a thorough physical evaluation. If there are no other injuries associated with the dislocated hip, the doctor will administer an anesthetic or a sedative and manipulate the bones back into their proper position. This is called a reduction.

Recovery depends on the person and severity of the dislocation and injuries associated. It takes time, sometimes 2 to 3 months for the hip to heal after a dislocation. The rehabilitation time may be longer if there are additional fractures. Patients often begin walking with crutches within a short time. Walking aids, such as walkers, crutches and, eventually, canes, help patients get mobilized. Physical therapy will often be required to speed up the recovery process.

If you have suffered an injury to your hip or think you may have dislocated it, request an appointment with the Colorado Center for Orthopaedic Excellence at (719) 623-1050 for immediate treatment. 

What is a Hip Arthroscopy and Why Do You Need One?

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A hip arthroscopy is a type of surgery that helps your doctor get a clear view of the inside of a joint. An arthroscopy may help doctors diagnose and treat joint problems. During an arthroscopy, a small camera, or and arthroscope is inserted into the hip joint. The camera allows the surgeon to visually see any damage to the joint.

When Do You Need a Hip Arthroscopy?

Hip Dysplasia:

Your doctor may suspect you have dysplasia, a condition where the socket is shallow and makes the cartilage more susceptible to tearing.

Synovitis

Synovitis is a condition that causes the tissue around the joint to become inflamed. Synovitis makes walking and day to day activities extremely uncomfortable, and maybe even impossible.

Loose Bodies

Sometimes, pieces of bone or cartilage may become loose. These fragments can damage the tissue around the joints or the joint itself.

Femoroacetabular impingement (FAI)

FAI is a bone disorder where bone spurs (or overgrow) around the joint socket.

There are many other conditions for which a hip arthroscopy may be needed to accurately diagnose the problem with the joint. As the hip is one of the most important joints in our body, it is imperative that the doctor can visually see the problem before advising a solution.

Ways to Prepare for a Hip Arthroscopy:

Most hip arthroscopies are performed as an outpatient procedure (meaning that patients are allowed to go home directly after the procedure). Here are some ways to prepare for the procedure:

·       Medications: Your doctor may advise that you stop certain medications before your surgery. You may also be advised to continue to take other medications up until the morning of the procedure. It is important to keep a record of all medications you take and keep a schedule of which ones to continue and which ones to stop.

·       Food: Your doctor may also advise that you stop eating the night before the procedure and avoid eating the morning of. A lot of patients find it helpful to schedule the procedure in the early mornings to avoid hunger and cravings.

·       Answer all questions as accurately as you can: Your surgeon will have questions, and so will the anesthesiologists. It is important that you answer all the questions as accurately as possible to ensure a smooth procedure.

A hip arthroscopy will help your doctor accurately diagnose any hip problems you may have. By visually seeing the condition, your doctor will be better able to diagnose the condition and create a treatment procedure to optimize success!

For more information about any hip related issue, or how a hip arthroscopy may be able to help you, schedule an appointment at Colorado Springs Olympic Training Center today! Call us at (719)623-1050.