Is hip pain slowing you down? You have options.
Ignoring hip pain now could cause serious trouble later.
Are you ignoring mild hip pain, dismissing it because you think you’re too young—and too active—to develop serious problems? You may want to think twice about that approach.
Ignoring hip pain at a younger age can increase your chances of needing a hip replacement later in life.
The good news for many is that recent advancements allow hip pain sufferers to have more options, according to W. Kelton Vasileff, MD, an Ohio State team physician and orthopedic surgeon at the Jameson Crane Sports Medicine Institute and Ohio State Sports Medicine and Rehabilitation Lewis Center.
“For a long time, there were surgical things that we could do for other joints—like shoulders and knees—that were short of a replacement, but there wasn’t a whole lot we could do for hips. Now there are a number of less-invasive, joint-preserving surgical approaches for the hip as well,” says Dr. Vasileff.
What does hip pain feel like?
It’s not what you might expect, explains Dr. Vasileff.
“Hip joint pain typically manifests as deep groin pain in the front of the hip,” he says, adding that it is sometimes mistaken for other issues, such as a hernia or gastrointestinal and gynecological issues.
“The pain feels deep, and it shoots from the front to the back,” explains Dr. Vasileff.
What causes hip problems in some people?
It’s important to understand that we’re not talking about just one problem.
Different people have different issues related to the hip, and they stem from static and dynamic factors:
- Static factors are based on your anatomy, or how you’re shaped.
- Dynamic factors relate to daily activities, including what you do for a living and what you do for recreation.
“The reason patients have impingement is different in each person,” says Dr. Vasileff. “It depends on how the top of the hip bone and socket are shaped and how that interacts with the activities people choose.”
Different sports require different ranges of motion and muscle forces, which can affect how athletes feel pain. For example, an ice hockey goalie requires much different motion from her hips than does a basketball player who runs up and down the court, cutting and jumping.
3 solutions to hip pain: Nonsurgical, surgical and hip replacement
Ohio State’s Hip Preservation Program has a multidisciplinary team approach to creating a personalized treatment plan. Your treatment team may include surgeons, physical therapists, athletic trainers, sports medicine specialists, researchers and more – all at Ohio State. Let’s run through the three main tracks to help with your hip pain:
Often, the first line of defense is an aggressive schedule of physical therapy, anti-inflammatory medications and, potentially, ultrasound-guided injections of local anesthetic and steroid compounds into the hip.
“The hip injections can help determine if it’s really the hip joint that’s causing the pain or if it is something else, like a muscle or tendon injury around the hip,” says Dr. Vasileff.
Experts at the Ohio State are exploring innovative nonsurgical methods to treat hip pain, categorized as orthobiologics. According to sports medicine physician, Michael Baria, MD, platelet-rich plasma injections and bone marrow concentrate injections are being used in an attempt to heal and restore joints.
These injections serve as natural anti-inflammatories and may encourage healing of cartilage. While research on these areas is limited, Ohio State Sports Medicine is exploring studies to further this science.
Surgically speaking, a hip arthroscopy is one possible option. With this outpatient surgery, the surgeon accesses the joint using a scope and cameras, through a series of small holes. The goal is to repair the labral tear and other cartilage injuries and reshape the bony structure of the hip to remove impingement. This in turn decreases the pain and improves patient functionality.
What’s the recovery time?
A patient can expect to feel relief relatively quickly, but the recovery certainly takes some time. Patients typically use crutches for two to four weeks, and usually can resume light jogging about three months after surgery.
Patients returning to more dynamic athletics such as jumping, cutting and twisting may take six months or longer, similar to recovery from an ACL reconstruction surgery.
3. Hip replacement
When is hip replacement surgery necessary?
When a patient has tried physical therapy and injections, has stopped doing certain activities that are painful and his or her daily activities are still limited, it may be time for hip replacement surgery.
Patients younger than 50 tend to benefit more from the noninvasive procedures and hip arthroscopy. Hip replacement surgery for these younger patients is a risk, mainly because the implant could wear out over time and they may eventually need revision surgery. For patients who are closer to 60 and older, there’s a greater likelihood that it will be their only surgery.
However, age is not the only factor with many younger patients requiring hip replacement and older patients able to pursue hip preservation.