Hip joint symptoms are commonly described in the front of the hip and can also radiate into the front of the thigh. Joint symptoms may take 15-30 minutes to “loosen up”. In addition, a loss of ROM and function will be described such as difficulty putting on socks and shoes. If buttock pain is the primary symptom, the source of pain may be referred from the lower back or coming from strained muscles in the buttock. Pain can be provoked by sitting, running, lunging, and squatting may be caused by muscles located in the buttock or thigh. A simple test is called the take off your shoe test. This test is done in standing where the good foot takes off the shoe of the involved leg. Pain that is reproduced can indicate a upper hamstring condition. Pain in the side of the hip may be coming from the lower back, hip bursitis, or hip tendonitis. Bursitis is an inflammation of the bursa. The bursa is a fluid filled sack that reduces friction between a tendon and bone. Tendonitis in an inflammation of the tendon. Pain that is provoked by standing on one leg without holding on, for a approximately 30 seconds can indicate muscular involvement. If pain is reproduced, this test could indicate greater trochanteric pain syndrome. Greater trochanteric pain syndrome is a chronic condition caused by several structures such as the bursa, gluteal tendons (gluteus medius and minimus), and IT band.
A history is taken during the evaluation to clarify what functional limitations (walking, stair climbing, sitting, running, etc) the pain is causing. The use of soft tissue mobilization, dry needling, joint mobilization, stretching, strengthening has been shown to provide pain reduction and improved function. The change in the strength and flexibility of the hip and LE muscles can make a big difference in a hip condition. The combination of gains in strength and mobility can provide a reduction in pain and an improved function during day to day activities.