Hip instability, or hip dysplasia, is becoming a widely accepted cause of hip driven pain. Hip instability refers to movement of the head of femur against the socket. Instability can be traumatic or atraumatic. In regards to physiotherapy, the majority of hip instability cases that are seen are atraumatic. Atraumatic causes of hip instability include bony deficiency or connective tissue disorders. It is thought that due to microinstability within the hip, movement of the femur against the structures of the socket of the pelvis leads to irritation and pain.
Patients will normally report either a gradual onset of sharp or dull pain that is usually localised to the groin, but can also refer to the lateral hip and anterior thigh region. Patients will often describe sensations of clicking and a feeling of instability, or giving way. They usually report pain with activities that are commonly related to hip impingement signs such as pain with flexion and prolonged sitting. Pain is also aggravated with hip extension based activities such as walking, running and standing.
Following a thorough assessment to determine if hip instability is the cause of pain, hip strengthening and postural awareness is key to rehabilitation. Many patients adopt what is called an anterior sway posture, which is an anterior shift forward of their hips in standing. This can further decrease stability around the hips. Becoming aware of movement in standing but also in other postures is important to help settle hip pain. In addition a specific strengthening program is needed to help support the hip joint. If rehabilitation fails then a review with a surgeon may be required, in order to see if other interventions are worthwhile, for the long term health of the hip.
To make a booking to see your local Melbourne physiotherapist for treatment of your Hip Instability or Hip Dysplasia, please call your local clinic or book online.