There has been considerable advancement in the understanding of both the structure and functional biomechanics of the hip in recent years. This has been accompanied by more precise identification of specific hip disorders along with enhancements in the treatment and general management of them. Dr. Cancel and Performance Sport Care in Walnut Creek, CA have been abreast of these advancements and have incorporated the latest non-surgical innovations to provide effective treatment and management of people with hip related complaints. Dr. Cancel also has the unique experience and knowledge necessary to determine which patients are most likely to respond to these different strategies.
Hip Impingement and Labral Tears
Three hip disorders that have been the focus of increased attention in recent years are: femoral acetabular impingement ("hip joint impingement”), hip labrum tears, and occult instability.
There are different presentations of hip impingement, but the common denominator is increased bone formation, either at the rim of the hip socket or at the upper thigh bone adjacent to the socket. This generally results in either friction or pinching of the adjacent joint cartilage with certain movements/positions. The resultant pinching and chipping away of cartilage can eventually lead to tears of the hip labrum or accelerated hip joint arthritis.
Like the labrum of the shoulder joint, the hip joint labrum is a fibrocartilaginous ring that lines the rim of each hip socket (acetabulum). A labral tear may cause pain and/or clicking in the affected hip. Sports that demand a great range of motion of the hip or activities that place instant or repetitive stress forces can produce labral tearing and hip pain.
Hip instability is becoming a more commonly recognized source of pain and disability in patients. When hip instability results from an instant injury or trauma, the cause and effect is clear. Hip instability that is not the result of an instant injury is usually caused by either repetitive external rotation of the hip with superimposed axial loading or generalized laxity of the hip joint capsule/ligaments.
Connective tissue disorders, like Ehlers-Danlos Syndrome, are among those conditions known to cause such laxity. Symptoms caused by non-traumatic hip instability often have a slow and “sneaky” onset. Patients may suddenly find themselves having a wide array of hip symptoms while demonstrating few abnormalities other than the subtle findings suggestive of capsular laxity.
Hip Arthritis (osteoarthritis)
Long term wear and tear can lead to significant arthritic changes of the hip. The development of arthritis can proceed so gradually that it can go unnoticed for years before patients become aware of a problem. Sometimes unrecognized hip arthritis can cause knee pain. Finally, the day comes when the hip doesn’t move well. Pain eventually follows, if it is not already present. Dr. Cancel has found that early recognition of hip arthritis can provide conservative, non-surgical options for patients that may preserve the functional life of their hip(s) before reconstructive surgery becomes the only option.
Bursae are small fluid-filled sacs that are situated in places where friction would otherwise occur. Bursae facilitate the gliding of muscles or tendons over bony or ligamentous surfaces. The most noteworthy bursae are located near the shoulder, elbow, knee, and hip joints. Inflammation of a bursa is known as “bursitis.” Bursitis usually results from impact trauma or continuous compression/rubbing from overlying muscles or tendons. The most common presentation of bursitis near the hip is called “trochanteric bursitis.” Fortunately, bursitis usually responds well to a range of conservative treatments.
Some over-trained athletes develop stress fractures or, otherwise, experience bone stress portending eventual fracture. Dr. Cancel and Performance Sport Care have observed this, in particular, among “Ultra-Marathon “ runners and offer these patients a spectrum of nutrition, re-training, and recovery strategies to address such situations. Whenever the clinical conditions arise, Dr. Cancel and Performance Sport Care will also move quickly to coordinate consultation with other medical care providers to provide patients with the most effective care for their problem.
Low Back Related Hip Pain
There are low back disorders that can refer pain to the hip region. Low back disorders need to be considered in those patients complaining of hip pain but are not displaying actual evidence of hip disease or injury. You can be assured that Dr. Cancel has the knowledge, experience and patience to determine the actual cause of your problem and provide effective treatments that target that problem.
Hamstring, Groin, and Hip Flexor Injuries
There are other common muscle/tendon injuries that are part of the spectrum of “hip” area problems which lead patients to consult Dr. Douglas Cancel and Performance Sport Care in Walnut Creek. These injuries include hamstring strains/tears, proximal hamstring tendinitis, adductor (“groin”) strains, and iliopsoas (“hip flexor”) tendinitis. Dr. Cancel has had extensive experience with these injuries and a track record of successful results.
Your recovery from hip problems and the restoration of your mobility and general physical performance is of paramount importance to Dr. Douglas Cancel and Performance Sport Care. We serve the residents of Walnut Creek, CA, and the nearby communities of Concord, Pleasant Hill, Danville and Lafayette.
Experience comprehensive treatment for hip related problems at Performance Sport Care. Feel free to contact us at (925) 945-1155 or use our Request an Appointment form to schedule your consultation.