Quadriceps muscle strains are usually the result of quick sprints or stops during running. A “bulge” or an area of localized tenderness may be present with a muscle strain of the thigh area. Raising the thigh, ascending/descending stairs, and rising from a seated position are a few activities that will exacerbate a muscle strain. Physical therapy treatments focus on proper stretching and re-strengthening of the hip and leg.
A quadriceps tendon rupture can occur with a forceful kick or a traumatic impact to the tendon, such as from a fall. A person can exhibit pain and bruising above the kneecap, trouble walking, and significant weakness of the quadriceps. Surgical is required to repair this kind of injury followed by physical therapy for rehabilitation of ROM, strength, and the ability to walk and return to normal activities.
Groin/adductor strains are typical in sports that involve cutting, side-stepping, pivoting, or other quick movements are needed. Oftentimes, there is a forceful pull of the leg outwards or an outward twisting of the toe that will cause pain and tenderness in the inner thigh region.
A hip pointer is more common in sports such as football, rugby, and soccer where it is likely for a person to receive a direct blow to the iliac crest. Common signs and symptoms include pain, tenderness, and bruising at the bony prominence over the front part of the hip area. Treatment involves rest, ice, and compression and physical therapy for more involved injuries.
Trochanteric bursitis is one of the most common causes of pain the hip/lateral thigh region. A bursa is a fluid-filled sac that acts as a cushion between a tendon and its attachment point to the bone in order to decrease friction. With trochanteric bursitis, there is excessive stress on the bursa between the IT Band and the greater trochanter. Pain will occur over the lateral aspect of the hip which is exacerbated by lying or standing on the affected side and excessive walking. Physical therapy treatments often involve ice/heat, modalities such as ultrasound, and progressive strengthening/stretching to improve function.
A hamstring strain most often occurs from quick acceleration during running or cutting. Sometimes a small pop may be felt or heard during a hamstring strain. Ice, compression, elevation, and physical therapy are all treatments for a hamstring strain.
A fall or a direct blow to the hip can cause a fracture in the femoral neck region. If the bone does not heal properly, the joint can degenerate as a result. Blood flow through the femoral head can also be affected, which can lead to necrosis of the joint.
Avascular necrosis (AVN) is bone death due to disrupted blood flow which can occur from a fracture, dislocation, or repetitive trauma to the femoral neck. An X-Ray, MRI, or a bone scan can help confirm this condition as well as signs and symptoms of pain, limited movement, and pain with walking. Surgical decompression or a total joint replacement may be necessary for relief.
Osteoarthritis of the hip occurs when the cartilaginous coverings between the femoral head and the hip socket begin to wear thin. Pain is noticeably worse during weight-bearing of the affected leg. Internal rotation and flexion are most often limited as well. Recent studies have determined that joint mobilization and stretching can offer significant pain relief.
A hip replacement can be the only option for some arthritic hip joints and femur fractures. In a total hip replacement, both the ball and socket are replaced. Patients will then start with physical therapy in the hospital and will follow-up with outpatient therapy when appropriate for further strengthening and balance training.