Hip

Question 1

Greater Trochanter Bursitis

Answer 1

-pain over greater trochanter
-bursitis, tendinopathy, ITB syn
-Glut min bursa (MC): above and anterior to GT
-Subgluteus med bursa: under glut med, pos and sup GT
-Subgluteus max bursa: lat to GT under max and TFL

S/S: pain in post lat hip, referred pain from L2-L4

Cause: glut tendinopathy, atrophy, ITB on glut med tendon, inflammation, trauma, hyperabduction, fall, tight muscles, gait

Better: rest, pillow between knees

Worse: ipsi sidelying, walking uphill, running, ER, abduction

Treatment:
-PT: ROM, decrease injury, decrease inflammation, mechanics, STM, strengthening

Question 2

Hamstring Strain and Tendinopathy

Answer 2

-microtears due to stress
-common due to biarticular
-mostly at musculotendinous junction, eccentric

S/S: pop or tearing sensation, post thigh pain, gluteal pain

Cause: non-contact eccentric rep loading. poor blood supply, degeneration, poor mechanics, imbalances, poor lumbars

Better: rest, slow walking, neutral hip w/ knee flx

Worse: running, eccentrics

Treatment:
-PT: ROM, decrease injury, decrease inflammation, mechanics, STM, strengthening (iso, con, ecc)

Question 3

Hip Labral Tears

Answer 3

-tear of labrum
-ass with hip issues
-Radial flap (antersuperior) MC
-Longitudinal LC

S/S: groin pain, locking, stiffness, painful ROM

Cause: disclocation, twisting, hyperflexion, hip abnormalities, rep mmts, degeneration, lax capsule

Better: distraction, open pack

Worse: twisting, squatting, walking

Treatment:
-PT: decrease pain, decrease inflammation, distraction

Question 4

Piriformis Syndrome

Answer 4

-sciatic n compression from piriformis

S/S: gluteal pain, sitting pain, PF pain, positive Lasegue’s sign

Cause: compression, muscle strain, trauma, pregnancy, sitting, weak glutes, weak core

Better: standing ER, traction

Worse: sitting, squatting, lunging

Treatment:
-PT: address impairments, education, ROM, STM