Musculoskeletal Care of the Mature Patient
Most hip injuries are not recognized as the source of symptoms for an average of 21 months from the time of onset. The hip is part of the CORE and it becomes difficult at times to differentiate between referred pain from the back, the pelvis or the vascular system, a diagnostic dilemma In the differential diagnosis, it is helpful to be aware that hip injuries are common in specific sports such as ballet, running, soccer, golfing and contact sports.
With the emergence of the MRI and more recently, hip arthroscopy, once the hip is recognized as the source if symptoms, it is possible to determine if the injury is extra-articular, chondral, capsular, bony, labral or systemic. The significance of the accurate diagnosis stems form the potential for non-operative rehabilitation of selected hip pathology.
It is not possible in the available space to provide individual exercise programs for ITB, adductor sprains, snapping hip syndromes, etc. All hip rehabilitation though is centered about Pelvic/Hip/Core exercises.
Stretching
Strengthening
Joint mobilization
Functional drills
Return to play
The take home message, a well-designed rehabilitation program is essential to a successful outcome. The return to play criteria demands restoration of an acceptable range of motion, restoration of hip strength equal to the uninvolved side, the ability to perform sports specific drills at full speed without pain or compromise, and the completion of a functional sports test.
My recommendation to patients who are interested in injury prevention is cross training. Avoiding repetitive stress and cumulative fatigue will go along way to prevent injury. Equally important is to environ your self with skill matched competition and the setting of realistic goals. If injury should occur, head to the water. There is nothing better that water based aerobics and wet vest running in the deep end of a pool for keeping you in shape as you heal.
