Knee Pain

Overview

The hip joint is the body’s largest ‘ball and socket’ joint connecting the leg to the torso, and is designed to allow the body to move comfortably and easily. It is responsible for our ability to walk, run and jump and is second only to the shoulder when it comes to range of motion.

It is a remarkably strong part of the body that can bear a reasonable amount of overuse due to the covering of cartilage over the hip joint that protects the area from friction and rubbing as the bone moves in its socket. The hip joint is also surrounded by numerous attachments of large muscles.

As with every body part, the hips are vulnerable to damage with age and wear and tear, which can result in pain to the area. This can be caused by cartilage wearing down, and the overuse of the muscles and tendons in the hip. Hip pain is a common problem with a multitude of causes, and can be caused by other parts of the body such as the knees or lower back.

The most common forms of hip pain treated by Dan Everson Podiatry are Trochanteric Bursitis, Inside Hip Pain, Illotibial Band Syndrome, Arthritis and Osteitis Pubis.

You can find more information about these forms of hip pain below.

Trochanteric Bursitis

Trochanteric Bursitis

Overview

Trochanteric Bursitis occurs when one or more of the fluid-filled, cushioning sacs (bursas) over the prominent bone on the side of your hip (femur) becomes irritated and causes pain and inflammation. It is more common in middle-aged and elderly women than it is in men and younger people.

Causes

Inflammation of the trochanteric bursa occurs when muscles or tendons rub over the bursa and cause friction between it and the thighbone. This can be caused by repetitive trauma to the area, leading to a gradual onset or from direct trauma such as a fall, collision or other forceful impact to the hip. Some of the more common causes of inflammation are:

  • Tightness in the hip muscles and weak muscles in the buttocks.
  • Abnormal walking patterns due to poor function in the feet or lower limbs.
  • Difference in leg length.
  • Lower back problems.
  • Osteoarthritis in the hips or lower back.
  • Scoliosis (abnormal lateral curve of the spine).
  • Lack of core strength to support the pelvis and trunk of the body.

Symptoms

Symptoms of this condition may include one or more of the following:

  • Pain, discomfort or tenderness when you press the affected area or when laying on that particular side of the body.
  • Pain in the hip that radiates through the buttock and down the outside thigh to the knee area.
  • Swelling and inflammation.
  • Redness or warmth from infection.
  • Increase of pain during and after long periods of sitting, walking, running, using stairs or other physical activity that causes repeated trauma to the area.
  • Limping or difficulty walking without pain.

Diagnosis

Dan Everson Podiatry can diagnose Trochanteric Bursitis through history taking, a physical examination of the hip and legs and a Biomechanical Assessment to study your range of movement. Pressing or applying pressure to the trochanter area may replicate pain or discomfort that will further aid correct diagnosis.

Other tests are not usually required but may be used if infection of the bursa is suspected. An X-ray or MRI may assist if diagnosis is not clear using other methods.

Treatment

Trochanteric Bursitis will typically resolve itself over time but it may take anywhere from a few weeks to several months before you are pain free. This is normal and usually not indicative of a more serious condition or further damage to the hip joint.

Dan Everson Podiatry would typically suggest one or more of the following treatment methods:

  • Rest and refraining from undertaking exercise and physical activities that aggravate the condition.
  • Anti-inflammatory medication to reduce swelling.
  • Applying ice to the area after exercise or movement that causes pain.
  • Keep your weight within a healthy range for your age and demographic.
  • Using a cane or crutch during recovery to keep weight off the affected hip whilst you walk.
  • Kinetic Orthotics can be prescribed to correct abnormalities or imbalances in the foot and leg. This is a range recommended by Dan Everson Podiatry, designed using patent-protected technology to optimise the way force is transferred as you move.

Prevention

Dan Everson Podiatry recommends the following activities to help prevent an onset or recurrence of Trochanteric Bursitis:

  • Monitor and regulate your workouts and physical activities to limit the amount of stress and trauma to the hip joint.
  • Warm up before undertaking exercise and avoid starting new exercises at full intensity until you are used to the movements.
  • Stop if you feel pain around the area.
  • Strengthen muscles in your core, hip area and buttocks to improve your balance and control during movement.
  • Keep your weight within a healthy range.
  • Orthotics may be prescribed to help prevent an occurrence of this condition in those at risk.
Illiotibial Band Syndrome

Illiotibial Band Syndrome

Overview

The illiotibial band (ITB) is a tendon that begins at the pelvis and runs down the outside of the thigh and crosses through the knee to attach to the shinbone. It serves to stabilise the outside of the knee as it flexes and extends during movements like walking, running and jumping.

ITB Syndrome, also called “runner’s knee”, refers to inflammation of this tendon as it slides back and forth over its connection point at the outside of the knee. Although this movement is part of the normal range of motion for the knee and tendon, repetitive sliding and overuse of the tendon through repeated bending and straightening causes friction and irritation, leading to this condition.

Causes

Some of the most common causes of ITB include:

  • Overuse and repetitive strain caused by increasing the distances you run or your general training intensity.
  • Inward rolling of the knees and hips during running.
  • Worn out, damaged, inappropriate or unsupportive footwear.
  • Downhill running or running on uneven surfaces.
  • Weak gluteal muscles, hip muscles and hip rotators.
  • Difference in leg length, bowed legs, abnormal pelvic tilt and flat feet.

Symptoms

There are varying degrees of ITB syndrome. Depending on the severity, you may experience one or more of the following symptoms:

  • An ache or burning pain outside the knee and occasionally outside of the thigh and hip joint.
  • Pain in the above areas that increases during running or other repetitive movements and improves with rest.
  • Swelling at the outside of the affected knee.
  • Limping after exercise or periods of repetitive activity.

Diagnosis

In determining whether you are suffering from ITB syndrome Dan Everson Podiatry would typically ask questions about your symptoms and health history. A careful physical examination of your posture and body and limb movement when walking will assist diagnosis. In some cases it may be necessary to conduct an ultrasound or MRI.

Treatment

With adequate treatment and care most cases of ITB syndrome can be resolved within a timeframe of six weeks to six months.

There are simple measures that can relieve symptoms of ITB Syndrome such as rest, icing the affected area on the knee and regular stretching of the ITB area.

Depending on the effectiveness of these, it may be necessary to undertake one or more of the following treatments:

  • Use pain-relief and anti-inflammatory medication.
  • Review and modify your training program to avoid excessive or repetitive running movements and activities.
  • Strengthening of the knee, hip and leg muscles.
  • Correct your running and landing technique.
  • If you have a gait imbalance, Kinetic Orthotics from Dan Everson Podiatry may be prescribed and inserted into your footwear to help balance weight loading in the foot and guide motion of the foot during walking and running. This is a range recommended by Dan Everson Podiatry, designed using patent-protected technology to optimise the way force is transferred as you move.

Prevention

Dan Everson Podiatry recommends the following steps to help prevent ITB Syndrome:

  • Avoid running on hard surfaces such as concrete or bitumen.
  • If running on the road, change direction often so that both legs are exposed equally to inconsistencies in the road.
  • Gradually increase your running distance and intensity. Avoid sudden and drastic increases to mileage and effort.
  • Ensure your shoes or joggers are not damaged or worn and distribute your weight evenly across the foot.
  • Schedule an appointment with your podiatrist to ensure you have appropriate footwear for your needs.
  • Orthotics may be prescribed to help prevent an occurrence of ITB syndrome in those at risk.
Arthritis of the Hip

Arthritis of the Hip

Overview

Arthritis is the inflammation of one or more of the joints and can impact the hip, making it challenging to move without pain. Cartilage between the bones of a normal hip allow a gliding movement and effectively absorb shock. Arthritis of the hip is characterised by the gradual disintegration of the cartilage and bone surfaces, and the resulting inflammation of the hip joint. It can result from a particular injury or gradual damage.

Arthritis of the hip most often occurs in people over the age of 50. It is more common in overweight people with a past history of hip injury.

Arthritis cannot be cured, however there are many care options available to treat the symptoms and slow its progress to help reduce pain. The most common forms of arthritis to impact the hip are osteoarthritis and rheumatoid arthritis.

Osteoarthritis

Overview

Osteoarthritis is the most common type of arthritis. It is a degenerative condition often experienced by middle-aged people. The cartilage in the joint disintegrates over time, becoming rough and minimising the protective space between the bones. As a result, the bones may rub together which causes the joint to become painful and inflamed.

When osteoarthritis affects the hip, the cartilage in the hip joint will gradually wear away and become rough, with the projective space between the bones decreasing. Bone rubbing on bone and bone spurs will often result. It is a disorder that develops slowly, with pain becoming more disabling as time progresses.

Causes

The most common causes of osteoarthritis of the hip are:

  • Obesity and a family history of the condition.
  • An injury of the hip.
  • The ageing process.
  • Improper formation of the hip joint at birth.

Symptoms

People with osteoarthritis of the hip can experience problems walking and develop a limp. Stabbing, sharp or dull pain is the most common symptom and is felt around the hip joint. Pain and stiffness of the hip can be worse first thing in the morning, or after a period sitting or intense activity. Many people find their hip pain becomes worse in rainy weather. Occasionally the joint will lock and a grinding noise can be heard during movement.

Diagnosis

Dan Everson Podiatry can diagnose osteoarthritis through history taking, a physical examination of the hip and a Biomechanical Assessment to study your range of movement, look for swelling in the joint and pain experienced through movement. An X-ray, MRI or CT scan may also be recommended to evaluate the stage of the illness.

Treatment

Dan Everson Podiatry would typically suggest one or more of the following treatment methods:

  • Anti-inflammatory and pain relief medication.
  • Weight loss may be recommended for overweight patients.
  • Your podiatrist can recommend certain exercises to strengthen and stabilise the hip, and minimise risk of injury.
  • Engaging in lower impact forms of exercise such as swimming.
  • A cane or walker can improve mobility and help people move with less pain.
  • Minimising activities that make the condition worse, such as climbing stairs.
  • Surgery may be recommended in some cases where osteoarthritis has progressed to an advanced stage or when other forms of treatment have not improved the condition. Dan Everson Podiatry can provide recommendations on the ideal procedure and costings.

Prevention

Dan Everson Podiatry recommends the following activities to help prevent developing osteoarthritis in the hip.

  • Control your weight to lessen strain on the hip.
  • Treat any hip injuries as quickly as possible.

Rheumatoid Arthritis

Overview

Rheumatoid Arthritis is a chronic autoimmune disease that often impacts multiple joints of the body, including the hip. Rheumatoid arthritis typically occurs in both hips at the same time.

This condition occurs when the immune system attacks its own tissues. The immune cells of people with this condition attack the soft tissue between the joint capsule and joint cavity of the synovial joints, which causes the area to become swollen.

This form of arthritis affects 1% of the population, with women more than twice as likely to develop the condition than men.

Causes

The causes of rheumatoid arthritis are presently unknown.

Symptoms

The symptoms most often associated with rheumatoid arthritis of the hip are:

  • Severe pain, stiffness and swelling of the hip, with pain worse in the morning and reducing with activity.
  • Fever, fatigue and appetite loss.
  • Stiffness and discomfort in the thigh, buttocks and groin.
  • Softening of the bone resulting in stress fractures and bone collapse.
  • Difficulties walking up inclines and stairs.

Diagnosis

Dan Everson Podiatry can diagnose rheumatoid arthritis through history taking, a physical examination of the hip and a Biomechanical Assessment to study your range of movement, look for swelling in the joint and pain experienced through movement. An X-ray, MRI or CT scan may also be recommended to evaluate the stage of the disease.

Treatment

Dan Everson Podiatry would typically suggest one or more of the following treatment methods:

  • Anti-inflammatory, pain relief and prescription medication that can help slow the spread of the illness.
  • Rest and applying ice to the area.
  • Canes and crutches may be advised for severe cases.
  • Your podiatrist can recommend certain exercises to improve your range of movement.
  • Surgery may be recommended in some cases. The most common procedure performed for rheumatoid arthritis is the fusion of the affected joints. Dan Everson Podiatry can provide guidance on the ideal procedure and costings.

Prevention

There is no known way to prevent rheumatoid arthritis, as the causes are presently unknown. There are several ways to reduce your risk of major joint damage after a diagnosis of this condition:

  • Consult with your podiatrist as soon as you have any symptoms.
  • Speak with your podiatrist about a program of gentle stretches and strength movements to reduce pain and strengthen the hip.
  • Rest from exercise during the periods you are experiencing the most pain.
  • Avoid smoking.
Osteitis Pubis

Osteitis Pubis

Overview

Osteitis Pubis is a debilitating condition common in athletes and sportspeople. It affects an area of the groin called the pubic symphysis, where the two pubic bones join at the front of the pelvis. The pubic symphysis is made up of cartilage that absorbs the force generated when we move our legs.

There are muscle groups attached near this area that contract when we perform certain movements such as running and kicking, sending a pulling force through the pubic symphysis area. When this force is either repetitive or of a high intensity (or both), the pubic symphysis can become damaged and irritated.

Causes

This condition is most commonly associated with overuse and repetitive activities that strain or place prolonged force through the pubic symphysis. Some of these activities include:

  • Overuse and repetitive strain through running larger distances or increasing your training intensity.
  • Sports that involve repeated kicking motions or changes of direction such as football, netball, tennis, soccer and athletics.
  • Pregnancy and childbirth.
  • Poor or abnormal biomechanical function in the foot, feet or legs. This can be as a result of tibial torsion contributing to duck feet or pigeon-toe.
  • Weak gluteal muscles, hip muscles and hip rotators.
  • Inappropriate footwear for your exercise of activities.
  • Major trauma such as a fall or car accident.

Symptoms

Osteitis Pubis can affect you in different ways depending on the severity of your condition. Most patients describe pain that increases gradually over time. Some of the symptoms you may experience include:

  • Sharp or dull pain that results from activities like running, changing direction, pivoting on one leg and kicking.
  • Pain when the abdominal muscles are contracted.
  • Tenderness, pain or discomfort when applying pressure to the pubic bone at the front of the pelvic area.
  • Pain when squeezing your legs together or moving one leg away from the centre line of the body.
  • Discomfort from lying on your side.

Diagnosis

Dan Everson Podiatry will ask questions about your symptoms and health history. A thorough physical examination including stress tests, range of motion and other mobility testing will likely be performed. In some cases a CT scan or MRI may be helpful to examine for abnormalities or irregularities.

Treatment

Most sufferers of Osteitis Pubis recover fully after taking the appropriate treatment measures. In extreme cases, surgery may be required. Some or all of the below treatment options may be recommended:

  • Rest and avoid performing any physical activities that cause pain to the area.
  • Use pain-relief and anti-inflammatory medication.
  • Ice and heat packs to the area may provide temporary relief.
  • Stretching and strengthening exercises as prescribed by your podiatrist.
  • If you have a foot imbalance or biomechanical abnormality contributing to your condition, Kinetic Orthotics from Dan Everson Podiatry may be prescribed and inserted into your footwear to help balance weight loading in the foot and correct motion during walking and running. This is a range recommended by Dan Everson Podiatry, designed using patent-protected technology to optimise the way force is transferred as you move.
  • Using a cane or crutch during the healing process to keep weight off the pelvis when you walk.

Prevention

It is common for Osteitis Pubis to recur. Some of the preventative measures Dan Everson Podiatry recommends are:

  • Stretching and strengthening exercises for the stabilising muscles.
  • Warming up properly before you exercise.
  • Reducing your exercise or training workload to limit the amount of time your pubic symphysis is exposed to force, stress and trauma.
  • Seeking advice from your podiatrist on the most appropriate footwear for your needs.
  • Orthotics may be prescribed to help prevent an occurrence of this condition in those with an imbalance or poor biomechanical function.