A joint is formed where two bones are joined together, with varying amounts of movement occurring between them. Pain may be related to the structures involved in the function and support of a joint. The hip joint is the joint most commonly related to pain at the front of the hip (Figure 1.1).
- The hip joint is the largest ball and socket joint in the body. The ‘ball’ is the head of the femur (thigh bone). The socket in the pelvis, is called the acetabulum (Figure 1.2).
- Both the ball and socket are lined with smooth cartilage which allows the bones to slide against each other easily (Figure 1.2).
- The smooth cartilage lining the socket merges into a fringe of a more fibrous cartilage that joins around the edge of the bony socket. This is called the labrum (acetabular labrum) (Figure 1.2). It has a variety of functions, assisting in joint stability and health. The labrum makes the joint deeper and hugs firmly around the head of the femur, providing a suction effect. Both of these features contribute to joint stability. The labrum is also involved in the flow of nutrient-rich joint fluid and trapping fluid between the bones when you land on your foot in walking and running. This provides a cushioning effect for your cartilage and helps maintain joint health.
- The ball and socket joint is surrounded by a fibrous capsule, reinforced by a number of ligaments that run between the pelvis and femur (Figure 1.3). These strong ligaments provide stability for the joint but are also flexible, allowing your hip to move in large ranges of motion. There is a large normal variation in how flexible these ligaments are in different people.
Pain Related to the Hip Joint
Changes in joint health:
- may occur in association with some conditions such as:
- hip osteoarthritis
- femoroacetabular impingement syndrome (FAIS)
- acetabular dysplasia
- hip instability
- childhood developmental issues of the hip (Congenital dislocation of the hip, Perthes Disease, Slipped Upper Capital Femoral Epiphysis)
- DO NOT ALWAYS RESULT IN PAIN (Some level of wear or injury to tissues within the joint is so common in adults, it is thought to be ‘normal’. Identification of changes in joint health on XRays or scans is therefore not considered meaningful unless related to pain or other symptoms)
- are poorly correlated with level of pain
- most often become painful with one or more of the following factors:
- too much or too little activity
- rapid changes in activity levels
- activities that put large forces across the hip joint (e.g. stretching too far or landing heavily)
- certain sustained or repetitive postures or movement habits that create small changes that add up over time
- high body weight
- other general health factors
Pain related to the hip joint is most commonly experienced at the front of the hip (anterior hip), but may also be felt in the groin, side of the hip (lateral hip) or deep in the buttock. Other things may also cause pain in these areas, so visit our Pain Locator Map to read about different things that may be related to pain in each of these regions.
After a thorough assessment, your Hip Pain Professional will be able to:
- tell you whether the hip joint and changes on any XRays or scans, are likely to be related to your pain.
- assess for factors that could be contributing to the problem
- set a plan to help you:
- reduce your pain
- improve your ability to do everyday activities involved with work and the household
- return to sport or modified activity
- look after your hip joints for the long term, such as through targeted exercise and education around positions, stretches, exercises or activities that may not be ideal for your joint
- refer you for further investigation if required
- provide or refer you for further medical intervention, if appropriate (injections, surgical opinion)