Hip & Glute

SIJ (sacroilliac joint) Dysfunction

 

 

 

 

 

 

 

What is it?      

Dysfunction in the sacroiliac joint, also called the SI joint, can sometimes cause lower back and/or leg pain.

 

What does it feel like?

  • Lower back pain that feels dull, aching, and can range from mild to severe. Lower back pain is typically felt only on one side, but in some cases may be felt on both sides.

  • Pain that spreads to the hips, buttocks, and/or groin. One of the most common areas to feel SI joint pain is in the buttocks and upper back or side of the thigh. Pain is typically felt only on one side, but may be felt on both sides.

  • Sciatic-like pain in the buttocks and/or backs of the thighs that feels hot, sharp, and stabbing and may include numbness and tingling. Sciatic-like pain from sacroiliac joint dysfunction rarely extends below the knee.

  • Stiffness and reduced range-of-motion in the lower back, hips, pelvis, and groin, which may cause difficulty with movements such as walking up stairs or bending at the waist.

  • Worsened pain when putting added pressure on the sacroiliac joint, such as climbing stairs, running or jogging, and lying or putting weight on one side.

  • Instability in the pelvis and/or lower back, which may cause the pelvis to feel like it will buckle or give way when standing, walking, or moving from standing to sitting.

Why does this happen?

Pregnancy or recent childbirth can commonly cause sacroiliac joint pain in women due to weight gain, hormonal changes causing ligaments in the SI joint to relax (hypermobility), and pelvic changes associated with childbirth. For some women, ligaments may remain loose after childbirth and cause sacroiliac joint pain and instability to continue.

Activities that place repeated stress on the joint, such as contact sports, regular heavy lifting, or labor-intensive jobs. If pelvic and/or low back muscles are unconditioned, stress from prolonged sitting or standing may also contribute to SI joint pain.

Piriformis Syndrome

 

 

 

 

 

 

 

 

What is it?      

Piriformis syndrome is an uncommon condition which involves the piriformis muscle (one of the deep muscles of the buttock) compressing or otherwise irritating the sciatic nerve as it passes under or through the piriformis muscle. This can occur by the muscle tightening or going into spasm.

 

What does it feel like?

The symptoms of piriformis syndrome include pain deep in the buttock, and pain radiating down the back of the thigh.

Why does this happen?

  • Running, extensive walking and bushwalking, prolonged sitting and trauma all contribute to piriformis syndrome.

  • Women are affected more often than men.

  • It is more common in people whose sciatic nerve passes through the muscle.

  • Piriformis muscle spasm can occur as a result of pelvic dysfunctions (loss of control of the pelvic bones) and is also seen in patients who have very poor core stability (or poor deep muscle stabilisers of the trunk) – in these cases the piriformis muscle compensates for this lack of strength.

Femoroacetabluar Impingement (FAI)

 

 

 

 

 

 

 

What is it?      

In FAI, bone overgrowth — called bone spurs — develop around the femoral head and/or along the acetabulum. This extra bone causes abnormal contact between the hip bones, and prevents them from moving smoothly during activity. Over time, this can result in tears of the labrum and breakdown of articular cartilage (osteoarthritis).

Types of FAI


There are three types of FAI: pincer, cam, and combined impingement.

  • Pincer This type of impingement occurs because extra bone extends out over the normal rim of the acetabulum. The labrum can be crushed under the prominent rim of the acetabulum.

  • Cam In cam impingement the femoral head is not round and cannot rotate smoothly inside the acetabulum. A bump forms on the edge of the femoral head that grinds the cartilage inside the acetabulum.

  • Combined. Combined impingement just means that both the pincer and cam types are present.

 

What does it feel like?

  • Pain

  • Stiffness

  • Limping

  • Pain often occurs in the groin area, although it may occur toward the outside of the hip. Turning, twisting, and squatting may cause a sharp, stabbing pain. Sometimes, the pain is just a dull ache.

Why does this happen?

FAI occurs because the hip bones do not form normally during the childhood growing years. It is the deformity of a cam bone spur, pincer bone spur, or both, that leads to joint damage and pain. When the hip bones are shaped abnormally, there is little that can be done to prevent FAI.

It is not known how many people have FAI. Some people may live long, active lives with FAI and never have problems. When symptoms develop, however, it usually indicates that there is damage to the cartilage or labrum and the disease is likely to progress.

Because athletic people may work the hip joint more vigorously, they may begin to experience pain earlier than those who are less active. However, exercise does not cause FAI.

Gluteal Tendinopathy

 

 

 

 

 

 

 

What is it?      

Gluteal Tendinopathy is defined as moderate to severe disabling pain over the Greater Trochanter (lateral hip pain).

This condition affects both athletes (particularly runners) and less active people.

GT has significant impacts on the quality of life, with similar symptoms to those of hip OA. It interferes with sleep (side lying) and common weight bearing tasks

 

What does it feel like?

  • Lateral hip pain

  • Pain when laying on side

  • Pain with exercise

  • Develops and worsens over time

  • Can be worse at night

Why does this happen?

  • Altered biomechanics

  • Tight muscles 

  • Stiff joints

  • Strength imbalance

  • Poor load management

Trochanteric Bursitis

 

 

 

 

What is it?      

Trochanteric bursitis is an inflammation of the trochanteric bursa. Trochanteric bursitis is an element of a greater term, hip bursitis, that envelopes 4 different types - Trochanteric bursitisIliopsoas BursitisGluteal Bursitis and Ischial Bursitis

It’s often used as a general term to describe pain around the greater trochanteric region of the hip.

 

What does it feel like?

  • Pain and/or tenderness in the lateral aspect of the hip that may radiate down the thigh

  • Ascending stairs is a painful activity

  • Patient is unable to lie down on the affected side

  • Development of pain-related sleep disturbance

  • Lower back pain (Trochanteric Bursitis can present as back pain)

Why does this happen?

  • Women more commonly affected than men.

  • Overuse of the muscles around the bursa or the joint underneath the bursa.

  • Incorrect position: this can cause an increase in pressure.

  • Too much pressure on the bursa (caused by friction of the Iliotibial band)

  • Excessive or rapidly increased mileage

  • Repetitive strain: e.g. frequent training with too much weight or training in a bad position

  • Leg length differences

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