Ask a PT

156 Posts
 
Posted - 12/14/2006 :  23:09:34  Show Profile  Reply with Quote
Our user asked: "Hello, I am 21 years old and have pain in my hip area. I noticed my hips hurting after we did lower quadrant screening exams in class. They hurt the most when I internally rotate them. I usually sleep on my side and lately it's been uncomfortable. I have to place a pillow in between my knees to relieve some pain. I noticed that external rotation also relieves some pain but only for a little while."

Ask a PT Response: "I'd need to ask a lot more questions and perform additional tests on you to be able to give you a more conclusive differential physical therapy diagnosis. However, I'll give you my thoughts which I hope you and your classmates can build off of and examine your situation further. You mentioned you experience hip pain after performing quadrant tests in class. Performing such tests as the FABER or FADIR are only a few tests which can help assist you in determining the etiology for your pain. Since you are young, I would not suspect any arthritic changes of the hip which could be causing your pain. "Internal rotation of the hip results in pain while external rotation of the hip relieves the pain." This could suggest impingement of the anterior hip capsule with IR, increase stress at the greater trochanter resulting in irritation of the trochanteric bursa or muscles/tendons that insert in this general location, pathology of the internal rotators ie. strain, improper length/tension relationship, etc. (take a look at pain with AROM or PROM). Basically, I would recommend you come up with a problem list and look at various factors which could be affecting the tissue of origin ie: subjective (past injuries, sports involved in, symptomology etc.), observation/posture, leg length, gait, functional pattern compensations, mechanics, strength, ROM (active & passive), joint play, flexibility and palpation. Then utilize special tests to further rule in or out possible contributing factors for your pain. One important thing to remember is to examine the entire body and to not just focus on the hip area as problems in other areas can affect the hip. When you have taken a closer look subjectively and objectively, then create that problem list. Address these problems and implement changes to correct for them. Hopefully, these changes will result in a positive outcome for you. Please feel free to contact me should you have further questions."