Hip dysplasia is a pathology whereby the hip joint is the wrong shape or that the hip socket is not in the correct position or is too shallow to completely cover and support the femoral head. This over time changes the way our hips should naturally move and causes increased force, and abnormal wear on the cartilage and labrum in the hip joint.
I am currently treating a 42-year-old female that was diagnosed with mild hip dysplasia as an adult. She has a history of hip pain, hip joint restriction, and a change in her walking gait. She is also hypermobile (more flexible) and sometimes presents with a leg length discrepancy.
There are a number of tests Myotherapists use to help diagnose adult hip dysplasia. These may include; the Trendelenburg Sign (identifies instability and potential weakness of gluteus medius and minimus muscles); Antalgic Gait (looks to identify leg length difference or muscle weakness); Hip Impingement Test (identifying bone spurs, labral tears and breakdown of articular cartilage); Apprehension test (looks for potential instability); and the Bicycle Test ( scans for abductor muscle insufficiency). An x-ray is also recommended to confirm the diagnosis, and then the severity of the condition is identified by measuring the centre-edge angle, which is 25-degrees or more in a normal hip joint.
There are a number of different treatments for hip dysplasia; the most invasive includes surgery, and non-operative options include weight loss if indicated, lifestyle modification, cortisone joint injections, and specialised physical therapy. As a Myotherapist we may assist in the non-operative area via education, hands on treatment and corrective exercises. Some lifestyle modifications include elimination of high impact activity such as running where cycling or swimming is preferred. Some of the exercises I prescribed to my client include; maintaining hip motions in all directions via stretching unless pain or pinching occurs; and strengthening exercises of the stabilising muscles of the hip abductors and external rotators.
My client has lost some weight, increased her over-all strength, and modified some lifestyle activates that were aggravating her hip. Now her hip joint is more stable, and she experiences reduced and less frequent pain intensity.
As part of the education component, it is prudent to mention Developmental Dysplasia of the Hip (DDH) which is the most common cause of hip arthritis in adults. Consequently, screening in the infant stage is important from birth to 6-8 weeks old. At this age, a few tests can be performed such as the Barlow’s test and Ortolani’s test. From 8 weeks until walking age the Abduction or Galeazzi test may be performed.
I hope this case study has been informative and gives you the motivation to get your hips checked out at your next appointment.
Nicole Davies – Elite Myotherapist