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Why Does My Hip Hurt?

1/15/2025

There can be many causes for hip pain. A common source of pain often seen in physiotherapy clinics is gluteal tendinopathy. This usually presents a deep ache in the back and/or side of the hip. This condition often feels stiff and sore in the morning and can be sharply aggravated by tasks such as increased walking, standing or climbing stairs.

What is it?
The gluteal muscles, or ‘gluts’, are a group of three muscles that sit around the hips. They are responsible for extending (lifting the leg backward) and abducting (lifting the leg to the side) the hip, as well maintaining stability during standing and walking. Like all muscles, they are attached to bone at either end via a tendon. At times these tendons can become irritated and inflamed which can cause pain, stiffness, and weakness.

Why?
Tendons become irritated and inflamed when they are over-worked, and the body can’t keep up. This can be a result of sudden increase in load such as standing, running, or other forms of physical activity. Sometimes there is no change to the amount of activity, but the body’s ability to recover has changed. This can be the case as we age or when there is a sudden change in hormones, particularly during menopause in women.

How is is diagnosed?
Physiotherapists are trained to assess pathology to determine the source of your symptoms. We use a combination of the subjective history (what you tell us), careful questioning, functional assessments and special tests to rule in and rule out different structures and pathologies.

Imaging such as x-rays or ultrasounds are rarely necessary or definitive in cases of suspected gluteal tendinopathy as these images often show that there are changes to these structures even when they are not the source of symptoms.

What can be done?

Once diagnosed the first goal is to bring the pain under control. This means reducing load on the specific tissue that has become aggravated. Very rarely is complete rest recommended and your physio can work with you to adapt your physical activity to reduce load while still maintaining as much as possible.

The next step is to gradually increase load on the tendon. It is important to build the tendon and muscle strength up in a controlled way. This will involve some fairly light glut specific exercises at first targeted at the gluteal muscles and then progressing to more challenging exercises.

If you have pain around your hip, either new or if it has been going on for a while, check in with us and we can help you figure out what is going on and create a management plan so that you can get back to what you want to do

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Lateral Ankle Sprains

1/6/2025

What is it?
A lateral ankle sprain is a very common injury that occurs when the foot rolls inward. This places force on the structures on the lateral side (outside) of the ankle. When this happens there can be damage to the soft tissue that supports that side of the ankle. This is commonly called rolling your ankle.

What have I injured?
There are a number of structures that may be damaged when rolling the ankle – bone, ligaments, muscles, and tendons. Through their assessment, your physio will identify which structures are likely to be injured.
Each of these injuries have different properties, different healing times, and management strategies.

How do I treat it?
Initially the goal is to protect and calm down pain without completely restricting movement. Treatment in the initial 24 to 48 hours includes:

Compression – this could be a bandage or a tubed bandage. The goal is to reduce swelling around the ankle. Ice is also sometimes suggested for swelling and may also help reduce the pain.

Protection – depending on the severity it is okay to begin some careful, gentle moving around. Using pain as a guide in the first few days is a good rule of thumb. Sometimes taping, a supportive brace or even a crutch can be helpful for day to day activity. In the absence of a fracture a CAM boot is very rarely necessary. Ask your physiotherapist about what will be most appropriate for you.
Ice – Ice doesn’t reduce swelling or promote healing as much as we once believed, but it may make a small difference and may also reduce some of the pain sensation.
Elevation – keep the foot up and let gravity do its work. If you are unable to walk around as normal your ankle will swell, by elevating the ankle any fluid or swelling in the ankle will start to drain toward the rest of the body.

After a day or two swelling and pain should start to subside This is the time to start some movement and exercise. Your physio will be able to help guide you through this process by providing appropriate exercises and support for your specific injury, this rehab program will likely include:

Range of motion - often pain and swelling result in a reduction in range of movement. This needs to be addressed as early as possible to ensure that there is no long term loss.
Strengthening - depending on the tissues involved, there may be a reduction in strength around the ankle that your physio will worth with you to improve.
Balance and proprioception - this is the often neglected part of ankle rehab the is the reason that an ankle still feels "not right", even years after the injury. Ligaments, muscles, and tendons are responsible for proprioception (the body's ability to know where it is in space). When there is an injury to these structures, this ability is impaired and does not improve without specific and deliberate rehabilitation.

How long will it take to get better?
It always depends on the severity, the tissues involved, and what you are looking to get back to doing. Your physiotherapist will work with you to get you back to what you want to do as quickly as possible while also doing so safely.

If not rehabbed properly the ankle can become unstable or weak. This can lead to pain, recurrent sprains, and functional impairments. A well tracked and progressed rehab program will ensure you get the best out of your body and prevent future ankle sprains.

If you have a new or ongoing ankle injury come have a chat to one of our physios to discuss the best way to manage it or progress your performance.

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