Your Hip Pain
Your hip joint is made up of two parts. A ball and a socket. The ball is called the Femoral Head and is the uppermost part of the thigh bone. The socket is called the Acetabulum and is part of the pelvis.
The hip joint is a “ball and socket” joint. The “ball” is known anatomically as the femoral head; the “socket” is part of the pelvis known as the acetabulum. The femoral head and the acetabulum are both coated with articular cartilage. The cartilage is smooth and when lubricated with synovial fluid, makes the joint very slippery with very low friction allowing for smooth, painless movement within the hip joint. This means the hip can move many, many times without wearing the cartilage. An average hip will move during walking about 2 million times per year!
When the cartilage is intact, the ligaments and capsule are un-injured and the muscles acting normally, your hip can do wonderful things! When any of the components becomes injured or the cartilage begins to wear out, pain and reduced movement can occur.
The hip, has a ring of rubbery fibrocartilage around the rim of the acetabulum, called a labrum. This deepens the hip socket and acts as a ‘suction seal’. An intact labrum seals the lubricating fluid within the hip and contributes to stability of the joint.
Surrounding the capsule are several Ligaments. These are strong, fibrous structures that keep the two parts of the hip joint close together, whilst allowing movement and are essential for stability.
Finally, several muscles act across or around the hip joint and are fundamental in making the hip move. The muscles over the front of the hip cause it to flex, and bring your knee up towards your chest. The muscles behind your hip cause your hip to Extend, and and move your leg backwards. Other muscles can rotate your hip in or out, move your leg towards the other one; Adduction, or away from the other leg; Abduction.
What can Cause Hip Pain?
Hip pain can come from several sources.
- Damage to the soft tissues around the hip such as the ligaments, muscles, joint capsule or the bursa. This can be from injury, arthritis or inflammation.
- Damage to the cartilage that makes up the smooth surface of the joint, called articular cartilage. This is most commonly from osteoarthritis but can be due to injury.
- Damage or injury to the bone of the joint. This is most commonly a fracture or break of the bone.
- Damage to the labrum, sometimes called a “labral tear”. When the labrum is torn, the ‘seal’ is broken, and the joint may lose its stability and lubrication. This may lead to loss of cartilage, and potentially early arthritis.
- Referred Pain. This is often from the lower back. The nerves can get irritated in the lower spine and often causes sciatica or leg pain. If certain nerves are irritated the brain registers this as pain in the hip.
- Failing Total Hip Replacement. Hip replacements usually last a lifetime. However, if put into young patients the hip replacement can wear out. Occasionally a total hip replacement can work loose or fail. This often causes groin or thigh pain or both. If your hip replacement is painful, it should be assessed by a surgeon who specialises in Revision Hip Surgery.