Hip and thigh problems

Nowadays we spend most of our days sitting. As a result, our hips and legs often remain in the same position for a long time, without much movement and / or muscle tension. Without movement, our muscles and joints become stiff, tight and weak.

With these stiff, tight and weak hip and thigh muscles you walk into the gym and start doing complex and exhausting movements such as squats or running. Often without proper warming up or activation.  This can cause a lot of issues.

Anatomy

A leg is divided into your thigh(femur), your kneecap(patella), your lower leg (tibia and fibula) and foot. The joints in your leg are your hip, knee, ankle, and all the joints in your foot and toes.

Your gluteal muscles primarily move your hip joint.

The thigh muscles (hamstrings, quadriceps and adductors) move both your hip and your knee.

 

An optimal balance between the muscles and joints in your leg provides a strong base of your body, more endurance and increased strength. If this balance is off, issues can occur.

 

Hip injuries

Hip osteoarthritis

Hip osteoarthritis (or coxarthrosis) is a common hip condition. In osteoarthritis, there is a decrease in the articular cartilage,making the joint surfaces less smooth. This process happens to everyone, but not everyone is symptomatic. The common symptoms of hip osteoarthritis are stiffness in the groin region or outside of the hip.  Although the osteoarthritis itself cannot be treated with physiotherapy, the symptoms can be treated well.

How? By making the muscles of the hip as strong as possible, especially in rotational movements. This stimulates the joint capsule to produce joint lubrication that allows the hip to move more smoothly.

Snapping hip

Snapping hip. A snapping hip is a collective name for cracking and snapping sounds in the hip during forward or sideways movements. The snapping or cracking happens when a muscle, tendon, or ligament rolls over a bony part on the hip. The snapping hip can happen in different places.

  • Often this is the iliopsoas tendon in the front or ligaments of the hip that are too tight.
  • The snapping can also be caused by an overly tight and fibrotic glute maximus muscle or the ITB on the side of your thigh.
  • Backside: This can be caused by the hamstring tendon that “snaps” over your ischial tuberosity (your sitbone).

Piriformis syndrome

Piriformis syndrome is a condition where the large leg nerve (sciatic nerve) is pinched by the piriformis muscle. This can lead to various symptoms such as:

  • Radioation and sometimes tingling to the bum and hamstringregion.
  • Lower back pain
  • Difficulty sitting for a longer amounts of time
  • Numb feeling in the hamstring and bum region

The piriformis syndrome can be caused by

  • Overuse
  • Prolonged sitting
  • Hip and pelvic instability
  • SI joint issues

Piriformis syndrome can be very persistent, so a thorough examination and diagnosis is essential to resolve the complaints properly and permanently. Often nerve entrapments like the piriformis syndrome are quickly resolved. If you have any questions about your injury, please let us know via the form at the bottom of the page.

Our treatment

The hip is a complex joint. To find the underlying cause, we analyze your previous injuries, your  past and current sports participation. We also examine your lower back, pelvis, knee, ankle and foot. The cause of your hip problem often lies somewhere in the surrounding joints.

Once we have found the underlying cause, we use a combination of manual therapy, Active Release Techniques and specific exercises to quickly and permanently solve your problem.

Thigh injuries

Thigh injuries can be divided into three categories. Hamstring injuries, quadriceps injuries and adductor injuries. Because we use our legs so much, leg complaints can have major impact on your daily life. Acute injuries often resolve themselves with dosed movement and time. However, if the symptoms persist for more than 1 week, it is wise to seek advice from one of our physiotherapists.

If you only have mild symptoms that do not seem go away on their own, it is also wise to make an appointment with one of our physiotherapists. We assess the underlying cause of your complaint and help you resolve it.

Hamstring injuries

A hamstring injury is the most common thigh injury. Acute hamstring injuries often happen when starting a sprint or when you strain it. Your hamstrings can also become tighter and stiffer over time, without any specifc reason. 

The hamstrings are located on the backside of the thigh. They run from your ischial tuberosity (sit bone) to your tibia and fibula. They provide knee flexion, hip extension and knee rotation. The knee rotation function of the hamstrings is often wrongly forgotten.

Hamstring complaints that develop gradually often do not have much to do with the hamstrings themselves, but with the rest of your body. Because we spend so much time sitting down, in a bent position, the extension chain is not strong enough in many people. The hamstrings are a part of this extension chain and are connected to both your neck and your toes. If a part of the chain does not work optimally and becomes weaker (e.g. the upper back), the hamstrings will compensate for this and become stiffer and tighter.   

If the latter is the case, stretching or foam rolling your hamstring isn’t going to solve your stiff hamstrings. You will benefit way more from actively shortening your hamstrings and strengthening your calves and back extensors. This way you can get more flexible hamstrings without stretching them! The best exercises for your hamstring depend on the underlying cause. Ask one of our physiotherapists for advice.

Quadriceps injuries

Quadriceps injuries are located in the front of the leg.

The quadriceps is made up of four parts, one of which runs over the hip and the knee and the other three parts only cross the knee.  Together, these four heads allow you to bend your hip and extend your knee. Together with the hamstrings, the quadriceps forms a force couple for your hip and knee flexion and extension. Problems or stiffness in one can cause or perpetuate problems in the other. So it is always important to do a thorough assessment to find the underlying injury mechanisms.

Acute quadriceps injuries often happen during a sprint or other explosive movements or by a bruise from trauma to the muscle like a kick or crash. These complaints often disappear within 6-8 weeks. However, physiotherapy can significantly improve recovery time.

Long-term complaints of the quadriceps can be found in the qaudriceps muscles themselves, but also towards their attachment on the knee like a jumpers knee or other patella tendon injuries. Tightness in the quadriceps causes an increased tension in the patella tendon. This prolonged tension can cause irritation and even inflammation in the patella tendon.

Quadriceps problems can also cause other knee problems, hip problems, back problems and patellofemoral pain syndrome.

Adductor klachten

Adductor klachten zitten aan de binnenzijde van het bovenbeen.

Er zijn twee adductor spieren die vanaf je schaambeen richting je heup en bekken lopen en vier die vanaf je schaambeen richting je bovenbeen en knie lopen. Een belangrijke functie van de adductoren is het stabiliseren van de heup. Daarnaast helpen de adductoren met het buigen, strekken en draaien van de heup.

Acute adductor klachten gebeuren vaak bij een sprint of snelle zijwaarste bewegingen waardoor een verrekking of spierscheur ontstaat.

Adductor klachten kunnen ook geleidelijk opkomen en over tijd steeds erger worden. Dit gebeurt vaak als er een onbalans is in de omringende spieren in het bovenbeen. Hierdoor compenseren de adductoren te veel en raken overbelast. Dit kan zich uiten in stijfheid en uitstraling aan de hele binnenkant van het bovenbeen of lokaal in de lies. De adductoren zijn dan vaak ook erg gevoelig als je er op drukt.

Problemen in de adductoren kunnen ook klachten ergens anders in je lichaam veroorzaken zoals knieklachten, heupklachten en rugklachten. Het is dus belangrijk om goed te kijken naar het onderliggende mechanisme bij adductorblessures.

Our treatment

In order to provide effective treatment, it is important to determine the underlying cause of your complaint. The cause of an acute complaint is often fairly clear. With long-term or chronic problems, there is often more going on than just the problem area. We assess the entire movement chain in order to get a good insight into the muscles and joints that influence the onset and development of the injury. This allows us to quickly and permanently resolve the underlying cause. 

If you have any questions about your hip or thigh problem, please contact one of our therapists. Often we can already give you useful tips that immediately reduce your complaints.

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