Lower Back Pain Injury

Hip injury can present in different ways, e.g. it can just start suddenly with severe aching in the hip. It can also gradually set on until it becomes an unceasing and excruciating pain. Hip, buttock or pelvis injury can yet come on as random and indefinite pain over a period of time.

Pain that is diagnosed as hip injury radiates from the groin rather than the buttock, but it can radiate downwards towards the knee, or upwards to the lower back. Lower back pain itself can also radiate towards the hip and feel appear like a hip injury. It can also cause pain to the pelvic area and buttocks.

Injury to one leg can cause us to use compensatory behaviour to lessen the pain, and this action can affect the function of the hip and create added pain in the process. Compensatory movement can originate from injuries to the same leg or the opposite one to the hip.

Considering that hip pain/injury can be caused or originate from any of the above scenarios, it is extremely necessary to pinpoint the exact cause of pain in order to treat it at the source—a thorough assessment is therefore necessary.

Lower Back Pain Injury Blog  Low back pain Hip pain

How does physiotherapy help?

Assessment will start with the way you walk in order to establish a pattern. The physiotherapist can also look at your functional mobility, e.g. when you sit and get off a chair, or when you squat—if you can squat. They will also assess the movement of both your hips at the joints, your posture and your lower back flexibility.
It may also be necessary for the physiotherapist to examine your feet and ankles, even assessing the kind of shoes you use, if they think this might have anything to do with your pain.

You can be treated in the following ways:

  • Joint mobilisations
  • Heat or ice
  • Electrotherapies like TENS, ultrasound or interferential
  • Massage
  • Stretches or strengthening exercises
  • Real-time ultrasound core muscle assessment
  • Low back mobilisations, stretches or exercises

Managing your Pain at Home

You can try to manage your pain at home before you see the physiotherapist. In the case of an acute or sporting injury, you can use the well-known RICE — Rest Ice Compression Elevation.

You can also use a pillow, cushion or rolled up towel for support if lying down on a bed or couch. The most comfortable position is on your side. Remember to keep your hip mobile, but not to the extent of straining it further or hurting yourself. Do not attempt to take positions that can cause you pain and possibly more damage to your hip.

Finally, you need to book yourself in to see a physiotherapist as soon as possible, in order to get a full assessment for the right treatment.

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In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)

image

Complete tear of rectus femoris
with large hematoma (blood)

image

Separation of muscle ends due to tear elicited
on dynamic sonography examination

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