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What is Hip Instability?

By Ebru Efe

What is hip instability?

Hip instability is an umbrella term for conditions where pain or weakness affect the function of the hip (or surrounding areas, such as the lower back). This may occur as a result of a ligament injury, a connective tissue disorder (such as Ehlers-Danlos Syndrome) or conditions affecting the bony shape of the hip, such as hip dysplasia. 

Hip dysplasia, or developmental dysplasia of the hip (DDH), is a congenital condition where there is insufficient bony coverage of the head of the femur by the acetabulum. This is often diagnosed following birth, but may be missed and present later in childhood or adolescence. It is more common in females, first born children, those with a family history of hip conditions, and those born in breech position. 

Hip instability may also occur without a structural issue, where lack of muscle strength or motor control produces abnormal movement of the ball of the hip (femur) within the hip socket (acetabulum). This may be as a result of excessive load on a particular area of the hip, a rapid increase or decrease in activity, or biomechanical issues in running or other physical activity. 

What does hip instability look like?

Because of reduced bony coverage at the hip, increased load is often placed on the labrum, ligaments & muscles of the hip in running & impact activities. Over time, this may present as a sharp or dull pain in the front of the hip or groin region. Pain is often aggravated by impact-based activity or end-range positions (such as high kicking, deep lunges or squats, the splits). There may also be a feeling of instability, weakness or tightness in the surrounding hip muscles. 

Who does this commonly affect?

Hip instability tends to occur more often in females than males. It can present at any age from childhood through to adulthood, but often becomes an issue during adolescence while participating in high levels of activity or sports, or following another lower limb injury (which may have contributed to a reduction in muscle strength around the hip). It commonly presents in people who currently or previously participated in activities requiring large ranges of motion, such as dancing or martial arts. 

What does treatment involve?

Managing hip instability often starts with understanding your aggravating activities, and positions where your hip is most challenged. This helps to guide treatment and strengthen muscles to best support the hip. Improving hip and core stability is a key focus in this condition. Where pain persists or symptoms do not improve with rehabilitation, an opinion from a hip specialist may be required to discuss management and explore surgical interventions to improve your hip stability in the long-term.

It is important to obtain a thorough assessment and well-informed diagnosis in the management of hip instability. Please contact us or visit one of our physios if you are struggling with hip pain. 

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