Danielle is a female swimmer who came in to see us with a chief complaint of right hip and knee pain. Her pain began after running a half marathon two years ago, and afterwards, she attended physical therapy at another practice and experienced a reduction in her symptoms. But while training for an upcoming half marathon, her symptoms returned once again and began to intensify. An MRI revealed that Danielle had a tear of a structure called the labrum in her right hip, and a joint injection was performed, which led to only a minimal reduction in symptoms. She also underwent another course of physical therapy, but this did not lead to any significant reductions in her pain either. Once Danielle decided to first visit Dynamic Sports Physical Therapy in New York City, she could not run or attend yoga classes due to pain on the side and front of her hip.
While performing a comprehensive evaluation, Danielle’s therapist Jon found that she had signs of both hip dysplasia and joint laxity. Hip dysplasia is a condition in which the socket of the hip doesn’t fully cover the ball of the upper femur (thighbone), while joint laxity is a term used to describe joints that are too loose, or lax. Danielle also displayed too much internal rotation of both her hips, stood with significant knee recurvatum (too much backwards motion of the knee), and had poor stability of her core muscles while performing exercises that postured her in right hip extension. Finally, it was found that she had limited external rotation of her hip, weak hip muscles, and squatted with right lower extremity valgus. After completing this evaluation, Jon confirmed her diagnosis as a right hip labral tear and greater trochanteric bursitis.
What we did at Dynamic Sports Physical Therapy in New York City to help Danielle improve
Before beginning treatment, Danielle stated that her primary goals were to return to her running routine, independent gym workouts, and yoga classes after completing her program. Danielle’s treatment started with an aggressive hip and core strengthening routine that focused on exercises to improve the extension of her right hip and strengthen a specific set of muscles called the hip abductors. Next, Jon incorporated some strengthening exercises at the end range of her hip internal rotation. Although the goal here was not to necessarily increase her range—since it was already too great before she started treatment—it was still important to focus on end range strength here so that Danielle was strong through her entire range of motion. This was key a key component of Danielle’s treatment and different than what she had worked on with previous physical therapists. She also worked on maintaining the flexibility of several muscles on the outside of her hip, including the iliotibial band, tensor fasica latae, and quadriceps muscles.
Once Danielle completed her personalized treatment program, she noticed a significant reduction in her pain levels and was able return to her running routine without noticing any pain. Getting to this point took a great deal of one-on-one time with Jon and further evaluation of her condition and response to treatment. Eventually, this process helped Danielle understand that her hip laxity/dysplasia was the main obstacle that was interfering with her ability to improve, which unfortunately cannot be changed by physical therapy because it’s an anatomical problem. However, Jon told her that if she continued with her core strengthening exercises in specific positions, hip strength at the end range, and flexibility exercises for the muscles of her hip, it is possible for her to become pain-free in the future.
Danielle had this to say about her physical therapy experience with us: “Jon was attentive and knowledgeable in diagnosing the source of my injury and how to resolve it. We worked together on a movement treatment plan that reduced my pain and allowed me to more my hip more easily. Now, when I do my exercises regularly, I can run, ski, do exercise classes, and stand for long periods of time (all previously problems!) without pain.”
Jon and the rest of the staff at Dynamic Sports Physical Therapy in New York City are thrilled to see Danielle finally find an effective solution for her condition, and we wish her continued, pain-free success in the future. If you’re dealing with some pain of your own that’s holding you back in any way, we’d like to help you next in achieving similar outcomes to Danielle. Contact us at 212-317-8303 to schedule an appointment today, or click here to read our last blog for more information on hip dysplasia.