Preserving and strengthening our hips becomes drastically more important than what is “hip” this season. We’re not talking about love handle tightening or the beautiful curves, we’re talking about what’s underneath – the ball and socket joint that has to endure for decades. What should we keep an eye on and is there a self hip-check like a self-breast exam? I spoke with OrthoCarolina Orthopedic Surgeon, Dr. Michael Bates, in order to strengthen my own knowledge about how to make sure I’m taking care of my hips. Here’s what I learned:

Explain the parts of the hip that usually cause problems?

Most commonly the hip joint itself (where the ball meets the socket) is the culprit for problems because of osteoarthritis or other types of less common arthritis. Other common hip issues relate to the glueteus minimus tendon (the large tendon that connects to the top of the hip bone). Like other tendons in the body, these can become injured through overuse or accidents, leading to persistent pain.


Arthritis, hip fractures, tendonitis, bursitis, hernias and gynecological and back issues are the top causes of hip pain for women. How do the top causes of hip pain actually affect a woman’s hip?

Arthritis is a very common condition that is partly due to genetic predisposition, morphology of the woman’s hip, and activity. The cartilage between bones wears away over time, leading to osteoarthritis. 

Hip fractures are common after the age of 50, when the drop in estrogen leads to weakened bones. Simple falls can lead to hip fractures with osteoporosis.

Tendonitis occurs in the hip as it does in the shoulder, elbow, knee, ankle. There isn’t always a clear reason; however, tendon-related pain is quite common. 

Hernia is a general term that refers to an abnormal opening within the body which can be associated with discomfort. Hernias can occur in many different locations and, therefore, the symptoms can vary dependent on their location. 

Gynecological issues tend to cause pain in the pelvis, rather than the hip itself, but occasionally some women will describe pelvic pain as hip pain. Some gynecological issues can cause a “mass effect” on nearby nerves, which cause pain in the hip.


What are signs women should look for to indicate a hip issue?

Unfortunately, Osteoporosis has no symptoms, but it can detected with bone density tests after 50. 

Osteoarthritis in the hips is often noticed when the patient has pain with putting socks/shoes on and/or pain with long car rides or prolonged walking. Tendonitis usually manifests with pain out lateral/outside part of hip and/or pain laying on hip while sleeping


What is joint preservation? 

Joint preservation refers to the field of orthopedics that aims to preserve the cartilage which softens the ends of the bone and reduces the friction when the bone ends move against each other. Joint preservation surgery seeks to reconstruct the joint in order to delay the need for joint replacement surgery. Joint preservation surgeries are more successful when the patient is young and the arthritis is limited to certain areas of the joint. After the age of 50, the role of joint preservation is much smaller than it is at younger ages.


Imaging – How do you determine when someone needs a hip replacement versus just a repair?

The need for hip replacement can usually be easily determined by x-rays in the office combined with the patient’s symptoms and physical examination. Osteoporosis can be diagnosed with dual energy x-ray absorptiometry (DEXA) scans. Tendon issues about the hip can typically be sufficiently evaluated with physical examination, x-rays, and patient history. Occasionally, an MRI may be needed.


Are hip problems often the cause of most falls?

There are many, many causes for falls including hip and/or knee pain, balance issues, previous strokes, and simple trip-and-falls. However, the hip is very often injured after fall. This is largely due to the prevalence of osteoporosis (weaker, more porous bones).


What is hip dysplasia, and how can it be prevented?

Hip dysplasia refers to a spectrum of abnormal developments of the hip. In women, this commonly takes the form of a hip socket that’s more “shallow” than it should be. This shallow socket causes increased force in the hip (the bone can’t go as deep as it needs to within the socket), which can lead to osteoarthritis over the course of many years.


Why are women more susceptible to hip problems?

A couple of reasons: Hip dysplasia is more common in women and can predispose women to osteoarthritis. And Osteoporosis, which we discussed in our last article, is a major cause of fracture in women vs men.


What should people be doing to prevent hip problems?

Keeping a healthy weight (BMI around 25) may be helpful in preventing osteoarthritis and tendon problems around the hip. After menopause, it’s crucial to talk to your primary care physician to ensure the appropriate medications are being used to prevent osteoporosis and the problems that develop from it.


Dr. Michael Bates, OrthoCarolina


If you’d like to learn more about weight bearing exercises to help prevent osteoporosis, check out OrthoCarolina’s online resources here.

For more information, contact a professional at OrthoCarolina.


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