Orthopaedics
Hip injuries: prevention and treatment
Lifestyle changes can strengthen your hip muscles and joints, the risk factors for hip injury. Discover the latest treatments for hip injury too.
Common hip injuries include hip fractures, dislocations, labral tears, bursitis, tendonitis, impingement and muscle sprains or tears. According to Dr Craig Solomon, an orthopaedic surgeon at Mediclinic Cape Gate, these injuries are often the result of ageing, accidents and falls, or sports-related overuse of the hip.
“In people over age 65, hip pain is often a result of osteoarthritis of the hip where there is a gradual degeneration of the cartilage because of wear and tear,” he says. “In younger people, hip problems are often a result of high-impact sports injuries, which cause ligament, muscle, and labral issues.”
Stay active, eat right
Of the lifestyle changes you can make to extend the longevity of your hip muscles and joints and prevent hip injuries, Dr Solomon says the most important thing is to stay active. “Exercises that maintain muscle strength will help improve balance and stability of the hip, which helps prevent injuries and falls, but remember to stretch for 10 minutes before and after exercise.”
It’s important to keep a healthy body weight, as extra kilos put more strain on your joints and muscles. “Eating a balanced diet is crucial. Aim for 1 000-1 200mg of calcium and 600-800 IU of vitamin D each day, as this can greatly lower the risk of hip fractures in older adults.”
Getting enough protein is also key for maintaining muscle strength. Foods rich in potassium, like avocados, bananas, lentils, and mushrooms, help with collagen production, which supports bone health.
Dr Solomon advises his patients to avoid smoking and heavy drinking, defined as more than two drinks a day on most days.
Risk factors for hip injuries
Another effective way to prevent hip injuries, especially in the elderly, is to schedule regular eye exams. “If you have poor eyesight and are elderly, you’re at a greater risk of falling,” he explains.
Fainting spells, which can affect all age groups, lead to falls. They are often caused by an abnormal or irregular heartbeat, known as arrhythmia. If you experience fainting, consult your doctor to rule out any underlying cardiovascular issues.
For people older than 65, or those at risk for osteoporosis, Dr Solomon emphasises the importance of having a bone density scan.
“Addressing low bone density can greatly lower the risk of fragility fractures. People at risk for osteoporosis include those with a long-term low-calcium and low-vitamin D diet, a family history of osteoporosis, women who have gone through menopause, individuals taking daily oral steroids, and those with several health issues like rheumatoid arthritis, diabetes, or thyroid problems. It's important for these individuals to get bone density tests starting at age 50."
Dr Solomon explains that several medications are available to treat osteoporosis, including bisphosphonates, selective oestrogen receptor modulators (SERMs), parathyroid hormone, calcium and vitamin D supplements, and hormone replacement therapy (HRT).
For young people with hip problems, these issues may stem from an anatomical abnormality known as hip impingement syndrome, or femoroacetabular impingement (FAI). This occurs when the femoral head (ball of the hip joint) pinches against the acetabulum (socket), which can lead to labral tears and cartilage damage.
Do I need hip surgery?
Dr Solomon says a doctor will consider surgery if a patient’s hip pain is affecting their ability to do daily tasks, socialise, play sport, or work, even after trying non-surgical treatments like pain medicines, anti-inflammatories, physiotherapy, biokinetics, and orthotic devices.
“If you’ve tried all these interventions and continue to have significant pain that affects your ability to function, then we would investigate further, doing X-rays, and MRI and ultrasound scans. Once we have information from these tests, we may consider a hip procedure.”
The most common hip treatment is a steroid injection, which can be intra- or extra-articular (given either inside or outside the joint). If these injections work well, Dr Solomon says they can be administered three to four times a year.
Common surgical procedures for hip issues include arthroscopic surgery, which is minimally invasive, and open surgery for injuries to ligaments, muscles, and the labrum. As a last resort, hip replacement surgery may be considered for patients with severe hip pain when all other treatment options have been exhausted.
To find an orthopaedic surgeon near you, go to www.mediclinic.co.za
