One of two things: you can either get sharp pain during running in the time of the injury,
or you can get a dull toothache sort of dull pain afterwards and that can occur either
that evening or over the next few days. What happens within the hip is the hip is basically
a ball and socket joint and if you've got a slightly egg-shaped oval hip, as the socket
moves up into - as the ball moves into the socket, you can get jarring and that can cause
labral tears or cartilage damage and that can give sharp pain immediately at the time
of the injury. With repetitive movements, you get swelling and bruising in the area
which gives you pain later on. So, you've got to be quite careful of how much running
you do and the sort of activities and avoid injuries. There's also different distributions
of pain and hip injuries. So, during running if you get sharp pain in the groin crease
or the skin crease of the pelvic region, that is typically internal hip pain. Some patients
get pain on the outside and outer buttock area and that can be a gluteal tendon pain
or also referred hip pain.
Hip injuries in running can occur if one hasn't been taking enough time to prepare correctly
for running. So, one of the key things is to make sure you have a good biomechanical
assessment for running shoes, insoles and preparation in planning for the running time
itself. So, you have to make sure you go to a good running school, you get someone to
look at how you're moving, how you're running so that you get good habits. You develop the
right habits in your running style. Within the hip itself, there are problems inside
the hip that can cause running injuries. There are problems on the outside around the bone
and around the muscles and tissues. Within the hip itself, sometimes the ball can become
a bit more egg-shaped and that can give rise to labelled tears and injuries. Something
like that here, you get an anterior extra bit of bone which can jar up against the socket
causing labral injuries. That's another cause. If that's delayed, you then get cartilage
lesions and problems with early wear and tear arthritis. Patients who ramp up the running
too far and don't address some good nutrition and bone health can get stress fractures in
the femoral neck region sometimes and also if you have imbalance and your biomechanical
assessment is not correct, you can get core gluteal tendon problems like trochanteric
bursitis and ITB syndrome problems.
I'm a big advocate of self-help. So education and empowering patients so that they know
the most about their condition, what they want to do, that's very important. So in order
to try and prevent injuries, I think forward planning for the run is important. So making
sure you have the correct gear, you're in the best of health, you've got good nutrition,
all of these things help. Having a good running plan with a 10% rule and building things up
slowly also helps. Also, not just running and being a dedicated runner but actually
having a varied exercise plan will make a big difference. That you need to keep a dynamic
exercise regime as well as muscle and bulb toning. There's a lot of evidence that physiotherapy
also helps in patients for prevention of hip injuries and there's been two very big publications
in The Lancet and the British Medical Journal last year which show that physiotherapy will
also help in treating these hip injuries.
Treatment is needed when patients basically hit a brick wall. When all the self-help treatment
and conservative management treatments have not really helped. If physiotherapy is not
getting you to the goal, that's the time that a surgeon gets involved. A lot of the times
within the hip, the ball and socket, the ball is supposed to be round and it's supposed
to be moving in a socket in an infinite way, but sometimes what can happen is the socket
is either overhung or the ball is slightly egg-shaped and that causes impingement and
jarring of the hip as it moves around and that can cause tears and damage within the
hip itself. If this is left, it leads to premature arthritis and that's a major problem. So coming
sooner rather than later is very important. I am able to then assess this with an MRI
scan, give you an idea of how much damage there is. We always do our best to preserve
the cartilage and the joint for as long as possible. So we can address the primary problem
by removing the bone, repairing the labrum. We also have our biological scaffolds and
collagen scaffolds to repair cartilage and keep you functional and natural for as long
as possible.
Having the correct kit is very important. Having a good plan for running and an exercise
regime is also very important and then having good nutrition and general body health is
very important. Those are really the key features. Not building over too quickly and ramping
up your running exercise, listening to your body, being aware of any minor injuries and
taking time to address those issues and actually having a consult sooner rather than later
will also prevent hip injuries.