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Hip Instability

Hip Instability

The hip joint is one of the largest and most essential joints in the human body. It is a ball-and-socket joint that connects the thigh bone to the pelvis, supporting the weight of the upper body. Using the hip joint, you can perform various movements, including walking, standing, running, and jumping. The joint allows you to evenly distribute your body weight, preventing excessive strain and stress.

However, a number of factors can negatively affect the structural soundness of the hip joint, causing hip instability. Overuse, trauma, hypermobility, and developmental abnormalities are some factors that can affect the stability of this joint.

Here are the essential points covered on this page:

What is Hip Instability?

Hip instability can result from abnormalities of the ball (femur) and socket (acetabulum) of the hip, the ligaments surrounding the joint, or other soft-tissue structures, as all of these components play an essential role in stabilizing the joint. This condition often occurs due to hip dysplasia, when the socket of the joint is naturally too shallow and does not fully secure the ball. However, there are other potential causes of hip instability, including joint trauma, overuse, congenital conditions, hypermobility, and muscle weakness or imbalance. Hip joint instability can disrupt normal function by causing pain and excessive or abnormal movement.

Types of Hip Instability

There are two main types of instability in the hips:

  1. Traumatic Instability

    This type of instability can be caused by injury to the hip joint. This can be due to traumatic events such as falls or direct blows to one's hip, causing damage to bones, muscles, tendons, ligaments, and/or cartilage.

    The trauma can range from mild to severe, which can determine the extent of instability in your hips. Stepping off of a curb or running around on uneven terrain may damage soft-tissue structures, causing instability. In more severe cases, trauma to the hip can cause fractures, subluxations (partial dislocations), or complete dislocations.

  2. Chronic Instability

    Chronic hip instability can be caused by various developmental conditions, which may become noticeable in patients at a young age. Overuse of the hip joint can also result in chronic instability.

Causes of Hip Instability

Several factors and conditions can contribute to instability of the hip joint:

  • Hip Joint Trauma: Motor vehicle accidents, falls, and direct blows to the hip joint can damage the bones, ligaments, muscles, and other structures, like the labrum, that support the hip.
  • Overuse: Repetitive use involving certain movements of your hips can cause instability. This often occurs when playing sports, including running, jumping, and other high-impact activities. The repeated forceful impact on the bones and cartilage can cause wear and tear of the joint and its supporting structures.
  • Congenital Causes: Some individuals are born with certain conditions that can affect the structural development of the hip joint from birth. Hip dysplasia, or a naturally shallow hip socket, for example, can result in hip instability. In some cases, congenital conditions can disrupt blood flow to the femoral head and other hip structures, leading to deformities.
  • Joint Hypermobility: Some people have increased flexibility in the structures surrounding the hip joint, specifically the set of ligaments encompassing the joint known as the hip capsule. This increases the risk for hip instability.
  • Muscle Imbalance and Weakness: The numerous muscles surrounding the hip joint help support the upper body and the overall function of the joint. Examples of these muscles include the glutes and hip flexors. If these muscles become weak, they can contribute to hip instability.

Hip Instability Symptoms

Patients experiencing instability in the hip joint report various symptoms:

  • Pain: Patients can feel pain in the hip joint, groin, buttocks, and outer hip region. The pain is often accompanied by a feeling of instability, as if the joint is about to give way.
  • Weakness: People may experience muscle weakness around the hip area, making it difficult to walk, go up and down stairs, run, and perform day-to-day activities.
  • Stiffness: Aside from weakness, some muscles and tissues surrounding the hip area may feel stiff and difficult or painful to move.
  • Popping and Clicking Sounds: Some patients may hear clicking and popping sounds with movement of their legs. In more severe cases, people report grinding sounds when they walk, sit down, or stand up, which can be alarming.

If you experience any of these symptoms, having your hips examined by a certified medical professional is recommended.

Hip Instability Tests

Several hip tests can be performed to assess for instability in the hip joint. These include:

  • Dial Test
  • Hypertension-External Rotation (HEER) Test
  • Abduction-Hyperextension-External Rotation (AB-HEER) Test
  • Prone Instability Test

Hip Stabilization Surgery

Before considering hip stabilization surgery, you can talk to your doctor about conservative treatments, including physical therapy, activity modification, and assistive devices. However, if these treatments fail to relieve symptoms, your doctor can suggest surgery.

Through a minimally invasive arthroscopic hip surgery, the set of ligaments surrounding the hip joint can be tightened to give the joint greater stability. This procedure, which involves tightly suturing the ligaments together, is known as capsular plication.

Work with Hip Specialists

Dr. Benjamin Domb is an orthopedic surgeon in Greater Chicago, specializing in sports medicine and hip arthroscopy. If you are looking for the best possible treatments for hip instability, our office can recommend treatments tailored to your needs, including minimally invasive procedures that can get you back on your feet in no time. Contact us today to schedule a consultation.