If you have hip pain, figuring out who to see to get your pain fixed can be a literal pain in your butt! The healthcare system is confusing and not set up for your or anyone else’s success. What follows is a simple step by step guide to get you back to doing what you love and fix your hip pain.
- Start With Physical Therapy
If you have a fall or are concerned for a fracture, your first stop should be an ER or an urgent care for an x-ray to rule out a fracture. For most people, that will not be the case however.
If you are more of the majority and did not have an acute injury but instead your hip has slowly started bugging your more and more, your first stop should be the best Physical Therapist you can find near you for your issue. The Physical Therapist will be able to assess your hip clinically and tell you what they think the diagnosis is. If they feel it is something they can help you with, ask them to outline the plan of care for you and make sure you are taking objective starting measures. These are going to be very important to measure your progress over the next few weeks. IF you are not measuring your progress, you are guessing and that does nothing but get expensive.
Every two weeks you should take a step back and ask yourself if you are seeing true, measurable improvement. Ask your Physical Therapist to help you with this and honestly look at it together. If you find that after two weeks nothing is changing, then you either need to discuss an incorrect diagnosis or a change in plan of attack. Hopefully, for most of you reading this article, this is where you get better and start doing what you love again.
Unfortunately, there are some of you who may need to move on to the next step. At some point, if there is no measurable progress, the Physical Therapist might recommend that you move on to the next step. But, before you do that, make sure your Physical Therapist has been doing a good amount of soft tissue work (putting their hands on you or utilizing IASTM, Dry Needling, ART or other hands on techniques) as well as starting to challenge you with some mobility or strength training exercises. Remember, theraband exercises are not strength training!! They should at some point be having you up and working on functional strength training.
2. Non-Operative Orthopedic
This is often times the next stop for some in clinic imaging, a possible injection or other medical intervention that will help your Physical Therapy become more effective. There is a HUGE difference between this type of MD and a surgeon so do your homework!
This should always be your last stop. Surgeons are great at fixing structural things that are broken. At the same time, their intense focus on this element that makes them amazing in the operating room also sometimes can make them blind to the other factors and possible impacts that could be at play. The great surgeons understand that their skill is a gift best used as a last resort.
Unfortunately, there are those surgeons out there who will cut if you ask them. So do your homework and ALWAYS make sure to get at least 2 opinions before going through with anything. I would also suggest using your Physical Therapist and the Non-operative MD that you already visited as sound boards in addition to the surgeon to make sure that you have covered all the conservative bases possible. If surgery is going to happen, you want to make sure that you have exhausted every other option first.
Now with all that being said about surgeons, let’s be clear that there are bad Physical Therapists who never put their hands on you and only throw exercises at you too. To expect you to get better with exercises when your tissues are unhealthy and not in a place to respond optimally to the stresses placed on them is silly and irresponsible. Be on the lookout for this bad practice as well.
There are also bad non-operative MDs who just want to inject you whenever they can without looking at other options or discussing other conservative options. Just be on the lookout and make sure you require them to talk through their thought process and explain everything to you.
The moral of the story is that in all professions, there are good and bad, OK and great professionals. Seek out the great ones. You are your own best advocate and that starts with having an understanding of what great is, what you should expect from each practitioner you meet along the way and most importantly, the landscape of what you have to navigate. Hopefully this gives you some insight into where to start and where you may end up.
Let us know if we can help guide you through the process at any point. We always offer free discovery calls and visits to just discuss your case and help you get to where you need to go to get back to doing what you love!