Hip Health for Active Women in Sydney CBD

Understanding and Managing Stress Fractures – What role does a good sports physio have to play? Evoker Physio, Hayley O’Brien dives in deep to the diagnosis and management of stress fractures. At Evoker, we are here to help you get better faster, and to help you keep this pain away such that your running performance can again shine.

In our fast-paced society, Sydney women are required to juggle demanding roles (particularly in the CBD), and this often leads to time constraints on our personal well-being. As the pursuit of a ‘balanced’ life becomes increasingly challenging, running emerges as a popular and accessible exercise choice for both men and women. It’s appeal lies in the ease of application (very little equipment is required to make a start), the efficiency of a run (the minimal time commitment required for max gains), and the potential for community building through platforms like Strava.

At Evoker Physio Sydney, we’ve recently observed a growing number of women embracing running, transforming into fitter, stronger, and faster athletes. However, this dedication to pushing physical boundaries with running can sometimes come at a cost to our bone health. Bone pathology initially presents as a deep, dull pain, often in the front of your hip (that is hard to actually put your finger on), and it will often increase during or after running (including the morning after a run). It’s not uncommon for women to walk through our doors with sometimes subtle, yet persistent, discomfort in their anterior hip.

These women share snapshots of their experiences:

• “I feel a deep, dull pain inside my hip.”
• “I think it’s my hip flexor, but I can’t quite pinpoint it.”
• “The pain surfaces during activities like running and HIIT classes.”
• “I’ve intensified my training.”
• “I’m gearing up for a marathon.”
• “I manage only one long run per week due to work and kids.”
• “I just had a baby and want to regain fitness through running.”
• “It hurts when I stand on one leg, putting on my shoes/pants.”
• “I’ve had this pain before, but it went away.”

These stories often point to a building stress response, or stress fracture, of the hip. Each person will have a different story, but there will always be a consistent theme. The first step in addressing this issue is determining the presence, and then grade, of such a stress reaction. An MRI is the gold standard in medical imaging here, and your Evoker physio will refer you for an MRI immediately – should they be at all concerned by a potential stress fracture at the hip. Once the MRI has indeed ruled in a stress fracture, your Evoker physio will tailor your physiotherapy treatment plan to your individual and specific needs.

• Can you still run (generally speaking, this is a no)?
• Could you low load run on the Alter G, or are we cross training another way?
• Is your low back moving as it should?
• How strong is your core?
• Is the tone of your glutes/TFL/ITB/hammy/quad all appropriate?
• Is the strength of your posterior running chain (glute, hammy & calf) where it should be?
• Has your hip joint got adequate power and protection when it is given the clearance to return to sport?
  • Your elite sports physio at Evoker Sydney CBD will guide you on all of the answers to these very important questions
  • Importantly, your Evoker physio will help you implement the necessary changes to your body, such that once your pathology has settled, you are far less likely to have the same pain return once your running builds up again.   

While a low-grade stress reaction may heal relatively quickly, more severe bone stress injuries require a longer recovery. Hearing about a potential hairline fracture can be confusing and frightening for these dedicated runners. At Evoker Physio Sydney, such conversations are not uncommon and we are here to help you understand what it means for you. Your Evoker physio is here to help you get better faster, and to help you keep this pain away such that your running performance can again shine.

If caught early, stress fractures in the hip are very manageable injuries with a super low likelihood of surgical intervention. Typically, bone recovery takes 6-8 weeks, and this gives us the perfect opportunity to build significant strength of key running muscles. We then follow this rest period (from running, but not the gym) with a careful regime of systematically loading the bone. To prevent recurring “hip pain“, that could definitely escalate into a more serious injury, a safe return to full load running might take 3-6 months – under the guidance of your physiotherapist. If these injuries are missed, and you continue to run through this hip pain until you can no longer walk, the consequences become much greater, and rather urgent surgery can be needed to stabalise your hip joint. Talk to us, and we will help you avoid this situation. 

In addition to load management and strength building, managing stress fractures requires attention to nutritional factors. Reduced intake of calcium and vitamin D can expose the bone to stress fractures (especially when high load running is frequent). Therefore, maintaining a healthy, balanced diet with adequate calorie intake and a stable weight is important. Discussions about nutrition should be conducted under the guidance of a doctor or dietitian.

At Evoker Physio Sydney, we aim to ensure that the joy of running remains sustainable for all, and we are here to keep female runners healthy. We understand the precise management that is required in these sensitive cases (get an MRI early!), and we are very confident in tackling stress fractures of the hip in the running community. We empower women to maintain their active lifestyles, whilst optimising their bone health for the long term.

By Hayley O’Brien | Evoker Physiotherapist

ABOUT THE AUTHOR…

Hayley O’Brien | PHYSIOTHERAPIST
MSc Physiotherapy | BSc (Hons) Sport and Exercise Science

Connect with Adam Monteith on LinkedIn

After completing a rather unique double degree – a Bachelor of Physiotherapy & Exercise Science in 2003, & a Masters of Manipulative Physiotherapy at the University of Sydney in 2010 (a voluntary, yet brutal, undertaking for a physiotherapist who wants to be better), Adam established Evoker in 2011. A physiotherapy practice with a difference. & that difference, or ‘niche’, was absolute excellence. 100% of the time. Attention to customer service detail, & excellence in physiotherapy.

Adam’s career in physiotherapy began in the ‘elite’ sporting arena at the Brisbane Broncos Rugby League Club. The lessons learned in this ‘sink or swim’, high pressure environment of the 03/04/05 seasons, created a platform for Adam to really excel in this profession. Adam has accepted invitations to look after the physical health of other Physiotherapists, Doctors, Specialists, Surgeons & none other than a former Prime Minister of this country.

Adam Monteith is a highly skilled musculoskeletal physiotherapist. You can be assured that when you see Adam, your complaint will be thoroughly assessed, and he will use the most appropriate and up to date techniques to treat your problem. Adam’s treatment will always be governed by research. He is constantly analysing the results of the most recent clinical trials so that you can receive the most up to date treatment, helping you to get better sooner. Adam only ever uses evidenced based and clinically proven treatment techniques. Adam Monteith is also a member of the Australian Physiotherapy Association.

Adam is very time aware and prides himself on seeing his patients on time. With a greater than 10 year history of treating and servicing the busy professional in Sydney city, he respects your time and does his best not to keep you waiting.

Adam has:
25 years combined study & clinical experience in physiotherapy/physical therapy
Worked in the heart of Sydney city for more than 15 years
Worked with both the elite athlete & ‘weekend warrior’
Had great success in treating:
– Acute sporting injuries
– Overuse running, cycling & swimming injuries
– Post operative shoulders, hips, knees and ankles
– Complex neck & back cases.
– Adam is often called on for 2nd and 3rd opinions in these complex scenarios.

Expect: A good listener, time spent in assessment phase, plenty of ‘hands on’ physio and exercise.