Hip Pain Treatment SYMPTOMS Most frequently, the pain that arises from the hip joint is felt in the groin or on the siteof the hip. When the joint is inflamed the pain could have a very sharp quality. In the chronic condition the pain is dispersed over larger area and is felt as dull and achy. CAUSES Hip pain disorders unless arising from trauma are mostly a combination of improper development of hip and pelvis bones and disturbance of walking mechanics.
DIFFERENTIAL DIAGNOSIS Differential diagnosis is based on clinical examination and radiology such as x-ray, ultrasound or MRI. Most common hip conditions include: labral tears, FAI (femoroacetabular impingement), degenerative hip disease (hip arthritis), degenerative hip tendon disorders and hip bursitis. Frequently, pain in the joint on the back or side of the hip is referred from muscles or joints in the spine. Pain arising from spinal nerve compressions at L2 - L3, L3 – L4 can refer to the hip and groin area. Spinal joint restrictions from the upper lumbar or lower thoracic areas can refer to pain in the hip and groin. Occasionally femoral, illiohypogastrioc and illioinguinal nerves can be impinged.
DIAGNOSIS At NYDNR we use a thorough clinical exam from both structural and functional perspective. We use diagnostic ultrasonography to visualize hip joint, tendons and bursas. We use sophisticated video ​gait (walking)
analysis to define function of hip and its relationship to other joints in kinetic chain during walking.
TREATMENT ADVANTAGE
at NYDNRehab
Our integrative approach and top notch technology allows us achieve excellent results with treating variety of hip conditions. We use extracorporeal shockwave technology to regenerate degenerated or damaged tendons and overused muscles. Computer-Assisted Rehabilitation Environment (CAREN) can detect problems arising from asymmetrical weight-bearing with the assistance of force-plate and motion-capture analysis, along with a feedback/feed-forward facilitation retraining that is unique among newest sports rehabilitation treatments. Last but not least, is our legendary DNS (Dynamic Neuromuscular Stabilization) therapy, which has become the hallmark of hip treatment standard in the industry. CONDITIONS TREATED at NYDNRehab - Hip labrum tears - FAI ( femoral-acetabular impingement) - Hip arthritis - Hip bursitis - Groin pain - Hip snapping conditions such as coxa saltans - Hip pain in runners and various athletes - Hip tendinitis and tendinoses - Post-surgical hip rehabilitation - Myofascial hip conditions
HIP SPECIALIST NYC While injuries of the hip and pelvis are not the most common cause of pain in the lower extremities, a hip pain can be quite serious and have significant repercussions for the function and stability of the other parts of the body. While older adults may suffer from degenerative diseases of the hip as they age, middle age individuals who used to be very athletic are especially prone to hip pain due to predisposing factors, excessive seating and carryover of the prior injuries acquired during teenage sporting activities. Athletes in general are more susceptible to injuries of the hip than the average population. Hip injury in runners is 2 to 11 percent higher than in the general population, while the hip is involved in 7 to 14 percent of all ballet injuries. Whatever the source of the problem, patients need the reassurance that they can receive proper diagnosis and practical conservative care such as walking and running specific physical with emphasis on gait and function of lower kinetic chain. The proper function of the hip is so paramount for pain free low back and ability of walking and running.
A BRIEF LOOK AT HIP ANATOMY
The hip joint is the largest joint in the body, and also one of the most stable. It derives much of its stability from being a ball-and-socket joint. A ball-and-socket joint is a joint in which the rounded end of one bone inserts into the depression of another. In this case, the “ball” is the head of the femur (the thigh bone) and the “socket” is the acetabulum, a sizable concave depression in the lower part of the pelvic girdle. The acetabulum is lined with a fibrous rim of cartilage known as the acetabular labrum, which deepens and further stabilizes the hip joint by
helping to keep the ball in the socket. If the acetabular rim is injured, a patient can develop labrum tears, resulting in pain and stiffness.
The major muscles of the hip region can be divided into four groups according to their various functions: the flexors, the extensors, the abductors, and the adductors. The iliopsoas and rectus femoris are largely responsible for flexion. Along with the hamstrings, the gluteal muscles assist in extension. (The gluteus maximus, which comprises much of the buttocks, helps to rotate the hip and leg.) The abductor muscles, which include the gluteus medius and gluteus minimus, function to pull the legs away from the midline of the body, while the adductor muscles pull the legs towards the midline of the body.
DIAGNOSIS
Diagnosing hip disorders may not be an easy job because hip/groin area is anatomically dense terrain where different structures are so functionally and structurally intertwined into a robust lumbo-pelvic engine, which defines human locomotive machine. The groin hip area is also very richly innervated by nerves of the lumbar plexus and is known to be a great mimicker. Although, the use of modern radiology is extremely helpful clinical experience is the key. The recent advances in the high resolution ultrasonography as well as gait analysis today allows the hip the clinician a practical arrival to the right diagnosis on the spot.
HIP DISORDERS
Osteoarthritis is one of the most common causes of hip pain in adults, affecting over 15 percent of the world’s population—and the numbers are steadily rising. Typically osteoarthritis develops as a person ages and the cartilage in the joints begins wearing away. Over time this loss of cartilage causes the bones to rub against each other, resulting in considerable hip pain. Osteoarthritis may be exacerbated by obesity or prior health problems, such as hip dysplasia, in which the hip socket does not fully encompass the femoral head. The femoral neck is the area is just below the “ball” part of the ball-and-socket joint in the hip. If this part of the femur becomes fractured, it’s called a femoral neck stress fracture. It’s a common injury in distance runners, and if treatment is delayed it can have serious
consequences for the career of the athlete. While this injury often occurs because of sudden changes in the intensity of a patient’s running or the rate of acceleration, it can also occur because of overuse, poor footwear, or training on unlevel surfaces. Symptoms may include pain in the hip, groin, and thigh, pain at night, and pain when engaging in strenuous activity or bearing weight. Femoracetabular impingement ( FAI) is a frequent source of hip pain in males but also affects females as well. The causes of FAI are a combination of predisposing structural anatomical variations together with poor gait mechanics and trauma. Hip dysfunction and weakness is also most frequently present in people suffering from low back pain, pelvic pain and foot pain disorders. Hip flexor strain can occur when a patient is flexing his or her thigh and something happens that forces the thigh to extend. It can also occur when the thigh is flexing and is suddenly struck by an external force, as when an athlete extends her leg to kick a ball and is hit in the leg. Symptoms may include sharp groin pain and pain that increases with rotation or extension. The most common cause of groin pain in athletes is adductor strain—strain of either the adductor longus, adductor brevis, adductor magnus, pectineal, or gracilis muscles. These muscles can be strained when an athlete suddenly changes direction or is forced to rotate the leg while pulling it towards the body. This injury most commonly strikes hockey and soccer players. It’s sometimes mistaken for femoral neck stress fracture or hip bursitis. Immediately following injury, symptoms may include piercing groin pain, bruising, and swelling. Later, victims may experience tenderness of the adductor muscles and associated tendons and pain when stretching.
HELP FOR HIP PAIN
Treatment for adductor strain and hip flexor strain typically depends on the severity of symptoms. Physical therapy is recommended following rest for the first one to two weeks after injury. A hip pain specialist will guide the patient in a program of physical therapy to restore motion, recover strength, motor control restore biomechanics of gait and functional alignment. Total understanding of all hip disorders is very important as ignored hip symptoms and functional hip deficit can lead to hip osteoarthritis. Therefore hip prevention is a duty of every hip specialist. When it comes to osteoarthritis, the goals of a hip pain doctor who is not performing surgery will be to alleviate pain and increase mobility for patients suffering from this incurable condition. This may include both medicinal and non-medicinal treatment modalities. Examples of the former can include NSAIDs, acetaminophen, and right type of hip physical therapy. Examples of the latter include a general program of exercise—lack of strength in the lower extremities is sometimes a contributing factor in osteoarthritis; weight loss; and weight reducing gait therapy which combines aerobic and strength training. Weight reducing therapy such as AlterG treadmill can be especially helpful because it lessens the amount of weight placed on the joints and allows for the performance of exercises that couldn’t otherwise be managed. The other type of most useful hip specific physical therapy is retraining weight-bearing symmetry and gait stability. This type of therapy is highly skilled and requires modern equipment.
HOW WE TREAT HIP PAIN AND THIGH PAIN
Patients struggling with FAI, osteoarthritis, femoral hip pain, anterior and posterior thigh pain, and other hip pain diseases will find help and most advanced care at New York Dynamic Rehabilitation Clinic (NYDNRehab). While there’s no magical hip pain cure for sports injuries, we do offer advanced rehabilitative treatment that can assist suffering patients in getting back on their feet. The success of our method lies in our ability to incorporate advanced technologies with various manual techniques. Because medical imaging (such as MRI) is limited in its ability to detect problems during movement, we employ computerized gait analysis, a system of viewing and measuring the forces at work when a patient’s body is in motion during walking or running. This not only allows us to see abnormalities, but to understand the complex relationships between the tissues of the body when viewed as part of a moving system. We are the first outpatient clinic in NYC providing a gait analysis lab. When used in conjunction with diagnostic ultrasonography and X-ray imaging, we can obtain a near-complete picture of the mechanics of a person’s gait and the integrity of the tissues surrounding the hip joint. If this analysis reveals damage to the integrity of those tissues, our doctors for hip pain combine standard rehabilitation techniques with biological treatment. In some cases extracorporeal shockwave therapy (ESWT) may be employed. ESWT sends low-intensity, high-frequency sound waves traveling through the skin at the site of injury to regenerate damaged tissue. In case of myofascial hip syndrome where trigger points and fascial adhesions are the sole source of problem we combine defocused shockwaves with ultrasound guided dry needling.Most importantly, we use Computer Assisted Rehabilitation Environment
(CAREN) to resolve problems that have arisen from faulty weight-bearing. Unique in the annals rehabilitation, CAREN creates a simulated, virtual-reality environment, similar to a holodeck, in which a patient is able to perform exercises in an artificial landscape that would not be possible elsewhere. Our clinic is the first in New York City to possess CAREN technology. HIP SPECIALIST NYC While injuries of the hip and pelvis are not the most common cause of pain in the lower extremities, a hip pain can be quite serious and have significant repercussions for the function and stability of the other parts of the body. While older adults may suffer from degenerative diseases of the hip as they age, middle age individuals who used to be very athletic are especially prone to hip pain due to predisposing factors, excessive seating and carryover of the prior injuries acquired during teenage sporting activities. Athletes in general are more susceptible to injuries of the hip than the average population. Hip injury in runners is 2 to 11 percent higher than in the general population, while the hip is involved in 7 to 14 percent of all ballet injuries. Whatever the source of the problem, patients need the reassurance that they can receive proper diagnosis and practical conservative care such as walking and running specific physical with emphasis on gait and function of lower kinetic chain. The proper function of the hip is so paramount for pain free low back and ability of walking and running.
A BRIEF LOOK AT HIP ANATOMY
The hip joint is the largest joint in the body, and also one of the most stable. It derives much of its stability from being a ball-and-socket joint. A ball-and-socket joint is a joint in which the rounded end of one bone inserts into the depression of another. In this case, the “ball” is the head of the femur (the thigh bone) and the “socket” is the acetabulum, a
sizable concave depression in the lower part of the pelvic girdle. The acetabulum is lined with a fibrous rim of cartilage known as the acetabular labrum, which deepens and further stabilizes the hip joint by helping to keep the ball in the socket. If the acetabular rim is injured, a patient can develop labrum tears, resulting in pain and stiffness. The major muscles of the hip region can be divided into four groups according to their various functions: the flexors, the extensors, the abductors, and the adductors. The iliopsoas and rectus femoris are largely responsible for flexion. Along with the hamstrings, the gluteal muscles assist in extension. (The gluteus maximus, which comprises much of the buttocks, helps to rotate the hip and leg.) The abductor muscles, which include the gluteus medius and gluteus minimus, function to pull the legs away from the midline of the body, while the adductor muscles pull the legs towards the midline of the body. DIAGNOSIS Diagnosing hip disorders may not be an easy job because hip/groin area is anatomically dense terrain where different structures are so functionally and structurally intertwined into a robust lumbo-pelvic engine, which defines human locomotive machine. The groin hip area is also very richly innervated by nerves of the lumbar plexus and is known to be a great mimicker. Although, the use of modern radiology is extremely helpful clinical experience is the key. The recent advances in the high resolution ultrasonography as well as gait analysis today allows the hip the clinician a practical arrival to the right diagnosis on the spot.
HIP DISORDERS
Osteoarthritis is one of the most common causes of hip pain in adults, affecting over 15 percent of the world’s population—and the numbers are steadily rising. Typically osteoarthritis develops as a person ages and the cartilage in the joints begins wearing away. Over time this loss of cartilage causes the bones to rub against each other, resulting in considerable hip pain. Osteoarthritis may be exacerbated by obesity or prior health problems, such as hip dysplasia, in which the hip socket does not fully encompass the femoral head. The femoral neck is the area is just below the “ball” part of the ball-and-socket joint in the hip. If this part of the femur becomes fractured, it’s called a femoral neck stress fracture. It’s a common injury in distance runners, and if treatment is delayed it can have serious consequences for the career of the athlete. While this injury often occurs because of sudden changes in the intensity of a patient’s running or the rate of acceleration, it can also occur because of overuse, poor footwear, or training on unlevel surfaces. Symptoms may include pain in the hip, groin, and thigh, pain at night, and pain when engaging in strenuous activity or bearing weight. Femoracetabular impingement ( FAI) is a frequent source of hip pain in males but also affects females as well. The causes of FAI are a combination of predisposing structural anatomical variations together with poor gait mechanics and trauma. Hip dysfunction and weakness is also most frequently present in people suffering from low back pain, pelvic pain and foot pain disorders. Hip flexor strain can occur when a patient is flexing his or her thigh and something happens that forces the thigh to extend. It can also occur when the thigh is flexing and is suddenly struck by an external force, as when an athlete extends her leg to kick a ball and is hit in the leg. Symptoms may include sharp groin pain and pain that increases with rotation or extension.
The most common cause of groin pain in athletes is adductor strain—strain of either the adductor longus, adductor brevis, adductor magnus, pectineal, or gracilis muscles. These muscles can be strained when an athlete suddenly changes direction or is forced to rotate the leg while pulling it towards the body. This injury most commonly strikes hockey and soccer players. It’s sometimes mistaken for femoral neck stress fracture or hip bursitis. Immediately following injury, symptoms may include piercing groin pain, bruising, and swelling. Later, victims may experience tenderness of the adductor muscles and associated tendons and pain when stretching.
HELP FOR HIP PAIN
Treatment for adductor strain and hip flexor strain typically depends on the severity of symptoms. Physical therapy is recommended following rest for the first one to two weeks after injury. A hip pain specialist will guide the patient in a program of physical therapy to restore motion, recover strength, motor control restore biomechanics of gait and functional alignment. Total understanding of all hip disorders is very important as ignored hip symptoms and functional hip deficit can lead to hip osteoarthritis. Therefore hip prevention is a duty of every hip specialist. When it comes to osteoarthritis, the goals of a hip pain doctor who is not performing surgery will be to alleviate pain and increase mobility for patients suffering from this incurable condition. This may include both medicinal and non-medicinal treatment modalities. Examples of the former can include NSAIDs, acetaminophen, and right type of hip physical therapy. Examples of the latter include a general program of exercise—lack of strength in the lower extremities is sometimes a contributing factor in osteoarthritis; weight loss; and weight reducing gait
therapy which combines aerobic and strength training. Weight reducing therapy such as AlterG treadmill can be especially helpful because it lessens the amount of weight placed on the joints and allows for the performance of exercises that couldn’t otherwise be managed. The other type of most useful hip specific physical therapy is retraining weight-bearing symmetry and gait stability. This type of therapy is highly skilled and requires modern equipment.
HOW WE TREAT HIP PAIN AND THIGH PAIN
Patients struggling with FAI, osteoarthritis, femoral hip pain, anterior and posterior thigh pain, and other hip pain diseases will find help and most advanced care at New York Dynamic Rehabilitation Clinic (NYDNRehab). While there’s no magical hip pain cure for sports injuries, we do offer advanced rehabilitative treatment that can assist suffering patients in getting back on their feet. The success of our method lies in our ability to incorporate advanced technologies with various manual techniques. Because medical imaging (such as MRI) is limited in its ability to detect problems during movement, we employ computerized gait analysis, a system of viewing and measuring the forces at work when a patient’s body is in motion during walking or running. This not only allows us to see abnormalities, but to understand the complex relationships between the tissues of the body when viewed as part of a moving system. We are the first outpatient clinic in NYC providing a gait analysis lab. When used in conjunction with diagnostic ultrasonography and X-ray imaging, we can obtain a near-complete picture of the mechanics of a person’s gait and the integrity of the tissues surrounding the hip joint.
If this analysis reveals damage to the integrity of those tissues, our doctors for hip pain combine standard rehabilitation techniques with biological treatment. In some cases extracorporeal shockwave therapy (ESWT) may be employed. ESWT sends low-intensity, high-frequency sound waves traveling through the skin at the site of injury to regenerate damaged tissue. In case of myofascial hip syndrome where trigger points and fascial adhesions are the sole source of problem we combine defocused shockwaves with ultrasound guided dry needling.Most importantly, we use Computer Assisted Rehabilitation Environment (CAREN) to resolve problems that have arisen from faulty weight-bearing. Unique in the annals rehabilitation, CAREN creates a simulated, virtual-reality environment, similar to a holodeck, in which a patient is able to perform exercises in an artificial landscape that would not be possible elsewhere. Our clinic is the first in New York City to possess CAREN technology. Introduction Pain in the hip may occur because of several different work- and running-related injuries that afflict the pelvis region. These include osteoarthritis, hip dysplasia, hip flexor strain, trochanteric bursitis, and iliopsoas tendinitis, any of which can cause debilitating and excruciating pain that prevents a person’s body from functioning properly and hinders the performance of daily activities. Basic Hip Anatomy Much of the stability of the hip joint stems from the fact that it’s a ball-and-socket joint, a joint in which one bone is rounded and can fit neatly into the depression of another bone. The head of the femur, the thigh bone, fits completely into the round concavity of the acetabulum, a vast depression in the pelvis. The acetabulum is just one of the forces that helps stabilize the hip and prevent dislocation. Because of its depth and because it surrounds the femoral head, it diminishes the possibility that the femur will become
dislocated. The hip’s stability is further strengthened by the acetabulur labrum, a rim of cartilage surrounding the acetabulum that makes it even deeper. This in turn provides a large articular surface that stabilizes the joint. There are some important muscles within and connected to the hip that allow movement. These movements include flexion, extension, abduction (pulling a structure away from the midline of the body), adduction (pulling a structure towards the midline of the body), and rotation. The muscles responsible for flexion are the iliopsoas, rectus femoris, and sartorius. The hip extends with the assistance of the gluteal and hamstring muscles. The gluteal muscles also assist in the abduction of the hips, while the hip adducts with the aid of the adductors muscles, the pectineus, and the gracilis. Rotation is provided with help from the gluteal muscles, biceps femoris, and hamstrings. There are over a dozen nerves that pass through the hip and innervate muscles, joints, and tissues in the lower half of the body. Of these, the two most commonly associated with hip injury are the sciatic nerve and the femoral nerve. The sciatic nerve, the longest and widest nerve in the body, passes along the back of the leg towards the knee, where it splits into the tibial and common fibular nerves. The sciatic nerve innervates the muscles of the posterior thigh and is often the site of injury in athletes. The femoral nerve is the largest branch of the lumbar plexus, an important network of nerve fibers located at the side of the first four lumbar vertebrae situated in the lower back. This nerve provides cutaneous innervation to the anterior and lateral thigh, as well as the medial leg and foot. Over the surface of the femoral head and acetabulum is a layer of articular cartilage, a white, shiny, rubbery material that cushions the joints and allows them to rub against each other without causing friction. They’re assisted in this task by the bursae, small sacs filled with a special lubricating fluid that moisten the soft tissues around the hip joints and make articulation easier.
Hip Conditions and Treatment of Hip Pain Hip osteoarthritis, one of the most common causes of hip pain, is a condition characterized by pain and dysfunction of the joints as a result of degeneration of the articular cartilage. Physical symptoms of osteoarthritis include pain in the thigh and groin, pain after prolonged walking. A patient suffering from this condition may also exhibit improper gait, decreased range of motion, stiffness, and continual creaking or popping sounds during movement. Because osteoarthritis is a progressive condition, patients will initially report intermittent symptoms. However, if the symptoms are not treated, they will escalate to the point where he or she may have difficulty sleeping. Osteoarthritis treatment for the hip includes gentle exercises along with ice and heat therapy to relieve symptoms. Non-steroidal anti-inflammatory medications may be prescribed for discomfort and inflammation. In cases where these are not effective, steroidal injections may provide long-term relief. Sciatica, or sciatic nerve dysfunction, is a condition involving compression of a nerve root in the lower back. Typically it begins with a nerve root leading into the sciatic nerve is compressed, either by a ruptured disc or a bone spur. The rest of the sciatic nerve becomes inflamed and pain radiates throughout the hip and leg. Sciatica can occur either through sudden trauma or the slow degeneration of discs as a result of aging. In both cases a disc in the spinal column becomes damaged, or herniated, and the inner, jelly-like tissue of the disc ruptures out into the vertebral canal. Although sciatica originates in the lower back, the pain it causes can create repercussions throughout the lower half of the body. Lateral femoral cutaneous nerve entrapment is different because it’s a pinched nerve condition that begins in the femur itself, one of the major bones that compose the hip joint. Symptoms of lateral femoral cutaneous nerve entrapment include loss of sensation, tingling, and pain in the area above the thigh that may necessitate pinched nerve in hip treatment.
Hip misalignment, or hip dysplasia, is a normally congenital condition in which a child is born with or develops a dislocation of the hip joint. Because the joint has not formed normally, it can easily be dislocated. However it happens, the patient’s acetabulum is less deep than is normal, and shaped more like a dish than a cup. The upper part of the concavity is inclined outward rather than oriented horizontally. As a consequence, the femoral head does not fit properly into and is not fully covered by the depression of the acetabulum. In mild cases the head of the femur simply becomes loose; in others it can be pushed out with enough pressure. In the most extreme cases, the femoral head is completely dislocated and hip misalignment treatment becomes necessary. Hip flexor strain is a condition characterized by tearing of the muscles that assist the hip in flexing. The most prominent of these muscles is the iliopsoas muscle that begins in the lumbar region and inserts into the femur. The hip flexor muscles assist in sprinting and kicking, and feel tension during stretching. Too much tension can cause the muscle fibers of the hip flexors to tear, necessitating treatment for hip flexors. The severity of the injury can range from minor tears with minimal impairment to total ruptures involving severe, agonizing pain. Symptoms include pain on the hip or groin during initial impact, and continual pain when running, going upstairs, or bending the knee towards the chest. Patients may also feel pain and stiffness, especially in the mornings, along with tenderness and bruising. Pulled hip muscle treatment involves rest and rehabilitation within the limits that pain permits. If the muscle becomes torn, it may be necessary to refrain from intense physical activity for between four to six weeks. Trochanteric bursitis is a form of hip bursitis, a condition in which the small, lubricating sacs that surround the joints become inflamed. The greater trochanter is the bony prominence at the side of the body to which several gluteal muscles are attached. Between these muscles and the greater trochanter lies the trochanteric bursa. When the gluteals contract, friction is brought to bear on the trochanteric bursa, and when this friction becomes excessive, the bursa may become irritated or
inflamed, resulting in trochanteric bursitis. This can occur as a result of prolonged or repetitive engagement in activities like running, jumping, walking uphill, or lunging. In some cases bursitis develops because of a direct blow to the tip of the hip. Symptoms may include outer hip pain and pain along the outer thigh running down to the knee. Patients may report aching or stiffness, especially when direct force is applied to the bursa, and a peculiar sensation of weakness in the lower limbs. Treatment for bursitis of the hip normally begins with alteration of the patient’s existing exercise and activity schedule to minimize the conditions that led to overuse. This may be combined with an exercise program of strengthening and stretching, along with heat and ice applications and, in certain cases, cortisone treatments to reduce swelling. Snapping hip is a clinical condition in which a patient experiences a loud, painful snapping when flexing or extending the hips. Extra-articular internal snapping hip is often the result of iliopsoas tendinitis, inflammation of the hip flexor tendon that drapes over the hip socket. This tendon can become inflamed with injury or overuse. As the tendon rubs over the bone of the socket, it can cause painful clicking. Treatment for hip tendinitis in this instance may involve modification of an existing schedule to curtail activities, along with anti-inflammatory medication or cortisone injections. In the most extreme cases snapping may be treated by removing the inflamed tissue. Treatment of Hip Pain at the New York DNR Patients seeking hip strain treatment or hip pain running treatment will find advanced care at the New York DNR. Because successful hip treatment depends on diagnostic precision, we employ computerized gait analysis with advanced technological equipment such as diagnostic ultrasonography and X-ray imagery to assess and treat movement dysfunction. In some cases extracorporeal shockwave therapy may be used to regenerate degenerated or damaged tendons and overused muscles. Finally, and importantly, Computer-Assisted Rehabilitation
Environment (CAREN) can detect problems arising from asymmetrical weight-bearing with the assistance of force-plate and motion-capture analysis, along with a feedback/feed-forward facilitation retraining that is unique among newest sports rehabilitation treatments. Last but not least, is our legendary DNS ( Dynamic Neuromuscular Stabilization) therapy which has become the hallmark of hip treatment standard in the industry. https://nydnrehab.com/what-we-treat/hip-pain/hip-groin-pain/