Hip subluxation is not always easy to diagnose. Unlike the hip dislocation which causes characteristic symptoms, subluxation does not necessarily appear on medical imaging. The fact remains that it can cause incapacitating pain and several limitations in daily life.
This article explains what hip subluxation is, how to diagnose it, and above all the management measures allowing its complete resolution.
Hip anatomy, what you need to know
La hip is a ball joint that connects the femur to the pelvis. It is a relatively stable joint, but it allows range of motion. The articulation of the hip is surrounded by a network of ligaments, muscles and tendons, which work together to stabilize the joint and allow normal movement.
Anatomically, the articulation of the hip consists of two main parts: the head of the femur, which fits into a cavity (the acetabulum) in the pelvis. The acetabulum is covered with a layer of cartilage, which helps reduce friction between bones and allows smooth movement.
In addition, a cushion cartilage (the labrum) surrounds the edge of the socket, helping to further stabilize the joint. Together, these structures provide a solid foundation for weight-bearing and movement.
Hip subluxation, what is it?
subluxation in babies
La hip subluxation is a congenital anomaly of the hip joint. Like hip dislocation, it corresponds to a lack of fit between the two elements of this joint, in particular the femoral head and the acetabular cavity (cavity of the pelvic bone or acetabulum).
Under normal conditions, the head of the femur sits in the bone cavity. When the femoral head is found completely outside this cavity, we speak of hip dislocation.
In subluxation, the femoral head positions slightly outside the acetabulum. It is therefore more difficult to observe the malformation, and it is not uncommon for the diagnosis to be overlooked, and for the children to grow up with this condition.
Subluxation in adults
Hip subluxation in adults may be of mechanical, genetic or hormonal origin. It is largely linked to various factors from birth such as the position of the baby in the uterus, insufficient amniotic fluid or a fetal reaction to maternal estrogen.
Often, the subluxation was not diagnosed during childhood, and the body learned to compensate over time. On the other hand, traumatic events, or simply joint overload, can cause symptoms of hip pain.
Following a hip prosthesis, it is also possible to develop a hip subluxation. This occurs in particular when rehabilitation is not optimized, and the muscles surrounding the joint do not work enough to stabilize the hip.
How does hip subluxation manifest?
Hip subluxation is different from dislocation. The latter is very painful and easy to highlight.
Subluxation, for its part, also causes hip pain, but of lesser intensity. It may be associated with limited range of motion in the hip, as well as weakness in the muscles surrounding the pelvis.
In some cases where subluxation is associated with nerve irritation, it is possible to observe neurological symptoms in the lower limb (paresthesia, tingling, numbness, etc.).
How to make a diagnosis?
Again, diagnosing hip subluxation is much more complex than diagnosing dislocation.
On medical imaging, it is not uncommon for the subluxation to be missed, although sometimes a non-optimal alignment of the femoral head with the acetabulum can be observed on X-ray or MRI.
In addition, a health professional or qualified practitioner could highlight elements related to hip subluxation:
- lower limb length asymmetry
- reduction of anterior sliding of the femoral head during manual tests (if the subluxation is anterior)
- reduction of posterior slippage of the femoral head during manual tests (if the subluxation is posterior)
- weakness of the stabilizing muscles of the hip
- reduced range of motion in the affected hip
- mother's difficult birth history
- wearing a hip prosthesis
- history of hip dysplasia
- hip trauma
What is the treatment for a hip subluxation?
Treatment of a dislocated hip mainly aims to return the head of the femur to its socket. There are different treatments depending on the age of the patient and the severity of the disease :
- manual therapy from a physiotherapist (physiotherapist), osteopath or chiropractor
- mobility exercises to improve the flexibility of the hip in certain directions (be careful not to increase hip instability, however)
- hip stabilizing muscle strengthening exercises
- hip motor control exercises performed by a specialized physiotherapist
- tapping (like the K tape) aimed at stabilizing the hip joint
Although extremely rare, it is possible to resort to surgery in the presence of a subluxation which does not improve over time despite well-conducted conservative treatment.
However, it is important to make sure that the hip pain is not caused by another diagnosis (like the following).
My name is Anas Boukas and I am a physiotherapist. My mission ? Helping people who are suffering before their pain worsens and becomes chronic. I am also of the opinion that an educated patient greatly increases their chances of recovery. This is why I created Healthforall Group, a network of medical sites, in association with several health professionals.
My journey:
Bachelor's and Master's degrees at the University of Montreal , Physiotherapist for CBI Health,
Physiotherapist for The International Physiotherapy Center