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hip-leg-knee - Dr. John Atwater

Dealing with hip, leg, and knee pain can limit your mobility and decrease your quality of life.

Nearly 15 million Americans live with extreme joint pain, and 15 to 20 percent of men deal with long-term knee pain.

At OSA, our orthopedic surgeons and physical therapists want your life to improve. We recognize that hip, leg, and knee pain can get in the way of the activities and relationships you cherish most. However, you don’t need to feel alone. Our experienced hip, leg, and knee pain specialists work with patients to develop treatment plans that suit their needs and lifestyle. We focus on giving you control over your path to recovery.

The Anatomy of the Hip, Leg, and Knee

The hip:

  • The hip joint is a ball-and-socket joint that is stabilized by ligaments and cartilage. It needs to be strong for standing, bending, and carrying things. The joint connects the leg to the pelvis.
  • The hip socket (acetabulum), holds the head of the large upper leg bone (femur). The acetabulum attaches to the acetabular labrum, which increases socket depth and stabilizes the joint.
  • The joint capsule has three ligaments for stabilization. They allow flexibility to move into different positions.

The lower leg:

  • The leg muscles (tibialis anterior, extensor digitorum longus, and extensor hallucis longus) extend from the front of your calf to your feet and toes. The extensor muscles help your feet bend and your toes move.
  • The calf muscles (gastrocnemius, soleus, and plantaris) give your leg its shape. They begin right above your knee, and go down to your ankle, providing mobility for those joints.
  • There are four deep muscles under the calf muscles (popliteus, tibialis posterior, flexor digitorum longus, and flexor hallucis longus), which allow the knee to rotate and move, stabilizes the foot, and flexes the toes.

The thigh:

  • The thigh muscles (adductor magnus, adductor longus, adductor brevis, obturator externus, and gracilis) run down the front of the thigh and help your thighs flex, move, and rotate, keeping your whole body.
  • Three muscles (biceps femoris, semitendinosus, and semimembranosus) make up the hamstring, which helps you move and rotate your hip and knees and extend your leg.
  • Many nerves go down your thighs. The sciatic nerve is the largest nerve in the body, and it connects most of the muscles in your leg.

The knee:

  • The purpose of the knee joint is to allow you to move, bend, and extend your leg.
  • The knee joint has three articulations (places where two bones meet).
  • The knee is made of many ligaments; however, the ACL (anterior cruciate ligament) and the PCL (posterior cruciate ligament) are the most commonly origins of knee pain. They meet in your knee and form an x-shape. Their purpose is to prevent your knee from bending too far forward or backward.
  • Your knee is filled with sacs, called bursae, that hold fluid and let your skin move over the joint.
  • The meniscus is a piece of cartilage that cushions where your thigh bone and shinbone meet.

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Causes of Hip, Leg, and Knee Pain

  • Overuse
  • Old age
  • Too much or too little exercise
  • Obesity
  • Genetic factors
  • One leg is shorter than the other
  • Falls and sports injuries
  • Car accidents
  • Poor circulation
  • Poor posture
  • Uncomfortable seating arrangements
  • Incorrect footwear, especially high heels

How Hip, Leg, and Knee Pain is Diagnosed

Your orthopedic surgeon will ask you various questions about your history, lifestyle, and how your symptoms affect your daily life. Your doctor will also ask about the severity of your pain, and he or she may want to watch you walk or bend over in the office. These questions and exercises can help diagnose your condition and allow doctors to narrow down types of treatments that would be most suitable for your unique experience.

Here are some ways you can help your hip, leg, and knee doctor:

  • Bring all medical records, scans, and recent laboratory results to your appointment. This is very important!
  • In the appointment, point to the area(s) of pain or discomfort
  • Wear loose clothes to your appointment so the doctor can easily examine the area of pain.
  • Tell your doctor if you have any other health problems, even if they don’t seem related to your hip, leg, or knee.

Many doctors will want to see what’s going on inside your body. They may order one or more of the following:

  • X-rays
  • MRIs
  • Blood tests
  • Nerve tests
  • Bone scans

Surgical and Non-Surgical Treatments

Many patients will not need to undergo surgery. In fact, pain and discomfort in these areas will often go away with rest or gentle exercises; however, some pain will persist for several months without any relief. If this is the case for you, you may want to ask your doctor if surgery will help.

Non-surgical treatments include:

  • RICE: Rest, ice, compression, and elevation
  • Physical therapy
  • Massages
  • Anesthetic creams
  • Exercise and stretching
  • Pain medication
  • Dietary changes
  • Chiropractic care
  • Epidural steroid injections
  • Cognitive behavior therapy
  • Acupuncture
  • Weight loss
  • Re-evaluating workplace seating arrangements (buying a better chair or desk)
  • New shoes
  • Splinting or bracing
  • Walking aids

The type of surgery you receive depends on your diagnosis; howver, common hip, leg, and knee surgeries include:

  1. Total hip replacement: Your surgeon will replace the head of the thigh bone (femur) and the hip socket with implant materials and prostheses.
  2. Hip resurfacing: If your condition is less severe, your doctor may recommend this surgery instead of a total hip replacement. The surgeon will trim your femur and cover it with a smooth metal cap.
  3. Lateral release: In this knee surgery, your surgeon will loosen the ligaments that pull your kneecap out of its groove. This surgery will help mend dislocated knees and relieve pain.
  4. ACL Surgery: ACL tears are common sports injuries. To repair your knee, your surgeon will remove your torn ACL and replace it with a new one.

Talk to your doctor if you would like to try any of these treatments for your hip, leg, or knee pain. He or she can help you develop a safe, long-term plan for better health.