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Acute or Cumulative Hip Trauma, Which Do You Have?

June 24, 2022

In this post Dr. Gorecki, hip pain specialist, discusses the difference between an acute trauma disorder and a cumulative trauma disorder. One heals on its own, the other gets worse over time.

Watch the Video on YouTube:  https://youtu.be/AjJYWLngOKI

In this post we're talking about how, regardless of your diagnosis, there are really only two types of hip injuries. I know that sounds like an oversimplification. I’m sure you’ve heard all the common hip diagnoses: arthritis, degenerative joint disease, bone spurs, osteophytes, labral tears, hip bursitis, and hip impingement. In reality, however, there are just two types of injuries going on in the hip.

The first type of hip injury is called an acute trauma injury. It is represented in the chart below as the gray line. Acute trauma injuries are things like, “I fell off a ladder”, “I got hit by a car”, “I was injured playing sports”.  Acute traumas usually require a trip to the urgent care or emergency room and as time goes on, the severity of symptoms grows less and less, until eventually everything is healed up and you're feeling good.

The reason you get better after an acute trauma is because the body is designed to heal itself naturally over time. And because the trauma only happened one time and was not happening repeatedly, the body is able to go to sleep at night, release human growth hormone during our REM sleep cycles, and repair itself. Your injuries heal. Your symptoms go away.

The second type of hip injury is called cumulative trauma disorder. This type of injury is caused by overuse or stress within the hip from various causes. The typical scenario can go some like this: “One day my hip hurt, but then it went away.  A couple days later when I was shoveling snow, it hurt a little more, but went away again.” Over time the symptoms get a little more severe and more noticeable and now, here we are three years later, and they're really severe. The pain is happening all the time, and I'm  now borderline disabled. This is the point at which most people finally seek physical therapy. On the graph below this time is shown as the red zone.

All of the diagnoses listed above: arthritis, degenerative joint disease, bone spurs, osteophytes, labral tears, hip bursitis, and hip impingement fall into this cumulative trauma disorder category.

Something is causing repeated trauma or stress that is not giving the body the time it needs to heal itself. That something is a movement disorder. Your body is losing the ability to move like it should in certain places, which causes trauma to the hip. Without addressing the root cause, the trauma is getting worse, because you're not fixing the root problem. You're either ignoring the pain or you're altering the symptoms with medications or injections

The reason we don't want to ignore hip trauma symptoms, or mask them with injections or medications is because the trauma is going to get worse until we finally identify what's causing the trauma.

Specialized functional movement physical therapy is the only way to identify the root causes of cumulative hip trauma. The good news is, this type of physical therapy can identify and stop the trauma, so your body can heal, and you can be pain-free again.

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