Author Archives: Tigran Garabekyan, M.D.

Many women experience pelvic pain which can be brought on by various reasons and conditions ranging from endometriosis or fibroids to more severe conditions such as cancer or an ectopic pregnancy.

Southern California Hip Institute (SCHI), led by prudent board certified orthopedic surgeon Dr. Tigran Garabekyan, provides various orthopedic surgery procedures to patients in Los Angeles, Century City, CA, and surrounding locations across the landscape.

Causes

Ectopic Pregnancy

It is important to rule out ectopic pregnancy as the cause of sudden pelvic pain in a woman. In this condition, the embryo attaches to the fallopian tube rather than to the uterus.

Along with pelvic pain, an ectopic pregnancy also typically causes vaginal bleeding.

Pelvic Inflammatory Disease

Pelvic inflammatory disease (PID) is an infection that impacts the reproductive organs of a woman including her ovaries, uterus, vagina, and fallopian tubes. Most cases occur due to a sexually transmitted infection such as chlamydia or gonorrhea. The primary symptom of PID is pelvic pain which may get worse during sex.

Endometriosis

In this condition, the tissue that usually grows within the uterus starts to grow outside it, usually on the fallopian tubes, ovaries, and intestines. The woman experiences pelvic pain due to this condition, specifically during sex and menstruation.

Uterine Fibroids

Uterine fibroids are noncancerous pelvic tumors that commonly lead to longer and/or heavier than normal menstruation cycles. They can also create pelvic discomfort which women typically describe as dull pain or pressure.  

Ovarian Cyst Rupture

Women in their reproductive years commonly experience ovarian cyst rupture. It may not lead to any symptoms or may cause one-sided pelvic pain. This pain is sharp and sudden and initiates following sex or vigorous pelvic activity.

Mittelschmerz Pain

Mittelschmerz pain is one-sided pelvic pain which a woman feels when an egg is released from an ovary every month. This is not a concerning symptom. However, severe pain may be an indication of endometriosis.

Ovarian Torsion

In this condition, the ligaments that hold the ovary in place twist and rotate which cuts off the blood supply to the ovary. The primary symptom is sudden, severe pelvic pain which may be dull, sharp, or crampy.

Gynecologic Cancer

Most forms of gynecologic cancer are associated with pelvic pain. However, the pain occurs only when cancer has advanced. Certain researchers consider ovarian cancer to be an exception to this occurrence and indicate that pelvic pain may be an early sign of this condition.  

Irritable Bowel Syndrome

Irritable bowel syndrome leads to crampy pain in the abdomen that may get worse due to eating or stress. A bowel movement eases this pain for many women. Other than pain, symptoms of irritable bowel syndrome are diarrhea, bloating, and/or constipation.

Nonrelaxing Pelvic Floor Dysfunction

The pelvis comprises muscles, tissues, and bone that work together for normal urination, defecation, and sexual function. If the pelvic muscles fail to contract and relax properly, it may cause pelvic pain. In addition, this can lead to problems in urinating, defecating, and sexual function as well.

Urinary Tract Infection

Urinary Tract Infection can lead to pelvic pain, specifically pain over the bladder (suprapubic pain). Other symptoms of this condition include frequent urination, a burning sensation when urinating, having an urge to urinate, and blood in the urine.

Committed orthopedic surgeon Dr. Tigran Garabekyan of SCHI receives patients from Los Angeles, Century City, CA, and nearby areas in The Golden State for orthopedic surgery.

Dr. Tigran Garabekyan is a board certified orthopedic surgeon specializing in hip preservation. To learn more about Southern California Hip Institute or to schedule a consultation, click here to contact us or call:

Century City / Los Angeles: 310.574.0375

Serving patients in Encino, Sherman Oaks, Van Nuys, North Hollywood, Burbank, Glendale, West Hollywood, Century City, Beverly Hills, Santa Monica, Los Angeles, and other neighboring cities in the greater Los Angeles, California area.

Also visit http://www.drgorthopedics.com/

In a hip labral tear, the ring of cartilage (labrum) that lines the outside rim of the socket of the hip joint sustains damage.

The labrum cushions the hip joint as well as acts like a rubber seal or gasket enabling the ball on top of the femur to be held firmly within the hip socket.

Key Sports

The risk of hip labral tear development is higher in athletes engaging in sports such as soccer, golf, hockey, and football. This condition may also occur due to structural abnormalities of the hip.

Southern California Hip Institute (SCHI), led by board certified orthopedic surgeon Dr. Tigran Garabekyan, provides advanced treatments for the hip and shoulder joint to patients in Los Angeles, Century City, CA, and other cities and towns in this part of the US.

Symptoms

There are no signs or symptoms in many cases of hip labral tears. However, at times, patients may experience one or more of the below mentioned symptoms:

• A clicking, locking or catching sensation in the hip joint
• Pain in the groin or hip
• Limited range of motion or stiffness in the hip joint

The patient should seek medical attention if the symptoms become worse or do not improve within six weeks.

Causes

Labrum tears can occur due to various reasons. At times, labrum tears can occur due to falls or sporting injuries where the hip is forced into extreme positions. Repetitive trauma in sports that require regular hip rotation such as golf, hockey, ballet, and soccer, may also cause this condition.

According to studies, up to 22 percent of athletes complaining of groin pain have a labral tear in the hip. But around 75 percent of cases of torn acetabular labrum does not have a known direct cause.  

Hip labral tears may occur due to:

Trauma

Dislocation or injury of the hip joint due to car crashes or playing contact sports such as hockey or football can cause a hip labral tear.

Structural Abnormalities

Some individuals are born with hip issues that can cause acceleration in the wear and tear of the joint, and eventually lead to a hip labral tear.

Repetitive Motions

Sports-related and other physical activities, such as sudden twisting or pivoting movements specific to sports such as softball or golf, can cause joint wear and tear that results in a hip labral tear.

Complications

Hip labral tears may predispose a person to the development of osteoarthritis in that joint over time.

Hip Surgery for Labral Tears

Certain hip labral tear patients will need orthopedic surgery to address the pain and clicking. The surgery should also lead to an improvement in the integrity of the hip joint. This will bring about a reduction in future joint degeneration which is typically associated with labral tears.

The surgeon performs the procedure by reattaching the labrum, and at times, debriding (removing the torn section) of the labrum. The patient will need post-op hip rehabilitation under the direction of the physiotherapist and surgeon to enable them to return to the sport in a safe manner.  

Prevention

In general, hip labral tears are associated with participation in sports. In case the patient engages in a sport that causes excessive strain on the hips, it is vital for them to condition the surrounding muscles with strength and flexibility exercises.

It is also vital to avoid loading the hip with the full weight of the body when the legs are positioned at the extreme ends of the normal range of motion of the hip.

Reliable orthopedic surgeon Dr. Tigran Garabekyan receives patients from Los Angeles, Century City, CA, and nearby areas across the landscape for hip and shoulder joint treatments.
Dr. Tigran Garabekyan is a board certified orthopedic surgeon specializing in hip preservation. To learn more about Southern California Hip Institute or to schedule a consultation, click here to contact us or call:

Century City / Los Angeles: 310.574.0375

Serving patients in Encino, Sherman Oaks, Van Nuys, North Hollywood, Burbank, Glendale, West Hollywood, Century City, Beverly Hills, Santa Monica, Los Angeles, and other neighboring cities in the greater Los Angeles, California area.

Also visit http://www.drgorthopedics.com/

Hip dysplasia refers to a hip socket that does not completely cover the ball portion of the upper thighbone. This causes the hip joint to dislocate partially or fully. A majority of people with hip dysplasia experience this condition from birth.

Shortly after birth and during well-baby visits, doctors will assess newborns for signs of hip dysplasia. If this condition is detected in early infancy, a soft brace can typically address the issue.

In cases of mild hip dysplasia, the individual may not experience symptoms until they are in their teens or young adulthood. Hip dysplasia can lead to damage to the cartilage that lines the joint as well as the labrum (soft cartilage) that rims the socket portion of the hip joint. This is known as a labral tear.

Older children and young adults may require orthopedic surgery to position the bones into correct alignment for smooth movement of the joints.

Southern California Hip Institute (SCHI), led by the successful board certified orthopedic surgeon Dr. Tigran Garabekyan, provides advanced treatments for the hip joint to patients in Los Angeles, Century City, CA, and surrounding communities in The Golden State.

Symptoms

The signs and symptoms of hip dysplasia differ by age. The condition may manifest in infants as one leg being longer than the other. As a child starts to walk, they may develop a limp. The parent may notice that one hip is less flexible than the other during diaper changes.  

Hip dysplasia can lead to painful complications such as a hip labral tear or osteoarthritis in teens and young adults. This can lead to groin pain while performing certain activities. Sometimes the patient may feel that the hip is unstable.

Diagnosis

At the time of the well-baby visits, the doctor will usually check for hip dysplasia by moving the baby’s legs in various positions to assess whether the hip joint fits together properly.

It can be challenging to diagnose mild cases of hip dysplasia, and they may not show any signs until young adulthood. The doctor may recommend imaging tests such as ultrasound or x-rays if they suspect hip dysplasia.

Causes

The hip joint is made of soft cartilage at birth which gradually hardens into bone. The ball and socket must fit together properly as they act as molds for each other. In case the ball is not seated firmly into the socket, the socket will not develop appropriately around the ball and will become too shallow.

In the last month of the pregnancy, the space within the womb can become increasingly crowded causing the ball of the hip joint to move out of its correct position. This may result in a shallower socket. The reduction in the amount of womb space may occur due to:

• Large baby
• First pregnancy
• Breech presentation

Risk Factors

Hip dysplasia tends to be genetic and is seen more commonly in girls. The risk of this condition is higher in infants born in the breech position or those with foot deformities.

Complications

Hip dysplasia can cause damage to the labrum (soft cartilage that rims the socket portion of the hip joint) later in life. This is known as a hip labral tear. It can also make the joint more susceptible to developing osteoarthritis.

This happens due to higher contact pressures over a smaller surface of the socket. In time, this erodes the smooth cartilage on the bones that enable them to glide properly against each other during joint movement.

Dr. Garabekyan’s Expertise

Being proficient in both hip arthroscopy and realignment osteotomies of the pelvis and upper femur (PAO/DFO), he provides a uniquely holistic approach to the treatment of hip dysplasia.

The judicious and cordial Dr. Garabekyan performs hip arthroscopy without a perineal post, enabling him to carry out simultaneous bilateral hip arthroscopy to minimize recovery time and get his patients back in the game faster.

Experienced orthopedic surgeon Dr. Tigran Garabekyan receives patients from Los Angeles, Century City, CA, and other cities and suburbs in this area of the nation for hip joint treatments.
Dr. Tigran Garabekyan is a board certified orthopedic surgeon specializing in hip preservation. To learn more about Southern California Hip Institute or to schedule a consultation, click here to contact us or call:

Century City / Los Angeles: 310.574.0375

Serving patients in Encino, Sherman Oaks, Van Nuys, North Hollywood, Burbank, Glendale, West Hollywood, Century City, Beverly Hills, Santa Monica, Los Angeles, and other neighboring cities in the greater Los Angeles, California area.

Also visit http://www.drgorthopedics.com/

Recovery following hip tendonitis treatment or orthopedic surgery will usually involve physical therapy. Physical therapists are professionals with the education and training to enable them to perform interventions.

Skilled and purposeful use of physical therapy methods and techniques can help generate changes that are aligned with the diagnosis, prognosis, and the patient’s objectives.

Southern California Hip Institute (SCHI), led by dependable board certified orthopedic surgeon Dr. Tigran Garabekyan, provides safe and proven treatments for the hip, knee, and shoulder to patients in Los Angeles, Century City, CA, and other communities and suburbs in this region of California.

Role of a Physical Therapist during Recovery

The physical therapist will undertake a detailed assessment and determine the following:

Tendon: The physical therapist will perform a series of tests to understand which tendon is affected.

Strength: In order to determine whether there are any associated weakness or strength imbalances, the physical therapist will perform resisted testing.

Flexibility: Poor mechanics and weakness can occur due to tight muscles which may create imbalances rendering the hip more prone to tendonitis.

Technique: The way people perform motions while undertaking certain activities such as running, jumping, cycling, or rowing may lead to a problem. The patient should discuss and observe the activities they participate in, and that may have initiated the problem in order to improve technique.

Training: The patient should review their training program and focus on any sudden changes that may have aggravated or caused hip tendonitis.

Alignment or Footwear: A physical therapist will determine the length of the leg, foot mechanics and alignment to detect any imbalances. An important part of balancing the pressure on the legs and body is checking for suitable footwear.

Scientifically Managed Recovery

At the outset, physical therapy for hip tendonitis must be conservative to avoid worsening the condition. The focus of the therapy will be on rest, reducing swelling, and enhancing blood circulation for healing.

After the initial swelling subsides, the physical therapist will initiate a program of strengthening and stretching exercises to restore flexibility to the affected muscles and enhance strength to reduce pressure on the hip and tendons.

It may also be necessary to tape or strap the affected tendon to rest it and reduce the pressure on it. A physical therapist is trained in specific techniques of taping.

Exercises for Full Recovery

The below mentioned exercise and tips may be helpful in recovering fully from hip flexor tendonitis:

• Adjusting the seat height to enable the hips to hit higher than the knees preventing “hip pinching.”
• Maintaining a strong, flexible hips and core
• Discussing the correct form with the trainer to avoid muscle compensation
• Muscle strengthening in its shortened and lengthened state

Hip Flexor Stretch

• Kneel on one knee with the hip behind the knee
• Tuck the tailbone beneath you
• Ensure that the back is straight as you move your body forward
• Stop at the point where the upper thigh feels stretched
• Hold this position for 30 seconds
• Do two repetitions

Hip Flexion All-Fours

• Tie a resistance tube to a pole and the other end to your ankle
• Position yourself on all fours and bring the knee into the chest
• Ensure that the back is straight
• Return the foot slowly to the initial position
• Feel resistance both ways
• Perform two sets of ten repetitions on each leg

Hip Extension

• Lie down with a fitness ball beneath your stomach
• Squeeze your buttock and lift the leg up to your trunk
• Hold this position for three seconds
• Perform two sets of ten repetitions on each leg

Side-Lying Hip Abduction

• Lie on your side, stacking hips and back to a wall
• Keep the foot against the wall while lifting the leg up
• Hold this position for three seconds before lowering
• Perform two sets of ten repetitions on each leg

Before starting an exercise program, the patient should consult with their physician. Experienced orthopedic surgeon Dr. Garabekyan receives patients from Los Angeles, Century City, CA, and other towns and neighborhoods in this part of the US for hip, knee, and shoulder treatments.

Dr. Tigran Garabekyan is a board certified orthopedic surgeon specializing in hip preservation. To learn more about Southern California Hip Institute or to schedule a consultation, click here to contact us or call:

Century City / Los Angeles: 310.574.0375

Serving patients in Encino, Sherman Oaks, Van Nuys, North Hollywood, Burbank, Glendale, West Hollywood, Century City, Beverly Hills, Santa Monica, Los Angeles, and other neighboring cities in the greater Los Angeles, California area.

Also visit http://www.drgorthopedics.com/

Hip tendonitis is a condition that usually occurs due to repetitive strain due to overuse. In general, people performing strenuous and heavy physical activities that involve the hip, such as performing exercises that are beyond the tolerance level of the body, experience this condition.

The muscles and tendons of the body may not be used to the motions required when a person undertakes a new type of sport or exercise, and this may lead to an injury.

Hip tendonitis may also occur due to an increase in the intensity and duration of exercise. A sudden progression in exercise without the necessary preparation can also lead to hip tendonitis.

People who are engaged in sports such as running and cycling have a higher probability of developing hip tendonitis with overstraining during these activities.

Southern California Hip Institute (SCHI), led by board certified orthopedic surgeon Dr. Tigran Garabekyan, provides safe and proven treatments for the hip, knee and shoulder to patients in Los Angeles, Century City, CA, and surrounding communities across the horizon.

Diagnosing Hip Tendonitis

It is crucial for the patient to be as detailed as they can when describing their hip pain to enable the doctor to make a correct diagnosis. The patient should note the activity or activities that trigger the pain, the location of the pain in the body, or anything that they do for pain relief (such as taking rest).

Tendonitis often feels sore in particular areas. Iliacus tendonitis leads to pain in the front part of the hip, and the patient may experience some tenderness due to inflammation in the region. If left untreated, the pain will slowly increase as the tendons continue to wear out.  

Symptoms

• The main symptom of hip tendonitis is the slow development of pain around the hip joint without any specific injury.
• The patient may experience tenderness when the affected hip tendons are touched firmly.
• Another symptom of this condition is a feeling of discomfort when stretching the muscle of the compromised hip tendon.
• Hip tendonitis causes a feeling of discomfort when the muscle of the affected hip tendon is contracted.
• The patient often feels hip joint stiffness in the morning or after periods of rest.
• There is a reduction in hip pain with activity, but the pain may increase again in a while.

Prevention

• Adequate warm-up prior to performing exercises or sports helps in the prevention of injuries that can lead to hip tendonitis.
• Performing exercises that help stretch the front, back and side of the hips and thighs can successfully prevent injuries such as hip tendonitis.
• Increase in the intensity of exercises or spending more time exercising should undertake gradually to provide the body sufficient time to get accustomed to the new activity level.
• Participating in new sports or activities gradually can help in the prevention of damage to the tendons and muscles of the hip joint
• Performing exercises on an even surface with safe and stable equipment helps avoid injuries to the hip.
• Wearing proper footwear while undertaking activities to ensure the ankles and feet are well-cushioned can help prevent hip injuries.
• Avoid exercising when feeling sick or perform only mild exercises to prevent hip tendonitis from developing.

Experienced orthopedic surgeon Dr. Garabekyan receives patients from Los Angeles, Century City, CA, and nearby areas in this section of The Golden State for hip, knee, and shoulder treatments.

Dr. Tigran Garabekyan is a board certified orthopedic surgeon specializing in hip preservation. To learn more about Southern California Hip Institute or to schedule a consultation, click here to contact us or call:

Century City / Los Angeles: 310.574.0375

Serving patients in Encino, Sherman Oaks, Van Nuys, North Hollywood, Burbank, Glendale, West Hollywood, Century City, Beverly Hills, Santa Monica, Los Angeles, and other neighboring cities in the greater Los Angeles, California area.

Also visit http://www.drgorthopedics.com/

It is important for an orthopedic surgeon to understand more about a patient’s lifestyle when diagnosing the cause of hip pain.

Who is the patient and what activities do they typically undertake during their day? Does the patient have a sedentary desk job or a job that involves significant lifting, pushing and pulling throughout the day?

Focus on these aspects can help the physician determine:

• Whether the patient’s routine activities increase the load on the hip and worsen it
• Whether they should take the patient’s professional necessities into account while determining how aggressive the treatment should be

The accomplished Southern California Hip Institute (SCHI), led by board certified orthopedic surgeon Dr. Tigran Garabekyan, provides various orthopedic surgery procedures to patients in Los Angeles, Century City, CA, and surrounding communities and neighborhoods in The Golden State.

Significant Concerns

The primary concern of the doctor will be to understand whether the patient has arthritis as a part of their pathophysiology. This is a vital concern as if arthritis is behind the hip pain, the treatment strategies will be different from those employed if the patient does not suffer from arthritis.

In comparison to other joints such as those in the shoulder and knees, physicians only have a limited ability to preserve the joint after it becomes significantly affected by arthritis. This can occur even in people in their 20s and 30s.

Once the hip loses cartilage, the ability to reduce strain on the joint via physical therapy or graft cartilage (such as for a knee joint) is limited. Moreover, surgical procedures to preserve the joint are very involved. Many patients and surgeons are reluctant to explore surgically reorienting the joint’s position.

Hip Arthritis Diagnosis

It is vital for the physician to understand the family history and history of the patient from birth. In assessing the history of hip arthritis patients, doctors have identified a genetic component as well as the fact that specific diagnoses predispose a younger individual to develop hip arthritis.

These diagnoses include hip dysplasia, Legg-Calve-Perthes disease (or simply Perthes disease), and a slipped capital femoral epiphysis, known as “skiffy” or (SCFE). People in their 20s, 30s, and 40s who have these conditions are predisposed to developing hip arthritis, which makes these questions vital.

Other Causes of Hip Pain

Arthritis may be a concern when pain is the primary symptom which manifests after the joint is strained through work and exercise. Therefore, pain during or after the activity, specifically in the groin area where the joint refers to pain can indicate a certain degree of arthritis.

In 80 percent of cases, hip arthritis will impact the groin area. However, in case the pain is transient or occurs on the outside of the hip or on the butt or goes down the leg, the doctor will explore other causes.

Focused orthopedic surgeon Dr. Tigran Garabekyan of SCHI receives patients from Los Angeles, Century City, CA, and other towns and suburbs in this region of the southwest for orthopedic surgery.

Dr. Tigran Garabekyan is a board certified orthopedic surgeon specializing in hip preservation. To learn more about Southern California Hip Institute or to schedule a consultation, click here to contact us or call:

Century City / Los Angeles: 310.574.0375

Serving patients in Encino, Sherman Oaks, Van Nuys, North Hollywood, Burbank, Glendale, West Hollywood, Century City, Beverly Hills, Santa Monica, Los Angeles, and other neighboring cities in the greater Los Angeles, California area.

Also visit http://www.drgorthopedics.com/

When the hip flexor muscles are strained, pulled, injured, or torn, it may cause hip flexor strain. A wide range of motions may lead to this condition, and the primary symptom of hip flexor strain is sharp pain.

The hip area can sustain damage ranging from minor injuries requiring little treatment to more serious injuries that lead to the muscles detaching from the bone. Third-degree sprains are the most serious hip flexor injuries. In this condition, there is a bone fracture along with the muscle sprain.

Southern California Hip Institute (SCHI), led by board certified orthopedic surgeon Dr. Tigran Garabekyan, provides various orthopedic surgery procedures to patients in Los Angeles, Century City, CA, and surrounding locations.

Key Facts about Hip Flexor Strain

Flexors refer to flexible muscle tissues that enable a person to move and stretch. In case these muscles are overstretched, overused, or forced to hyperextend, it can cause injury. Medical treatment is required in some cases of hip flexor injury.

The psoas forms a part of the hip flexor muscles and can be strained. The hip flexors connect the top of the femur (which is the largest bone in the body) to the lower back, hips, and groin.
There are different types of hip flexor muscles that work in tandem to allow a person to move, including:

• The iliacus and psoas: These are major muscles that are also called iliopsoas
• The rectus femoris: This forms a part of the quadriceps

The overstretching or overuse of these tendons and muscles can cause injury leading to pain and decreased mobility.

Hip Flexor Strain Symptoms

The symptoms of hip flexor strain are as follows:

• Sudden sharp pain in the pelvis or hip following trauma to the site
• A clenching or cramping sensation in the muscles of the upper leg region
• Tenderness and soreness in the upper leg
• Strength loss in the front of the groin in addition to a tugging sensation
• Muscle spasms in the thighs or hip
• Inability to kick, jump, or sprint
• Decreased mobility and discomfort when moving, including limping
• Constant pain and discomfort in the upper led region
• Inflammation and bruising around the thigh or hip area
• Stiffness or tightness after being stationary, for instance, after sleeping

Causes

The hip flexors are engaged when the knees are brought up towards the torso, such as during dancing, running, or performing martial arts.

Athletes who engage the hip flexors in their training and sport are more vulnerable to hip flexor strain which can lead to muscle tears.

Many hip flexor injuries are associated with hamstring strains in sports medicine.

Exercises

Exercises allow the hip flexors to remain flexible and supple which helps prevents injury.

Inactivity resulting from activities such as sitting for extended periods can lead to tightness in the hip flexors. This can cause pain in the lower back and hip as well as damage and strain to the region.

Hip exercises can strengthen these muscles. A majority of exercises can be performed at home and involve gentle stretches. These can help decrease tension and prevent future or further injury.

Experienced orthopedic surgeon Dr. Tigran Garabekyan of SCHI receives patients from Los Angeles, Century City, CA, and nearby areas for orthopedic surgery.

Dr. Tigran Garabekyan is a board certified orthopedic surgeon specializing in hip preservation. To learn more about Southern California Hip Institute or to schedule a consultation, click here to contact us or call:

Century City / Los Angeles: 310.574.0375

Serving patients in Encino, Sherman Oaks, Van Nuys, North Hollywood, Burbank, Glendale, West Hollywood, Century City, Beverly Hills, Santa Monica, Los Angeles, and other neighboring cities in the greater Los Angeles, California area.

Also visit http://www.drgorthopedics.com/

Tendonitis involves the swelling of the tendons. Tendons are thick cords of soft tissue which connect the bone and muscle.

Hip flexor tendonitis refers to the swelling of the tendon sheaths of the rectus and/or iliopsoas.

A hip flexor strain is a tear in the muscles, and these tears can be categorized from mild to severe:

• Grade I Tear: This is a minor tear with damage to a few fibers only.

• Grade II Tear: Multiple muscle fibers sustain damage, and the patient has a moderate hip flexor function loss.  
• Grade III Tear: The muscle tears or ruptures completely, and the patient is unable to walk without limping. In a few cases, orthopedic surgery may be required.

Southern California Hip Institute (SCHI), led by board certified orthopedic surgeon Dr. Tigran Garabekyan, provides safe and proven treatments for the hip, knee and shoulder to patients in Los Angeles, Century City, CA, and surrounding locations.

Diagnosis and Examination

At the outset, a musculoskeletal expert should complete a health history and physical exam. The doctor may order diagnostic imaging tests such as x-rays or MRI to rule out the possibility of other conditions. The patient may undergo an EMG to rule out nerve compression. The doctor may also recommend an image-guided injection.

Exercises

Mild stretching exercises can help in the reduction of hip flexor muscle tension and the possibility of an injury in the future. The patient can try these hip flexor stretches but ensure that they are not too vigorous as these stretches must be gentle.

The application of moist heat and warming up the muscles with a gentle walk for around three minutes prior to stretching can help reduce the risk of a hip flexor strain.

Psoas Tendonitis Treatment

Psoas tendinopathy, also known as tendonitis, refers to the swelling and/or partial tearing of the psoas tendon. This tendon is located deep within the hip joint connected to the lesser trochanter (a tiny bony prominence adjacent to the hip).The psoas is a vital hip flexor.

If the tendon becomes irritated or inflamed, it can lead to hip pain. This pain is typically felt in the inner thigh or groin. Furthermore, the psoas may also become swollen after a total hip replacement.

The treatment goals will include a reduction in pain and swelling, preservation or mobility, and prevention of recurrence and disability.

The doctor may recommend a combination of physiotherapy, massages, rest, cold application, and heat to address this condition. Advanced treatment options include:

• Non-steroidal anti-inflammatory medications, such as naproxen or ibuprofen
• PRP (Protein Rich Plasma) or Corticosteroid injections administered by the patient’s medical care provider. The injections rapidly reduce the swelling and pain.
• Physical therapy including a range of stretches, motion exercises, and hydrotherapy can be quite beneficial.

Surgery

When other treatment options are ineffective, only then orthopedic surgery may be recommended. Arthroscopic (keyhole surgery) psoas tenotomy can effectively treat Recalcitrant psoas tendinopathy.

This procedure lengthens the tendon enabling it to heal in a lengthened position within the tendon sheath. This inhibits tendon irritation. A local anesthetic is injected around the wound prior to the procedure to ensure that the patient remains comfortable.

Recovery after Psoas Tenotomy

The wound may take between seven to ten days to heal. A majority of patients experience dramatic improvements within the initial six weeks. At times, there are periods in which the hip feels sore and then resettles.

This is nothing to be alarmed about and is a part of the normal healing process. It takes around three months for the hip to heal following a hip arthroscopy procedure.

Astute orthopedic surgeon Dr. Garabekyan receives patients from Los Angeles, Century City, CA, and nearby areas for hip, knee and shoulder treatments.

Dr. Tigran Garabekyan is a board certified orthopedic surgeon specializing in hip preservation. To learn more about Southern California Hip Institute or to schedule a consultation, click here to contact us or call:

Century City / Los Angeles: 310.574.0375

Serving patients in Encino, Sherman Oaks, Van Nuys, North Hollywood, Burbank, Glendale, West Hollywood, Century City, Beverly Hills, Santa Monica, Los Angeles, and other neighboring cities in the greater Los Angeles, California area.

Also visit http://www.drgorthopedics.com/