Why does the side of my hip hurt – The dreaded lateral hip pain!
Gluteal tendinopathy or lateral hip pain can be a very pesky injury that affects people in all walks of life. From elite runners, to hikers, to older people wearing out. It seems to be a common condition turning up due to the increase in people staying fit and moving more.
What is it?
Traditionally this condition was known as trochanteric bursitis (inflammation of the fluid filled sac around your hip joint), yet further research into this area has proved the tendons of the muscles surrounding the hip to be the main factor when looking at lateral hip pain. In technical terms it is a insertional tendinopathy involving the glute minimus and medius tendons, meaning there is a breakdown of tendon fibres as it attaches onto the bone of the hip causing pain, weakness and inability to generate force.
It is caused by compressive forces as the tendon wraps around the bony lip of the hip causing friction which irritates the tendon interface.
What causes it?
- Progressing your training load to quickly.
- Poor pelvic control leading to your knees rolling in as you move.
- ‘Hanging’ out on your hip – Yes, I am thinking of all those new mums out there sitting their babies on their hip.
- Woman are affected more than men due to wider hip morphology.
- Increasing hill running load to quick or running on cambered surface like the beach.
- Lack of hip strength and tight groin muscles.
- Excessive crossed legged sitting and side lying at night time.
What to look out for?
- General ache in and around the bony part of the outer hip.
- Pain lying on your affected hip at night time.
- Your symptoms may improve as you warm up, this will be short-lived and your symptoms may worsen over the next 24-48 hours.
- Pain ascending and descending stairs as you push up on one leg.
- Pain or inability to walk or run uphills.
- Tenderness to touch the bony part on the outside of your hip.
- Morning stiffness after activity or walking.
- Sitting in low chairs or crossed legged.
Great I think I have a tendinopathy… Now what?
Rehab will change depending on the duration of your symptoms, how it occurred, age, gender and stage of tendinopathy its important to seek guidance from a health professional.
- SETTLE SYMPTOMS
– Ice.
– Topical anti-inflammatories (Short term use only).
– Isometric muscle loading.
– Deload training schedule. - ADDRESS DAILY IRRITATIONS
– Avoid crossing legs during the day and sitting in low chairs.
– Use a pillow at night time for sleeping.
– Stop glute stretches.
– Address standing postures. - ISOMETRICS
– Muscle contractions in a static state 3-5 x 30-45second holds.
- PELVIC & HIP STABILITY
– Weight bearing exercises like squats, lunges and step ups.
– Gradually adding load to stimulate greater tendon capacity.
– Single leg stability training is crucial.
– Core stability and general strength programming of lower limb muscles. - GRADED STRENGTHENING AND GENERAL RETURN TO ACTIVITY
– Regular exposure to heavy loads.
– Gradual exposure to normal activity under guidance of a health professional.
Written by Pat Lincoln
(Director and Physiotherapist)
