Tendonitis, the inflammation or irritation of a tendon, can affect the hip, causing discomfort and limiting movement. Tendons are thick, fibrous cords connecting muscles to bones. When hip tendons are affected, it can be a painful condition impacting daily activities and athletic performance.
Understanding Tendonitis in the Hip
Tendons play a significant role in facilitating movement by transmitting forces from muscles to bones, allowing for actions like walking, running, and lifting. The hip joint is a large ball-and-socket joint, formed where the thigh bone (femur) meets the pelvis. Several major tendons around the hip joint are susceptible to inflammation or irritation.
One prevalent type is gluteal tendinopathy, often referred to as trochanteric tendonitis, which affects the outer hip. This involves the tendons of the gluteus medius and minimus muscles, responsible for moving the leg away from the body. These tendons attach to the greater trochanter, a bony prominence on the outside of the femur.
Iliopsoas tendinopathy, or iliacus tendonitis, occurs at the front of the hip and groin. This condition involves the iliopsoas muscle group, comprised of the iliacus and psoas muscles, which are the primary hip flexors, helping to lift the thigh. These muscles originate from the lower spine and pelvis and attach to the upper thigh bone.
Adductor tendinopathy involves the tendons of the adductor muscles located on the inner thigh, which are responsible for bringing the legs together. Proximal hamstring tendinopathy affects the hamstring tendons near the “sit bone” area, at the base of the buttocks. These tendons can also become irritated due to overuse or strain.
Common Causes and Symptoms
Hip tendonitis often arises from overuse due to repetitive activities like running, cycling, or dancing. Sudden increases in physical activity intensity or duration can also stress tendons, leading to irritation. Improper training, muscle imbalances, and poor body mechanics contribute to this condition’s development.
Age-related degeneration of tendons can also make them more susceptible to injury. Tendons have a relatively poor blood supply, which can slow their healing. Engaging in sports involving high kicking, squatting, or weightlifting also increases the risk.
The most common symptom is pain that develops gradually. This pain often presents as a dull ache, worsening with activity and intensifying later in the day. Some individuals experience sharp pain during specific movements, such as hip flexion or extension.
Stiffness, particularly after inactivity (e.g., in the morning or after sitting), is another common symptom. The affected area may also be tender to the touch directly over the inflamed tendon. Depending on the type, pain may localize to the outer hip for gluteal issues or the groin for iliopsoas involvement. A clicking or snapping sensation in the hip can occur.
Diagnosis and Treatment Approaches
Diagnosing hip tendonitis begins with a physical examination. The doctor assesses the hip’s range of motion, flexibility, and stability. They may also palpate the hip area to identify specific points of tenderness or swelling, and perform orthopedic tests to pinpoint affected tendons.
Imaging tests provide additional information and help rule out other conditions. X-rays check for bone issues or arthritis, as tendons are not visible on X-rays. Ultrasound imaging can visualize tendons and detect inflammation, while an MRI offers a more detailed assessment of tendon damage or tears.
Conservative treatment is usually the first approach. Initial self-care includes resting the affected hip to reduce tendon stress. Applying ice packs to the tender area can reduce inflammation and pain, and over-the-counter pain relievers like NSAIDs (e.g., ibuprofen) may be recommended.
Physical therapy plays an important role in recovery, involving specific stretching and strengthening exercises to improve flexibility and build muscle support around the hip. Eccentric loading programs, which involve lengthening a muscle while contracting, are often incorporated. Corticosteroid injections may be administered directly into the affected area to reduce severe inflammation and pain, but their effects are temporary and carry risks. Surgery is a last resort for persistent cases not responding to conservative treatments. A gradual return to activity with proper technique is advised to prevent recurrence.