Tendonitis is the irritation or inflammation of a tendon, the fibrous tissue connecting muscle to bone. The hip is a ball-and-socket joint supported by numerous powerful muscles and tendons, making it highly susceptible to this injury. Hip tendonitis is a common cause of pain in active individuals. When hip tendons become strained or overused, they develop microscopic tears and inflammation, leading to pain and reduced mobility.
Where Tendonitis Occurs in the Hip
The complex anatomy of the hip means multiple tendons are vulnerable to inflammation from repetitive strain. One frequently affected area is the outer hip, involving the gluteal tendons. Specifically, the tendons of the gluteus medius and gluteus minimus muscles, which attach near the greater trochanter, can become inflamed. This condition is often referred to as gluteal tendinopathy and is a major cause of lateral hip pain.
Another common location is deep in the front of the hip and groin area, involving the iliopsoas tendon. The iliopsoas muscle is the primary hip flexor, and its tendon attaches to the lesser trochanter on the femur. Inflammation here, known as iliopsoas tendinopathy, is common in sports requiring repeated hip flexion, such as running and cycling. This location is sometimes associated with a “snapping hip” sensation as the tendon moves over underlying structures.
Tendon issues can also occur where the hamstring muscles originate near the pelvis, at the ischial tuberosity, or “sit bone.” This is known as proximal hamstring tendinopathy. While the hamstrings primarily extend the hip, this attachment point is prone to injury from activities like sprinting or long-distance running.
Identifying the Warning Signs
Hip tendonitis typically begins as pain that develops gradually over weeks or months, rather than from a sudden, traumatic event. The location of the pain offers clues: a deep ache in the groin or front of the hip often points toward iliopsoas involvement, while pain on the outside of the hip is characteristic of gluteal tendinopathy. This pain always worsens with activities that engage the affected muscle and tendon.
A distinguishing feature of tendon irritation is stiffness, commonly felt first thing in the morning or after prolonged sitting or rest. For example, a person with gluteal tendinopathy may notice pain when lying on the affected side or standing on one leg. The pain may initially lessen as the tendon “warms up” with light activity, but often intensifies later in the day. Tenderness and swelling are also often present directly over the affected tendon attachment point.
Confirming the Diagnosis and Common Causes
Confirming hip tendonitis begins with a physical examination and a review of the patient’s history. A healthcare provider tests the hip’s range of motion, observes gait, and performs specific movements against resistance to pinpoint the painful tendon. Palpation, or pressing on the area, is important, as localized tenderness directly over the tendon attachment suggests inflammation. For instance, a single-leg stance test often aggravates gluteal tendon pain, helping confirm the diagnosis.
Imaging supports clinical findings and rules out other causes of hip pain, such as a stress fracture or arthritis. While X-rays show bone structure, diagnostic ultrasound or MRI are used to visualize the tendon itself, confirming inflammation or degeneration. The underlying cause of hip tendonitis is usually related to overuse or repetitive stress. This often occurs with a sudden increase in the intensity or duration of an exercise routine, exceeding the tendon’s capacity to adapt.
Biomechanical factors also contribute to the development of tendonitis. Muscle weakness, particularly in the core or gluteal muscles, can force other tendons to work harder, leading to chronic strain. Improper movement patterns or poor technique during activities like running, cycling, or weightlifting also place abnormal stress on the tendons. Addressing these underlying issues is essential for long-term recovery and preventing recurrence.
Paths to Recovery
Initial management focuses on reducing pain and inflammation, typically involving rest from the aggravating activity and using over-the-counter NSAIDs. Avoiding painful movements is the first step, as continued strain prevents tendon fibers from healing. Once acute pain subsides, recovery proceeds through a structured program of physical therapy.
Physical therapy focuses on strengthening the muscles surrounding the hip, especially weak or imbalanced groups, to restore function and reduce load on the injured tendon. Stretching exercises improve flexibility and range of motion, normalizing joint mechanics. A physical therapist also analyzes movement patterns and technique to correct issues that contributed to the injury, such as poor running form.
For cases that do not respond to several months of conservative treatment, a physician may consider advanced interventions. Corticosteroid injections can provide temporary relief by reducing inflammation directly at the injury site. Regenerative treatments, such as platelet-rich plasma (PRP) injections, are sometimes used to stimulate tissue healing. Recovery from tendonitis is often slow; mild cases may improve within a few weeks, but chronic issues can take several months to heal fully.