The hip has many tendons that can be injured either due to trauma or repetitive overuse. Tendons are the dense fibrous ropes that connect muscles to bone. Hip tendonitis is a painful inflammation or irritation of the tendon near where it attaches to the bone. The tendon usually gets inflamed because it has been overused for a long time or it has been overused too quickly. Sometimes tendonitis starts out of the blue, because just getting older causes tendonitis to happen more easily.
The range of tendonitis injuries that can occur throughout the body, resulting from overuse, are often referred to as tendinopathy.
Tendonitis is very common. Some tendons around the hip that are affected by tendonitis are:
- Iliopsoas Tendon (pain in the groin)
- Hip External Rotator Tendons (pain over the side of the hip and pelvis)
- Hamstring Tendon (pain in the buttock or sit-bone)
Most tendonitis can be treated at home with rest and avoiding movements that hurt. Ice and heat can also provide relief of pain. If the pain is severe or is not going away after a week or two of home treatment, you should consider seeing your Sports Medicine specialist for evaluation to confirm that it is tendonitis. Your Sports Medicine specialist may use an ultrasound machine to look at the tendon to confirm tendonitis or sometimes to reveal a tear of the tendon.
A majority of tendonitis can be treated non-surgically. Non-surgical treatments options include:
- Modified physical activities and avoiding movements that strain inflamed tendons
- Physical therapy
- Manual therapies like ASTYM® and Graston Technique®
- Dry needing
- Therapeutic ultrasound
- Non-prescription pain relievers like ibuprofen or naproxen or prescription topical diclofenac gel
- Prolotherapy injections
- Platelet Rich Plasma injections
- Occasionally corticosteroid injections into the bursa next to the tendon
Scientific studies have shown physical therapy to be the best treatment for the majority of tendonitis cases, although many of the most effective exercises recommended by physical therapists can result in temporary soreness.
Greater Trochanteric Pain Syndrome
Lateral hip pain is very common, affecting 10 to 25% of the general population. “Hip Bursitis” is a diagnosis that is often given to pain and tenderness over the bony part of the side of the hip known as the greater trochanter. Sports Medicine doctors have discovered that the pain over the greater trochanter is not always caused by an inflammation of a bursa sac but most often is due to tendonitis of the muscles that attach to the greater trochanter such as the gluteus medius or gluteus minimus tendons. Sometimes the pain is due to a thickened Iliotibial (IT) band.
Like other tendonitis, greater trochanteric pain symptoms happen with overuse activities such as running, sports or fitness classes that involve a lot of jumping or bicycling. Sometimes a fall or bump to the side of the hip can cause the hip to become inflamed.
Sharp, intense pain and tenderness of the side of the hip that extends to the side of the thigh is one of the most common symptoms. Other common symptoms of greater trochanteric pain syndrome or include:
- A dull ache over the side of the hip with sharp pains with certain movements
- Trouble sleeping on the painful side
- Swelling and redness
- Pain with prolonged standing, sitting or walking and especially up or down stairs
Many people with greater trochanteric pain syndrome find pain relief through non-surgical treatments such as physical therapy and injections to reduce inflammation and soft tissue irritation.
Surgery is rarely necessary, but treatment usually takes a very long time. Recovery from most types of greater trochanteric pain syndrome take between several weeks and several months. If in the course of treatment, a tear of a tendon is discovered and non-surgical options have been exhausted, your Sports Medicine doctor may recommend surgery and refer you to an Orthopedic surgeon.