Causes & Symptoms
The hip and pelvic girdle serve as the anchor for a large number of muscles, tendons, and ligaments that support the hip and provide strength and stability. Muscle tendons attached to the thigh and pelvis control hip movement. Small fluid-filled sacs (bursae) located between bones and tendons decrease friction and allow for smooth movement.
Injuries to the hip can occur acutely, as in a single event of trauma, but injuries to the hip are more commonly a result of overuse, repetitive movements, or tightness/imbalance in the muscle that places high stress on a muscle group or tendon.
A few injuries unique to the hip can cause significant pain and limit the ability to play sports and exercise comfortably:
- Gluteus Medius Syndrome causes pain in the outer portion of the hip. The gluteus medius muscle moves the hip away from the body and provides stability when walking, running, and jumping. Pain and tenderness can occur if this muscle is excessively tight, weak, or strained. Patients may limp and experience pain or weakness when lifting the leg away from the body.
- Piriformis Syndrome is tightness and irritation of the piriformis muscle, a deep hip rotator. Piriformis syndrome can cause deep pain in the back of the hip and deep in the buttock and may also cause pain that shoots down the back of the leg (similar to sciatic nerve pain because of the closeness of the muscle and nerve in the hip). Patients may experience weakness and tightness during hip rotation stretches.
- Snapping Hip is a term used to describe more than one hip problem. In the presence of tightness and overuse, the tendons that run over bony areas may be painful and “snap” or “roll” over the bone. This can be felt on the outside of the hip a result of tightness in the iliotibial (or IT band) that causes a snapping or rolling sensation as the leg is moved forward and back. IT band snapping can be accompanied by inflammation of the bursa found there. Snapping may also occur in the front of the hip when the hip flexor tendon snaps over the front of the hip as the leg is moved into hip flexion and extension with the knee bent.
Diagnosis & Treatment Options
Tightness, strains and injuries of the hip may have similar pain patterns. Evaluation by a sports medicine specialist and in some cases imaging such as X-rays, ultrasound or MRI is necessary to identify and distinguish and cause of hip pain and affected structures.
Treatment for hip pain related to overuse or injuries is based on the injury and the patient’s activity level. Non-surgical options include activity modification, physical therapy, anti-inflammatories, acupuncture and dry needling. Alternatives include injections such as autologous conditioned plasma (ACP) or platelet rich plasma (PRP), which promote a healing environment and reduce pain. In the event conservative management fails, surgery may address the injured muscle/tendon.
Learn more about how hip muscle and tendon overuse injuries are treated at Temple.