by Rich Boeckmann PT, MTC
Hip pain is an all too common complaint that can be caused by a wide variety of problems. Among adults who play sports, the incidence of chronic hip pain is 30 to 40 percent and among all adults over 60, the incidence of hip pain on most days is 12 to 15 percent. The precise location of your hip pain can provide valuable clues about the underlying cause.
Rich Boeckmann, Clinic Director of our North Phoenix physical therapy location, has decades of experience treating patients and training athletes, including spending two years as a PT for the Milwaukee Brewers. In this blog, Rich explains what actually causes hip pain and how to treat it.
What Causes Lateral Hip Pain?
Historically this pain has been associated with what is called trochanteric bursitis. However, with the advancement of diagnostic testing including MRI and ultrasound, the most common source of lateral hip pain has been found to be tendinopathy of the gluteus medius and gluteus minimus tendons. The gluteus minimus and medius are muscles that attach the pelvis to the thigh bone while crossing the hip joint and are integral in providing stability to the hip. This stability of the hip is necessary for normal walking mechanics. While the bursae may be involved, it is no longer believed to be the primary problem. Past treatments have included non-steroidal anti-inflammatories, cortisone injections, and stretching, which often proved inadequate in resolving the problem.
Tendinopathy symptoms include localized pain over the lateral hip and gluteal region, which can range from mild to severe. Gluteal tendinopathy is commonly treated in physical therapy, and the recovery time often correlates with how long a patient waits to seek treatment. Avoidance of treatment for ongoing lateral hip pain can often result in a long rehabilitation process.
How Foothills Sports Medicine Physical Therapy Can Help
A patient’s initial physical therapy visit includes a comprehensive evaluation to identify all the contributing factors of lateral hip pain, including posture, lower extremity biomechanics, flexibility, and strength. A treatment plan is developed and implemented to best address the patient’s specific deficits, reduce pain levels, and assist in a quick recovery. Initial treatment often includes what is called “relative rest”, which means avoiding activities or positions that place abnormal stress on the injured tendon. A physical therapist can assist in identifying which activities should be modified to accelerate recovery. In the case of the hip, this may include avoiding prolonged sitting, sitting in low chairs, sitting with crossed legs, or standing with more weight shifted to one leg. In cases where long walking or running are factors in lateral hip pain, temporarily reducing the volume/distance walked or run can help the healing process.
Your Foothills physical therapist may also include various manual therapy techniques such as gentle soft tissue mobilization for tendinitis, or instrument-assisted soft tissue mobilization and dry needling in chronic situations involving tendinosis. Appropriate modalities such as heat, ice, and electrical stimulation may also be used as necessary. As a patient begins to heal, specific exercises will be prescribed to assist their body as well as increase the tensile strength of the gluteus medius and minimus.
Your therapist will also assist in normalizing functional movements and biomechanics to allow for a safe return to pre-injury activities. Establishing appropriate strength, flexibility, stability, and biomechanics will also assist in reducing the incidence of re-injury in the long term.
If you are experiencing hip pain, don’t wait to seek treatment. Contact a Foothills physical therapist for a free consultation.
Foothills Sports Medicine Physical Therapy provides a variety of services to patients all across the Valley. Our philosophy is that every person is different, so every person needs an individual, specialized therapy plan to be successful. Our highly skilled staff can even provide you with a free assessment of your needs.
