Healthy Hips are Happy Hips or Hot Tips for Happy Hips – so many options….HIP HIP HOORAY! we’ve got the answers just for you.
Have you been diagnosed with hip bursitis, hip tendonitis or lateral hip pain?
Often referred to as hip tendinitis or trochanteric bursitis this is a common condition in which people often experience pain in the side of you hip – roughly around where your leg joins your pelvis.
You may also have heard it called Gluteal Tendinopathy or Greater trochanteric pain syndrome.
Hip anatomy
The hip is a ball and socket joint and has a large range of motion available to it. As such there are many muscles working at the hip joint to allow it to function effectively.
When we look at lateral hip pain we tend to be interested in the deep rotators of the hip joint.
These are :
- Gluteus medius
- Gluteus minimus
- Gemilli superior
- Obturator internus
- Gemelli inferior
- Obturator Externus
These muscles are important in helping keep our pelvis level when we are on one leg in walking , climbing stairs or coming down stairs or any activity on one leg.
If the get weak and long then movement pattern of the hip dropping on the stance leg becomes more apparent. This is often referred to as Trendelenberg gait.
What’s happening in a painful hip?
This is where the tendons of your gluteal (bottom) muscles have become unhappy and are making it LOUD and clear.
Tendons become unhappy because:
- They are either being overloaded perhaps by increasing activity too quickly. This could be a result or going on a holiday that required more walking than usual or taking up running after an extended break.
- Being underloaded and losing their ability to cope with normal daily activity.
- Being squashed or compressed because we lie on them for too long or cross our legs.
- As the muscles get weaker then our leg tends to drift across midline a causing compression of the tendon against the bursa on the greater trochanter. All these factors can create a painful tendon , bursa or both giving rise to the symptoms of lateral hip pain.
Postures and activities that cause hip bursitis and tendonitis:
A common and easy to fix contributor to the problem can be your daily postures, especially ones where the leg is crossing midline. In some cases we have seen dramatic reductions in pain just by following these simple guidelines.
So have a think about whether you do any of these:
- Stand with your weight on one leg – pushing your hip out to the side.
- Sit in a chair with one leg crossed over the other
- Lie on your side – painful hip up OR down
- Sitting in low chairs with your knees above your hips
- Stand on one leg – for example when getting dressed
- Walking up stairs or hills.
Our quick fix tips on how to settle hip bursitis and tendonitis.
-
Don’t cross your legs or feet when sitting
2. Don’t let your legs cross midline in standing
Try not stand with weight on one leg so you drop your hip. This like crossing your leg increases compressive forces at the tendon resulting in development of tendinopathy.
3. In bed lie on the unaffected side.
Use two or three pillows under the leg that is on top. Stops the top painful leg crossing the midline position.
4. Strengthening the deep muscles of the hip one of the best ways to treat hip bursitis or tendonitis.
The target of this is to strengthen the deep muscles of the hip. This helps reducing the “hip drop” often seen in walking with this type of problem as well as improving the tendons ability to tolerate daily stresses without pain. This is a very important component of your rehabilitation as it can determine how well you recover in the short and long term. Exercises need to be progressed as you get better to ensure the best recovery and prevent recurrence.
5. The role of physiotherapy in managing lateral hip tendonitis or bursitis pain.
Physiotherapy soft tissue techniques, shockwave therapy or dry needling / acupuncture approaches can have significant impact on your pain levels and help with your recovery. They can be especially useful in calming down the initial acute pain.
However going hand in hand with these techniques are changes to daily habits and a progressive hip and core strengthening program.
The LEAP trial was an exercise versus corticosteroid piece of research that demonstrated the incredibly effective benefits on strengthening exercise in getting rid of hip pain. It saw an improvement of symptoms in 80% of participants with hip pain compared to only 50% who had an injection. You can read more and get the exercises from the trial here
The happy hip round up
Although we need to do many of the above mentioned activities in our life, if you are currently suffering from hip pain, they can aggravate it and slow your recovery.
The good news is that with the right approach you can get on top of this issue and not let it kick you in the butt.
You can read more here about the hip based strengthening program here.
If you are struggling with lateral hip pain then book in to see one the team to get you back on track.
Cheers
Dave
