Lateral Hip Pain – are you suffering?

Hip pain can be a painful and often debilitating condition. Previously, it was a difficult condition to treat and people suffering often chose to put up with the pain. However, greater research has been done so you do not need to suffer and live in pain anymore – you can seek treatment.   

Hip pain can also affect other areas of the body, with pain felt in the buttock, lower back, knee, thigh, or groin. This will depend on whether the pain is caused from within the hip itself, or from the hip joint or the muscle around the hip (hip flexor).

Lateral hip pain has a variety of different causes. Most of the time, it is caused by two very common conditions – gluteal tendinopathy and trochanteric bursitis. 

Both conditions are caused by an injury to your tendon or bursa from an increase in stress or compression as they pass over your hip (the greater trochanter). This pressure can be caused by repetitive overloading or from a direct trauma to your hip.

Gluteal Tendinopathy 

Gluteal Tendinopathy is caused by poor posture and poor movement associated with sitting with your legs crossed, walking, squatting, stair climbing, or running with excessive hip adduction. Over time, this leads to a loss of strength and control at the hip and pelvis. 

Gluteal tendinopathy affects 25% of women and 10% of men over the age of 50. This can be in association with hormonal changes (post menopause or during pregnancy) and in patients with a history of inflammatory disorders such as arthritis. It also affects active fit runners who lack sufficient strength and control around their hip. 

Symptoms of Gluteal Tendinopathy

• pain over the greater trochanter;
• lateral thigh pain and upper lateral shin pain as well as some groin and glute pain;
• It may be painful sleeping on the affected hip, but there may also be pain with the affected leg;
• it may be painful walking up hills, climbing stairs and running;
• if it is severe, it may be painful to stand on one leg to dress, to walk for the first few steps after sitting and may even be painful during sitting.

Trochanteric Bursitis 

Trochanteric bursitis is less common, but still has considerable implications for your hip joints. This condition is inflammation of the bursa, which is a fluid-filled sac near the hip joint. 

It can be caused by:

• Injury to the hip
• Running up stairs, climbing, or standing for long periods of time
• Incorrect posture
• Stress on the soft tissue 

In both conditions, the hip pain is described to be over your lateral hip. Typically you will have an inability to lie on your affected side. Hip pain with hip movements, walking, and weight-bearing activity is also common. Often an underlying weakness or tightness of your gluteal muscles or a biomechanical dysfunction around the hip is also present.

How Your Physio Can Help

At City Physiotherapy & Sports Injury Clinic Adelaide we diagnose you based on a thorough history and musculoskeletal assessment. We talk to you about your pain, check how you stand and walk, and examine what movements cause you pain. 

Our physiotherapists will coach you through how to recruit the deep gluteal muscles, which are essential in correcting muscle imbalances and poor movement patterns, it is also effective in improving hip associated pain. The exercises would help to improve postural control, movement patterns and strength in standing, sit to stand, single leg stand, squats, climbing steps and running.

Your movement patterns will be assessed to where you have weaknesses and then corrected through training and strengthening of other areas of the body such as abdominals, gluteus maximus and quadriceps.

Clinical pilates is another way that City Physio addresses these issues, it is a very effective way to progress through your rehabilitation program allowing you to complete supervised exercise and to improve whole body control and strength.

A lot of the time, people think they suffer from trochanteric bursitis when it is gluteal tendinopathy. Our skilled and experienced physiotherapy team are trained to diagnose and treat all forms of hip pain, so you are in safe hands. 

Physiotherapy for gluteal tendinopathy and trochanteric bursitis will focus on rest, pain relief and addressing underlying biomechanical dysfunctions and muscle weakness.

Our physiotherapists will educate you about what activities should be avoided, such as positions that increase compressive forces around the hip, and advise on how to safely remain active. 

Pain relief is dependent on the patient’s needs, and can be achieved through physio techniques such as: 

• Dry needling
• Soft tissue massage
• Unload taping and stretches 
• Strengthening exercises or resistance training

Strengthening of the lateral hip musculature and improving core stability are usually the primary goals of management in order to help prevent recurrent episodes. Sometimes, if the condition is not responding to physiotherapy management alone, we may refer you for an ultrasound-guided cortisone injection to assist with our management of your symptoms.

Can Hip Pain be Prevented? 

There are many ways in which hip pain can be prevented. 

• One of the best ways to prevent hip pain is to exercise, particularly low impact activities such as walking or yoga. Regular exercise also helps keep the muscle strong, so it is less likely to be injured. 
• Healthy weight management is also important because excessive weight can put extra pressure on the joints, making them less flexible. 
• Make sure you do not ignore minor injuries, because when ignored, they could turn into major injuries that become debilitating down the road. 
• Regularly stretch; this ensures the joints are loose and blood is flowing to the area. It keeps the connective tissue around your hip warm and flexible. 

Talk to our physiotherapists to tailor a prevention programme to you if you are at a high risk of experiencing hip pain. 

Book online today with City Physio in Adelaide for an assessment on your hip from one of our qualified physios and start your journey to recovery with our qualified and highly experienced physiotherapists. 

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