WHAT IS THIS PAIN ON THE SIDE OF MY HIP?
WHY IS HIP PAIN STOPPING ME FROM EXERCISING?
Pain into the lateral hip can at times, literally, be a pain in the bum! So you think you are doing all the right things, going to the gym, swimming, running, cycling, etc.
But you seem to have this persistent, niggling, annoying pain in the side of your hip. What is it? What can you do to help hip pain?
You will learn the possible causes of this hip pain.
And how a physio can get you back to doing the things that you love!
WHERE IS MY HIP PAIN COMING FROM?
There are a number of places that lateral hip pain could be originating from. Your physio is able to perform a number of different, specialised tests to help locate the source of your discomfort.
Below I discuss some of these conditions…
Trochanteric bursitis is the inflammation of the bursa. (a small, cushioning sac located where the tendons pass over the areas of bone around the joints), which lies over the big bone on your hip (femur).
The bursa may become inflamed by a group of muscles or tendons rubbing over the bursa and causing friction against the hip bone. It can also be aggravated by a direct blow to the bursa i.e. a fall or tackle. It may also be a gradual onset issue due to repetitive trauma to the bursa. Which can be from running with poor technique or muscle control, cycling with too high a seat or walking to fatigue.
Symptoms can vary but will usually present with pain or swelling directly over the head of the femur. Also referred pain from the outside of your leg to the knee, or pain sleeping on the affected side, pain on climbing stairs or after prolonged sitting.
Gluteal tendinopathy is the most common type of lateral hip pain. A tendon injury may occur suddenly but is more likely the result of a repetitive/overuse type injury.
Tendons are designed to withstand high, repetitive loads. However, when a load applied to the tendon is too great and too often, the tendon can become stressed. This can start to cause pain.
A gluteal tendinopathy presents with increasing pain on activity e.g. running and pain or stiffness first thing in the morning and overnight.
Piriformis syndrome is a dysfunction relating to the sciatic nerve that originates from the lower back and sacrum. It then travels to the centre of the leg and down to the foot. This injury can occur from a number of predisposing factors. Such as, poor postural habits, long periods of sitting, muscle imbalance around the hip and poor flexibility around the hip and lower back. Symptoms can present with a radiating pain down the side of the leg or hip but usually originating around the glutes/lower back.
The lower back can be a common area to refer to the lateral hip due to the complexity of the spinal cord and associated nerves. Compression or irritation of these nerves can cause referred pain towards the hip. Sometimes the pain may only be felt in the hip itself. Symptoms usually occur with prolonged postures e.g. long distance cycling.
Muscle imbalance or weakness can occur in any of the above conditions and is usually an associated factor. When no pathology is present in a person with lateral hip pain, then you can assume it is then caused by a muscle imbalance around the hip. This usually relates to a tightness or pulling of muscles in one direction with the muscles in the other direction being too weak to be able to support the joint. This is common in asymmetrical type of activities e.g. kicking sports, golf or tennis.
HOW CAN WE HELP?
So what can Physio do for you? Firstly, a thorough history and assessment will be undertaken to understand the underlying cause of your hip pain as this will determine the type of treatment used. This may vary from heat/cold therapy, some manual therapy to help loosen tight muscles, relieve inflammation and generally make you feel more comfortable.
Your Physio will then put together a specific exercise program to help strengthen weak muscles and correct any imbalance. An important factor will also be discussing exercise load as this often is a major factor in hip pain. Striking the right balance in your exercises and fitness program will go a long way to helping you recover faster.
If you believe you are suffering from lateral hip pain, call one of our myPhysioSA clinics to get you back to full fitness!
Written by David Wilson, Partner Physiotherapist at Mount Barker myPhysioSA