Outer Hip Pain & Tenderness – what is it?
Pain and tenderness along the outer region of the Hip and thigh region is commonly associated with Gluteal Tendonopathy. The Gluteal medius and Minimus muscles are located in the buttocks and their role involves moving the hip joint in an outwards direction. Tendonopathy involves weakness and often chronic inflammation at the attachment point of the gluteal tendons to the Greater Trochanter of the thigh bone. Hence the tenderness that is felt around the ‘Pocket’ region of the thigh. It occurs in both adults are not very active and also in Road Runners.
Causes of Gluteal Tendonopathy
It is caused by a sudden contraction or shortening of the Gluteus medius muscle when slipping or falling to the ground. In an Athlete, it can also occur during a ‘Side-Step’ movement or when drastically increasing their running or walking load over a short period of time.
Signs & Symptoms of Gluteal Tendonopathy
Pain and tenderness on the outside of the Hip area.
Pain can radiate down the outside area of the thigh towards the knee.
Symptoms occur without any know trauma to the Hip region and gradually worsen overtime.
Difference between Osteoarthritis of the Hip Joint and Gluteal Tendonopathy is Hip Osteoarthritis patients have difficultly tying laces and putting on socks, whereas Gluteal Tendonopathy patients don’t have this problem.
Gluteal Tendonopathy is aggravated by;
Sleeping on Symptomatic Hip at night
Standing momentarily on single leg when putting on a trousers
Rising from a Seated to a standing position
Walking after sitting for a prolonged duration
Extending Hip backwards when walking can cause Hip pain and restriction
Stretching your knee towards opposite shoulder (common stretch of athletes)
Treatment & Management
Treatment involves initially identifying and avoiding the aggravating factors such leg crossing habits, stretching glutes and leg collapsing inwards. A progressive strengthening program of the Glute medius and Glute minimis is required to strengthen its weak tendon attachment point at outer area of the thigh. This achieved by basic load isometric exercises that progress without pain to concentric followed by force loading eccentric strengthening exercises. This is performed under the guidance of your Physical therapist without pain. Alterations to walking and running technique need to be addressed also to aid the healing process.
Tomás Ryan is a Registered Physical Therapist with The Irish Association of Physical Therapy (MIAPT) and is based in Clonmel & Thurles. Contact Number: 0504 26672