What is tendonitis in the hip?
Hip tendonitis is inflammation and degeneration in the tendons, the thick cords that attach muscle to the hip bone, typically due to overuse.
The iliac muscle starts in the hip bone, and the psoas muscle starts in the lower spine. These muscles come together in a tendon at the top of the femur, and this is where tendonitis in the hip occurs giving it the scientific name iliacus tendonitis or iliopsoas tendinitis.
Causes of hip tendonitis
Hip tendonitis typically occurs when the tendon is under abnormal stress from activity that you are not used to doing. Hip tendonitis is a degenerative injury that causes a disorientation in the tendon fibers. Because blood supply in the tendons is poor, they are slow to heal.
Other causes of hip tendonitis include:
- Sudden progression of exercise without adequate training
- Repetitive stress related to overuse
Risk factors for hip tendonitis
Risk factors for hip tendonitis include:
- Specific sports — people who participate in sports such as running, cycling or high kicking are at a higher risk for developing hip tendonitis. Also sports that require squatting or lifting weights put you at higher risk.
- Rapidly increasing training — people who rapidly increase intensity and duration of training are at a higher risk for developing hip tendonitis.
Symptoms of hip tendonitis
The most common symptom of hip tendonitis is pain that develops gradually over time.
Other symptoms of hip tendonitis include:
- Tenderness on the hip where the tendon starts
- Hip stiffness in the morning or after long periods of rest
- Pain that lessens as you warm up but intensifies later in the day
- Discomfort when contracting the muscles in the hip
Diagnosis of hip tendonitis
Your primary care, orthopedist or sports medicine doctor can diagnose hip tendonitis during a full physical examination. You will be assessed for range of motion, joint stability and flexibility. Your physician will also look for torn or ruptured tendons in the hip and discuss training that led to the injury.
In some cases, the physician will order an x-ray or MRI to determine if there is a severe tear or a hip fracture that is causing the pain.
Treatments for hip tendonitis
Early treatment for hip tendonitis includes rest and anti-inflammatory medication to reduce the inflammation.
Physical therapy
Physical therapy in the early stages of hip tendonitis is aimed at decreasing pain and reducing inflammation. The physical therapies may use massage, ultrasound or electrical stimulation to speed the healing process and minimize further damage. Your physical therapist will also prescribe exercises to stretch and strengthened the injured area and correct muscle imbalances.
Orthotics
Orthotics can help improve the knee alignment and function of the patella.
Surgery
Surgery is a last resort treatment after nonsurgical options have been exhausted. Surgery stimulates healing through restoring the blood supply to the injured hip or quadricep. The damaged tissue is removed and the tendon is repaired. Most patients who require surgery will have arthroscopic surgery, which is less invasive, and patients can go home that day.
Recovery from hip tendonitis
If you have not had surgery for hip tendonitis, the injury can heal with four to six weeks of physical therapy. The goal of the physical therapy is to reduce the pain and inflammation as well as to improve function of the hip.
Physical therapy after surgery is intensive and involves a full team of specialists, including your orthopedic surgeon. The team will work together to develop a treatment plan for your case. The physical therapy will intensify as you progress to ensure you are fully healed before resuming your normal activities.