What is tendonitis in the hip?
Hip Tendonitis is an inflammation of a muscle tendon. Muscles attach to bone through a thick fibrous cord which is the tendon. The tendon of a muscle can become frayed and begin to degenerate over time with overuse and repetitive type activities. Rubbing over a bony area can also cause the tendon to begin to wear down and become inflamed. The blood supply in tendons is poor so they tend to heal slowly.
What types of activities cause hip tendonitis?
Hip tendonitis typically occurs when the tendon is under abnormal stress from activity that you are not used to doing. So, a sudden increase in training or exercise can over time lead to tendonitis. Repetitive motions that can eventually result in hip tendonitis include those used for walking up steps, sitting up from lying down, and walking. In sports, higher-level cycling, sprinting, kicking, jumping, and squatting can over time result in an inflamed tendon. High-intensity interval training (HIIT) workouts, spin classes, and the use of a Stairmaster can also leave you at risk for this type of injury.
Once the tendon is inflamed, positions that place the muscle group on stretch can also be painful (like lunging forward with the painful hip in the back). Two common hip muscles that can get tendonitis are Iliopsoas and Rectus Femoris. In addition to feeling pain in the front of your hip, you may also experience a snapping or clicking sound at the hip during movement, which is why it can also be referred to as a “snapping hip.”
Five Self-Treatments
1. Stretching of hip flexors. Can be done both by lying on a bed and kneeling on the floor. See examples: Massage can also be used to lengthen muscles (foam roller or massage gun).
2. Cross Fiber friction massage if the rectus femoris tendon is affected. Find the bony hump on the front of your pelvis on the side of the hip pain. Photo of Pelvis Feel for a tender spot approximately 3 inches below the bony hump. If tender perform cross-fiber friction massage over the area. 5 minutes every day. Pain and tenderness over the tendon should begin decreasing after 30 to 60 seconds (or at least not getting worse). If getting worse, stop and use ice and anti-inflammatories if recommended by your doctor.
3. Proper use of your gluteus muscles (maximus and medius). It is difficult to explain how the gluteus muscles can adversely affect the hip flexors. Let us just say that if the gluteus muscles are weak or not able to perform up to their potential, they can place increased stress on the hip flexors. The hip flexors can be workhorse muscles. They often pick up the slack if the gluteus muscles are not working up to their potential. So, these three exercises are helpful:
A. Clam Shells (5-15 repetitions or until fatigued).
B. Gluteal Pumps (prone lying or quadruped) (5-15 repetitions or until fatigued)
Shown with a resistance band. Can do without it. Lift toward the ceiling. Lying on the stomach.
Shown on all fours with a resistance band. Can do without it. Lift toward the ceiling.
C. Walking correctly (engaging the gluteus muscles). Push off with the back leg to engage the glutes. Shorten stride. Initial foot contact should be mid-arch and not heel. Not really an exercise but can help immensely.
4. Avoid painful activities that can increase the stress on your hip flexors: Sitting with hips flexed beyond 90 degrees. In sports, higher level cycling, sprinting, kicking, jumping, and squatting. High-intensity interval training (HIIT) workouts, spin classes, and the use of a Stairmaster can also leave you at risk for this type of injury.
5. Strengthen the hip flexors in a lengthened and shortened state. Attach one end of resistance tubing to an ankle cuff and the other end to a wall anchor or some type of stable surface. On all fours bring knee to chest. Return the foot slowly to the start position. Feel resistance both ways. (2 sets of 10 repetitions or until fatigued)
Check out the full Hip Pain Relief Program series of videos along with downloadable guide sheets for each video on our website here: https://www.bobandbrad.com/health-programs/hip-pain-relief-program
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