Why Does My Hip Hurt?

There can be many causes for hip pain. A common source of pain often seen in physiotherapy clinics is gluteal tendinopathy. This usually presents a deep ache in the back and/or side of the hip. This condition often feels stiff and sore in the morning and can be sharply aggravated by tasks such as increased walking, standing or climbing stairs.

​What is it?
The gluteal muscles, or ‘gluts’, are a group of three muscles that sit around the hips. They are responsible for extending (lifting the leg backward) and abducting (lifting the leg to the side) the hip, as well maintaining stability during standing and walking. Like all muscles, they are attached to bone at either end via a tendon. At times these tendons can become irritated and inflamed which can cause pain, stiffness, and weakness.
 
Why?
Tendons become irritated and inflamed when they are over-worked, and the body can’t keep up. This can be a result of sudden increase in load such as standing, running, or other forms of physical activity. Sometimes there is no change to the amount of activity, but the body’s ability to recover has changed. This can be the case as we age or when there is a sudden change in hormones, particularly during menopause in women.
 
How is is diagnosed?
Physiotherapists are trained to assess pathology to determine the source of your symptoms. We use a combination of the subjective history (what you tell us), careful questioning, functional assessments and special tests to rule in and rule out different structures and pathologies.

Imaging such as x-rays or ultrasounds are rarely necessary or definitive in cases of suspected gluteal tendinopathy as these images often show that there are changes to these structures even when they are not the source of symptoms.
 
What can be done?
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Once diagnosed the first goal is to bring the pain under control. This means reducing load on the specific tissue that has become aggravated. Very rarely is complete rest recommended and your physio can work with you to adapt your physical activity to reduce load while still maintaining as much as possible.

The next step is to gradually increase load on the tendon. It is important to build the tendon and muscle strength up in a controlled way. This will involve some fairly light glut specific exercises at first targeted at the gluteal muscles and then progressing to more challenging exercises.
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If you have pain around your hip, either new or if it has been going on for a while, check in with us and we can help you figure out what is going on and create a management plan so that you can get back to what you want to do

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