There can be many causes for hip pain. One of the common ones we see here in clinic is gluteal tendinopathy. This usually presents a deep ache in the back/side of the hip that can feel stiff and sore of a morning and can be sharply aggravated by tasks such as increased walking, standing or climbing of stairs.
What is it? Glute muscles are a group of muscles that sit around the hips. They are responsible for the pushing back movement of the upper leg and maintaining stability during standing and walking. Like all muscles they attach to bone at either end with a segment of tendon. At times these tendons can become aggravated when the body cant recover from the work it is being asked to do.
Why? Tendons get aggravated when they are over worked, and the body can’t keep up. This can be a result of increased demands such as a lot of standing and walking, or if body mass has increased. 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 hormone levels in the body (particularly during menopause in women)
Other things tendons don’t like is being stretched (sitting with crossed legs or sleeping on the side with the sore leg dropped across the body.) and pressure (sleeping on the affected side)
What can be done? First of all, a scan is not necessary for the diagnosis of this condition. A thorough history and physical assessment is a very effective way of diagnosing this condition (or another hip condition) Once diagnosed the first goal is to bring the pain under control. This means reducing load on the specific tissue that has become aggravated. Initially this may include (if possible) reducing LL exercise/ activity. But also adapting the way you move your body to divert load to other areas of the body. And maybe a few tips and tricks to avoid aggravating it at rest (sleeping position, sitting position etc.)
Sometimes a Corticosteroid injection is suggested. If treated early enough there should be no need for this. And for long term management it is best to be avoided.
The next step is to increase the amount of load the tendons are able to manage. Like with any part of the body, if you don’t use it, you lose it. So it is important to build the tendon and muscle strength up in a controlled way. This will involve some small exercises at first targeted at the gluteal muscles and then moving on to exercise that challenges you at an appropriate level.