Lateral Hip Pain – What is it Really?

It is a common complaint especially in those who have started an exercise program, such as walking or running and more common in peri or post menopausal women to suffer from lateral hip pain.  It occurs in people with OA of the hip and in 20-35% of people with lower back pain.  It is made worse by activities that require pelvic stability such as walking/running and going upstairs and when it is more severe affects daily activities such as sleeping on your side, prolonged sitting and walking or single leg stance.  It is due to a tendinopathy of the Gluteus Medius tendon which inserts into the lateral (outside) hip.  It is quite often misdiagnosed as Greater Trochanteric Bursitis (there may be bursal distortion, but no histological signs of inflammation).  It develops due to tendon compression from a lack of pelvic stability (causing relative hip adduction) and weakness/poor activation of the deep hip and pelvic stabilisers.  It is due to an overactivity and hypertrophy in the outer hip muscles as a compensation for this weakness.  This overactivity in the muscles, as well as the poor hip/pelvic control causes the compression of the tendon.  It is correctable with changes in everyday lifestyle such as sleeping with pillows between the knees, walking and going upstairs with a wider base of support and not sitting with legs crossed.   Stretching of the hip/glut muscles is commonly prescribed by physios causing compression and therefore aggravation of this condition.  This whole process of correction involves an analysis of activities of daily living and changes in lifestyle/training techniques.  To correct the problem long term, rest is not advised as the tendon becomes weaker, but a specific series of progressive non painful exercises.

By Melanie Roberts

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