Lateral Hip Pain – What is causing the issue and what hip tendinopathy exercises can I do to remove the pain || Battersea, Physiotherapy
Lateral hip tendinopathy problems can cause a number of issues, aside from the pain in your hip, it can greatly affect your daily activities. So we are going to take a deep dive into lateral hip pain and find the key hip tendinopathy exercises to get you back enjoying life again. As always we need to start with understanding the pain and helping you confirm that this is indeed a lateral hip tendinopathy issue. There are a few other key differential diagnosis you could have and it is important you start the right management plan for your injury. As always with complex pain issues seeking professional advice and assessments can help you make sure you are doing the best course of exercises for your specific condition.
So you have lateral, outside, hip pain but can you confirm that the issue is being driven by a hip tendinopathy issue. The most telling information will be the exact area you are experiencing your hip pain along with the type and behaviour of your pain. If you palpate your lateral hip you will find a big bony area at the most lateral part, as you palpate, or feel, your way to the upper part of this bony lateral hip region you will start to feel the bone goes and the area becomes more soft tissue related. If your pain is primarily about 1-3 cm above the bony point on this soft tissue then you are right on your gluteus medius tendon, and so a lateral hip tendinopathy is a likely diagnosis for your current pain issues. You will certainly benefit from the hip tendinopathy exercise programme that we are about to present to you as phase one of your recovery.
Our team of chartered physiotherapists have wokred hard to build a clear treatment pathway for lateral hip related tendinopathy issues. Review our pathway outline and find out how you can get back to the activities and sports you enjoy – Resolving Tendinopathies
The type of pain is important in your initial diagnosis and so you are looking for the following issues being present with your current lateral hip pain;
- Superficial ache over this soft tissue region
- Long ache in the morning, that is dull in nature and takes time to settle as you move
- Pain sleeping on your painful hip at night time, therefore needing to roll over or wakes at night
- Stiffness created by sitting for long period, stiff to get moving again
- Pain going up and down stairs, loading the single leg
- Pain walking or standing after longer periods, painful loasding one leg and you can put your finger on the painful ache
- Pain will not settle with ice or NSAIDs (neurofen or ibruprofen)
Obviously there are a host of other hip injuries that could be causing your pain. The main ones to be concerned about here are osteoarthritis of the hip, especially early on, however in this case the pain will be much deeper in the hip joint and likely into the groin region and you willl feel pinching in the hip on deep range hip flexion (pulling the knee up to your chest) neither of which will be painful for a lateral hip tendinopathy issue. The other likely related diagnosis is that of a lateral hip bursitis, which can cause many of the loading issues described above however it will respond to ice and NSAIDs, in fact very well indeed so this should give you an clear indication of a different problem, while the pain will be directly over the bony point of your lateral hip, not the soft tissue area as in the current lateral hip tendinopathy pain response. Do check these carefully as they can be related and you may have a number of factors present in your hip pain. It is quite possible there are a number of pain driving factors present that will need careful management of your hip injury.
There are a number of different phases when looking to address a hip tendinopathy issue, an the exercises are of key importance to your progress and long term success. Personally resolving a tendinopathy issue is a difficult injury to manage by yourself. For the best results you will need the input of a good physiotherapist or sports rehabilitation expert to help you manage your journey. There are generally three phases in your recovery, and today we will look at phase one and getting your to begin to move away from you hip tendinopathy pain. This is essential for improving your tissue tolerance and beginning to build strength in your hip and tendon complex again.
As you move forwards into phase two and three of your recovery you will start to load both the hip region and hip tendons more aggressively. So you can begin to build true strength back into the lateral hip muscles, you will likely need to build in hip mobility work at this stage too. Reduced hip mobility can have a dramatic effect on lateral hip injuries and their long term recovery, so make sure you work on this area as part of your long term pathway to success. In phase three you will add more dynamic loading to your recovery plan and begin to add in jumping, hopping type acitivies to improve stress capability of the hip tendinopathy. This is the phase that you will being to add in sport or activity specific training to help manage your progress back to these activities.
Please don’t forget the huge benefits that can be acheived through shockwave treatment for lateral hip tendinopathy issues. ESWT, or shockwave treatment can help tissues remodelling, especially in the early phases and improve your recovery from pain while allowing you to complete your exercises to achieve the best initial results.
There are many different treatment options to address lateral hip tendinopathies and the options are discussed in more detail on our dedicated tendinopathy page www.bodylogichealth.co.uk/resolving-tendinopathies , including a discussion on the wonderful effects of shockwave treatment to help settle your hip pain to start your journey to recovery.
The attached video has a good run through of all the exercises that we discuss here for you. Please use the video to help make sure you are completing your hip tendinopathy exercises effectively. You will find here, what we believe are the best starting exercises regardless of the intensity of your pain, length of time you have had your hip injury or the level of activity you are keen to return too. The starting point will be the same for everyone, so get the foundation in place to make sure your recovery pathway is smooth throughout your hip injury recovery.
So here are the top three lateral hip tendinopathy exercises for you to begin right now at home and start to make a difference to your tendinopathy problem.
- Small knee bend with a looped band around the knees – this adds a small amount of resistence loading to the lateral gluteal muscles with the key being this is a static exercise, begin with ten second holds and repeat x10 times however you are aiming to build this to completing x3 of sixty second holds as you progress. The static nature of the exercises means the tendoninopathy will not be aggravated, so this should not increase your current hip pain, it should remain static throughout the regime. Make sure this is the case, get your form right and if it is painful try without the bend to begin.
- High lunge with increased load on front leg – this has a number of different phases and the level you work at will depend on your ability and pain levels. You can wokr at the most challenging level that doesn’t increase your pain, it should remain at a 3-4/10 following this exercise. Begin with the high lunge work, using the back foot as balance and with about 80% of your load through the front heel, this helps active the gluts effectively. If this gets easier then progress to a single leg small knee bend, and finally you can move to using a looped band (easy to pick up at places like Decathlon). Again you are building static work so begin with 20 second holds and devleop this into x3 sets of about 60 seconds work for the maximum benefit.
- Side lying lateral hip lift and rotate holds – It is great to load the hip in standing, it is how we use it mostly during day to day activities and is therefore an essential part of your rehabilitation process for hip tendinopathy issues. However completing this one loading exercsie in side lying can really help build your strength through the tednon region and muscle. The key is not to lift the foot too high during the exercise, you need to come about 10 cms above the lateral hip bone only, keep the lower side from compressing into the floor and make sure you extend at the hip and not your low back. Again we are looking for x3 sets of 60 seconds but you will take time to be able to work to this level so build it up starting at about 20-30 seconds first.
The key during your first phase of recovery is to make sure you are beginning to load the lateral tendon region of your hip. It sounds odd but it is so important to build this loading into your routine as soon as possible, remember it should be pain free to complete these exercises. If it is not then ease back on your timings of your holds or number of reps until you are loading comfortably, then build. You pain, on the pain scale should remain in the 3-4/10 throughout and after you have completed the exercises.
Be patient, tendinopathies take time to settle so don’t expect a sudden change in your pain levels, that said shockwave therapy can help your progress in these early stages. So get the right advice and treatment from an expert to maximise your results.
Build Stronger Hips