FAQ: Lateral hip pain

Injury? Lateral hip pain, trochanteric bursitis & glute tendinopathy. Trochanteric bursitis and glute tendinopathy are common causes of lateral hip pain – these are often coupled together to be called Greater Trochanteric pain syndrome. Trochanteric bursitis involves inflammation of the bursa, a fluid-filled sac that reduces friction between the tendons of the gluteus medius and the ITB when they pass over the greater trochanter. Glute medius tendinopathy refers to a degenerative process of the tendon of the glute medius due to overuse or damage. 

Where will I feel pain? Pain is typically felt on the outer side of the hip, specifically over the greater trochanter (bone on the side of the hip). It may also radiate down the outer thigh or even to the knee in some cases. 

What movements will I struggle to perform if I have injured this tissue/region? Movements that may be challenging include: 

  • Walking or climbing stairs, especially uphill. 
  • Sitting for extended periods, especially on hard surfaces. 
  • Lying on the affected side. 
  • Activities that involve repetitive hip movements, such as running or cycling. 

Will I feel pain in any other regions of my body? Pain may sometimes refer to the lower back, thigh or lower leg, but the primary site of discomfort is local to the lateral hip. 

What are the causes? Trochanteric bursitis and glute tendinopathy can be triggered by factors such as excessive use, muscle imbalances, suboptimal biomechanics, or physical injury. Engaging in repetitive actions such as running or cycling can induce irritation, while direct physical trauma can be a precursor to bursitis. Additionally, women, especially those aged 40-60 years old, may be more susceptible due to hormonal fluctuations, as well as the wider hip structure can exert added stress on these muscles and bursae. 

What things should I try initially once I’ve hurt myself? Given the typically gradual onset of this condition, it is advisable to first seek guidance from a health care expert, such as an Osteopath or Physiotherapist. Additionally, you can make some simple lifestyle adjustments, including: 

  • Refraining from crossing legs while sitting 
  • Avoiding lying on the side of discomfort 
  • Not shifting weight onto one hip when standing 
  • Attempt to widen your walking stance to around hip-width to alleviate compression
  • Trigger point release work to the glute muscles with a trigger ball

What things should I try to avoid in the initial stages of injury? In the early stages of injury, it’s important to steer clear of certain activities to promote healing. These include high-impact exercises that can exacerbate the condition, as well as prolonged periods of both sitting and standing, which can strain the affected area. Additionally, it’s advisable to avoid activities that demand repetitive movements of the hip, as they can further irritate the injured tissues. 

What type of exercises or movements do I need to learn/control/be stronger at to rehab the injury?  Rehabilitating the injury typically entails a combination of exercises and movements. This includes incorporating: 

  • Gentle stretching routines aimed at the hip flexors and gluteal muscles. 
  • Exercises tailored to strengthen the hip abductors and gluteal muscles. 
  • Focusing on core stabilisation exercises to enhance hip stability. 
  • A careful and controlled return to physical activities, with a gradual progression into sports or exercise regimens. 

What other considerations contribute to the injury? In addition to the injury itself, various holistic factors can play a pivotal role in its development. These involved modifiable factors such as weight, activity levels or sedentary behaviour. Biological influences are also crucial to consider to correct any muscle imbalances within the surrounding muscle groups. Furthermore, avoiding training errors by engaging in warm-up and cool-down routines, along with a gradual progression in activities, is essential to minimising the risk of aggravating the injury. 

What treatments can help relieve some pain or fast-track my rehabilitation? Following a thorough assessment and diagnosis, you will receive a tailored program to target your specific needs. This program often incorporates manual therapy techniques to alleviate symptoms and address any compensatory issues. In some cases, it might be advisable to consider anti-inflammatory medication to reduce bursa inflammation (this should be done under the guidance of your doctor). Lastly, it’s crucial to implement the lifestyle modifications mentioned earlier to enhance your overall prognosis. 

What are the expected timeframes of rehabilitation? Recovery time varies depending on the severity of the injury and individual factors. Mild cases may resolve in a few weeks with conservative treatment, while more severe cases could take several months. It’s important to follow a gradual return to activity plan and adhere to your healthcare provider’s recommendations for the best outcome.