Treatment for Hip pain in runenrs | My Health Team

Treatment for Hip pain in runenrs

As a physiotherapist, I have many clients who present to me with hip pain aggravated or caused by running. The first step in this instance is to determine the source of the pain so can determine the best course of action for treatment.

Common causes of hip pain in running

  • Muscle strains and tendinitis
  • Apophysitis and avulsion fracture
  • Bursitis
  • Osteoarthritis
  • Stress fracture
  • Snapping Hip syndrome
  • Acetabular labral tear

 

Muscle Strains and Tendinitis

Gluteus medius

  • Muscle in the side of the hip which controls side to side movement through the hip
  • The tendon passes over the bony prominence on the outside of the hip and can become inflamed if the hip drops downwards or inwards when running (see diagram B)
  • Signs/Symptoms
    • Pain over the outside of the hip
    • Weakness when lifting the leg out to the side
  • Treatment
    • Hip strengthening: graded exercise program aimed at return to pain free running
    • Correction of running technique
    • Soft tissue release/Dry needling

Trendelenburg

 image: www.burleighphysio.com.au

Hamstring

  • More common in sprinters
  • Usually caused by sudden direction change
  • Treatment
    • Research shows that specific hamstring strengthening combined with agility and trunk stability exercises provided greatest results and decreased risk of reinjury (Sherry and Best, 2004)

Trochanteric Bursitis

  • Usually presents with gluteus medius tendinopathy
  • Caused when increased friction is created between gluteal tendons and the fluid filled sac (bursa) which lies between the muscles and bones in your hip
  • Treatment: as gluteus medius tendinopathy

Hip inflammation

 image: drhipandknee.com

 Apophysitis and Avulsion Fracture

Apophysitis: irritation at bony prominence where muscle attaches

Avulsion fracture: fragment of bone is pulled away from the main bone, where muscle attaches

Treatment

  • Rest – generally tend to heal in 4-6/52
  • Ice in acute phase
  • Surgery to reattach in severe cases
  • After period of rest, exercise and therapy to restore range and strength

Osteoarthritis

  • Cause: repetitive loading of joint
  • Treatment
    • Hands on therapy to improve range of movement
    • Muscle strengthening and stretching
    • Hydrotherapy/bike to decrease load
    • Weight loss
    • Last resort: hip replacement

Stress Fracture

  • Usually femoral neck due to repetitive loading
  • More common when running on hard surfaces
  • Symptoms:
    • Usually poorly localized anterior thigh/groin pain which is worsened with impact
    • Night pain
  • Treatment
    • 3-12 months recovery
    • Crutches during healing, with gradual return to weight bearing
    • Physio can assist with improving muscle tension/strength

 

 

Hip degeneration

Image: www.houstonmethodist.org

 

Snapping Hip Syndrome

  • ITB ‘snapping’ over greater trochanter during running causing irritation
  • May also feel pain over outside of knee
  • Cause: altered biomechanics
  • Treatment: as gluteus medius tendinopathy

4

 

Image: www.steppingstoneacu.com

 

Acetabular Labral Tear

  • Tear of cartilage that lines the hip ‘socket’
  • Caused by excessive/repetitive rotation through the hip
  • May experience ‘clicking’ or ‘catching’ deep in hip/groin
  • Treatment:
    • Surgery to repair labrum
    • Followed by physiotherapy to restore range of movement and strength

 

Hip pain

Image: www.gingergarner.com

  

Johannah Wilson

Physiotherapist

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