In this video, I'm going to tell you everything that you need to know about hip tendinitis.
Specifically, I'm going to cover the anatomy, the symptoms, and the causes of hip tendinitis,
so that you can know how you got it and what to begin to do about it. It's often mistaken for hip
arthritis, but I'm going to explain the difference about that later on in this video as well.
My name is Dr. David Middaugh, and I'm a specialist physical therapist at El Paso
manual physical therapy. And this channel is dedicated to helping people stay healthy,
active and mobile, while avoiding unnecessary surgery, injections and pain medications. please
consider subscribing to our channel so that you don't miss out on any of the helpful videos we
post every week. So let's get right to it friends. I've got some pictures here to help us out
with understanding the anatomy of hip tendinitis. So what you're looking at here on this picture,
closest to me is the front of the hip bones, you've got the spine right here. And this will
be your pelvis bones or your hip bones, your hip joints right here. And here's your thigh
bones coming down. And what I want to highlight on the front here are the two hip flexor muscles.
The psoas and the iliacus muscle, they're often grouped together, and they're called the iliopsoas
group. But those are your hip flexor muscles, which help you to pick up your leg like this.
This is called hip flexion. And because those muscles are right here, they can be overused
and cause hip tendinitis on the front of your hip. That's less common, the more common hip tendinitis
is on the outside of the hip over here. And that's what's on this other side.
This picture right here is showing you the outside. This would be the the left hip. So
this is the front, this is the back, here's the tailbone. Here's the thigh bone. There's a little
hole right here, that's part of the hip bone. And then I've drawn some of the muscles here,
there's tons of muscles, I've labeled them all right here. But my drawing would get
kind of messy. And there's pictures all over the internet. If you look, if you just Google
hip muscles or hip tendinitis muscles, you'll find all the muscles that I'm talking about here.
But just to give you a comprehensive list here, gluteus medius gluteus minimus, gluteus maximus,
I should put it up here, the gym li muscles, and there's a gym LA Superior inferior. So
there's actually two gym Li and two operators and internist and Externus. But there's the
arbitrator muscles, all these help with the rotation of the hip, the piriformis muscles,
another one and then the Quadratus Femoris muscle is the lowest of all those deep glute muscles.
Now, the important thing to note about all of these muscles, just show you on the hip of the
skeleton here. If you look at the skeleton on the hip joint, all of those muscles that I just
mentioned, attached to this area of the thigh bone, close to the body. And that's exactly where
you can get that hip tendinitis to happen on the outside of the hip, or on the front of the hip.
That's what ties all these muscles together. T here's so many to worry about. So many healthcare
practitioners get confused, and they start splitting hairs on Well, is it the gluteus medius
Is it the the minimus muscles at the so as Could it be the Quadratus Femoris muscle and one of the
muscle that I didn't mention that I think commonly gets involved is also the TFL muscle, the tensor
fascia Lata muscle. I didn't put it on the list here because it doesn't attach to this bone,
but it's in the area. And that muscle can often be used in the imbalance that sets up hip tendinitis.
That muscle though, attaches into the IT band, which is a big
tissue, a big thick tissue that runs on the side of the hip and actually goes all the way
down into the outer knees. So you've got hip pain on the outside for part of your hip and knee
pain on the outside of your knee pain, you might actually have something called IT band syndrome,
but it's also the same root problem as hip tendinitis. So this video is going to help
you out in understanding what causes it just in case you get both issues happening simultaneously.
Now the biggest symptoms that you're going to find for hip tendinitis is point specific
tenderness. In other words, if you poke the spots around this hip bone right here are yourself
and you feel tenderness right there and it's not deep, it's more superficial, kind of superficial,
deep, you know, in between, it's on the tendon and muscle. That's where you'll find the tenderness.
And that is, that's how it's diagnosed. You typically don't have a loss of motion,
you know, you can move your hip joint all the way in every direction that you want to.
And you don't really have a lot of stiffness associated with this, maybe a minor amount,
but nothing that really stops you in your tracks. This tends to get worse as you use it more.
And to be specific. If you especially got this from exercise, you might actually feel
better Once you begin to exercise, but then as you as you progress to your exercise and
you get towards the end of your workout, then it tends to feel a little more painful at that
point. And then after you're done exercising, is when it definitely tends to be painful.
Now for those of you that aren't exercising regularly, if you've got this and you're more
of a person who does chores around the house can be yard work, or you like to walk for exercise,
you're not really doing intense exercise, you'll probably feel the symptoms bothering
you more as you go through your chores, your yard work and towards the end of your walk,
rather than at the beginning of your yard work chores and walk. If you've got more tendinitis
on the front of your hip, which to show you myself, that would be about where the leg folds
right in here. And if you're on the outside of the hip, that my hip bone, the top of my hip bone
is right here, that would be the top of this. So this bone right here, where you would find
the tenderness is going to be down, we're kind of on the on the outermost part of
your hip right here for me. And another way to find that bone. If you just put your hand on
the outside of your hip right here, and you twist your leg in and out like this, you'll feel a bump
in there moving. And what that is, is that's the bump rotating back and forth like this. So you can
easily find that spot. It's kind of a big bone. But it's kind of hard to find for some people
because it's so big, they can't find a one spot on it, that gives them certainty that they're
on it. But if you move it around like that, then you'll get an idea for for how big it
is and where it is. And if you just poke the edges of it, then you'll find a tender spot
and that helps you to diagnose hip tendinitis. Now on the front of your hip, it's a little more
challenging to find that point specific spot that gets you to diagnose the hip tendinitis,
which you need to know is on the front of the hip, you can also have hip arthritis pain,
that's the most common spot to get hip arthritis pain is right where the leg folds right there.
The difference is if you dig in there and you find a muscle,
kind of a something that you can roll over a bit, a spot that is tender, than that's more often hip
tendinitis. hip arthritis is usually way too deep to poke. There's just so many tissues, ligaments,
muscles, tendons that are in the way of the joint, they're covering up the front part of the hip,
you can't quite get to a tender spots. Now the causes of this is typically overuse.
What I mean by that is you're doing too much in too short a time. Typically, if you're exercising,
you've ramped up your exercise, or maybe you didn't do any exercise, and you started to pick
up an exercise routine. And you've just done too much all at once. That will overload the tendons
and causing to become inflamed, irritated. And that's what causes the pain for you.
The most common forms of exercises that causes are going to be running using a bicycle using an
elliptical and exercises that involve jumping, which could be team sports, like basketball,
football, soccer, those kinds of activities all obviously involve running and jumping and cutting.
And they can use all those muscles that I mentioned in the hip, that it's just a matter
of where's the weakest link, because that's where the tendinitis will tend to develop.
A treatment for this is pretty straightforward. And the good news is, it's 100% fixable,
and just about every case, as long as you begin to do the right things for treatment, you should
see this progress feel better. And you should be able to overcome it and get back to doing
activity exercises, your housework your yard work without this coming back over and over again,
if that's the case for you, you're ramping into things too fast, or you really lack
a lot of strength, or you have a big muscle imbalance, which is probably the bigger problem.
And you need to fix those issues so that you can get into your activities without that
tendinitis coming up over and over again, which is dangerous for arthritis. And I'll speak more
to that in just a moment. But your first course of treatment that you're going to do if you're
watching this video right now and your hip is flared up and you think this is hip tendinitis,
you've got to rest you got to cut back on those activities that have gotten you to this place.
So you've got to back off on the running of the exercise, the gym exercises,
also your yard work your housework, I would cut down to just doing the minimum that you
need to do to do your normal daily activities. You know, your housework that needs to happen, or else
you're going to be in trouble and your typical walking around that you need to do within your
home to take care of yourself to work but don't do extra things like go on a walk or go on a jog.
Avoid the exercises potentially setting this off right now. Typically,
for a mild to moderate bout of hip tendinitis. You shouldn't need more than about two to four weeks
to flare down enough to begin to exercise again, if it's a more severe case of hip tendinitis,
you're looking at closer to six to eight weeks to recover from this problem.
Even after the tendon has flared down and your hip tendinitis is under control,
what you should feel is no pain to maybe just a teeny tiny bit of pain that comes here and there.
At that point, you need to begin to exercise the right muscles, which are usually glute Maximus,
there's usually a muscle imbalance within all of those hip muscles that I mentioned earlier
in the video, go back if you want to look at those. And usually glute Maximus is the muscle
that really needs to get stronger in order for you to not overload the other tendons.
And the reason for that is glute Maximus is the biggest muscle back there on the hip.
And so it should be taking most of the forces. If you're not using your gluteus maximus
correctly, then you're going to be using other muscles which have smaller tendons,
and those tendons just can't take as much force as your gluteus maximus should.
So you're going to overload those little tendons and cause a tendinitis problem again.
Now that's the case for hip tendinitis on the outside of your head. But if you've got it more
on the front of your hip, then we've got to look at those hip flexors, the psoas and the iliacus
muscles, if those are the ones that are becoming inflamed and irritated, and that's where you
develop your tendinitis, then usually there's an abdominal muscle weakness, because those muscles
on the front of the hip are covered up by the abdominals, abdominals tend to be weaker, and so
they're causing those hip flexors to be overused. It could also be gluteus maximus. And whenever
we see patients with this problem, here in our clinic, we're strengthening both of the abdominals
and the gluteus maximus muscles. What I'm talking about here is a muscle imbalance, meaning there's
certain muscles that are too strong or dominant and other muscles that should be acting in certain
motions and activities. And those are just not turning on when they should or they're not strong
enough to work like they should for the given activities that you're putting your body through.
Now, we've got some videos linked in the description below that do go into exercises
and some more specific tests that you can do for hit tendinitis. And we've got some playlists
linked in there as well for other hip problems, including hip arthritis. So if you think that
you have hip arthritis, go down there, check out the description and look at the links in
there and go look at those videos so that you can learn more about how to help that problem out.
Speaking of hip arthritis, if you think that you've got it, what you need to know about
hip tendinitis, if you have that, too, is that hip tendinitis is the setup for hip arthritis.
So it's important that you take care of your hip tendinitis problem as soon as possible.
Because if you keep getting it to recur, if it keeps coming back, and you never really get a
good handle on treating it and make it go away, if you never figure out how to train properly,
so that you're not running into hip tendinitis all the time, then it's just a matter of time
before you start to affect that hip joint, and it becomes an arthritic situation.
And the reason for that is when you've got hip tendinitis, then you've likely got a muscle
imbalance between those glute muscles or the hip flexor muscles, and it causes the ball and
socket joint here to be pressurized, abnormally, it pulls on the hip joint here, and it pushes the
ball into the socket in an incongruent position. So instead of it sitting nicely in the middle of
the socket, it kind of moves over to the side or up or forward or twist a little differently
than it should rest in there. And if you live like that, if that's how you go run, if that's how you
walk around, that's how you do your, your chores, your yard work, then it's constantly going to be
grinding a little extra, as your months and years go on throughout your life. And that's the setup
for hip arthritis where the joint begins to get worn down inappropriately, that typically people
hit this in their late 50s to 60s and beyond. So if you're younger than that, then now's the
time to make sure that you eradicate this hip tendonitis problem. And if you're watching this
video and you're in your 50s 60s 70s and beyond, then it's not too late. Go check out the link in
the description below for hip arthritis videos. We've got tons of help for that too. I hope this
video was helpful for you. If you liked it, give us a thumbs up on it. Please don't forget
to share it with somebody that needs to hear this and we'll see in the next video friends bye