Hip Tendonitis Treatment & Symptoms (Hip Flexor Tendinitis)

Is it possible to have hip tendonitis, similar to other areas of the body like the shoulder or elbow? The answer is a definite Yes, and many people are not aware of it.

Compared to other areas of the body, our hips are constantly working overtime. They help us walk, run, bend, stand, and balance. Two muscles, the psoas and the iliacus, which start in the lower spine and pelvis, join together and attach to the tendon in the upper thigh.

When this tendon becomes irritated or inflamed, it can develop into a painful condition known as hip flexor tendonitis or to be more scientific – iliopsoas tendonitis.

This is a condition that can affect anyone, but is more common in very active people. Unfortunately, it is also more likely to occur as a result of the aging process.

What Causes Hip Tendonitis?

There are a couple of factors that can lead to tendonitis in the hip. One is a sudden trauma from an accident or, perhaps, the hip tendon coming under an abrupt, unexpected stress related to a particular motion.

More likely though, hip tendonitis (also known as hip flexor tendinitis) is caused by overuse or repetitive movements that generate wear and tear on the hip. Those who over-train or don’t properly warm-up before workouts or athletic performances are most at risk.

Some types of athletes are especially prone to issues of tendonitis in the hip, and these include:

  • Cyclists
  • Dancers
  • Swimmers
  • Runners

They’re not alone, though. People who exercise regularly, especially those doing particularly vigorous movements like heavy squats, jumping, gymnastics, and sprinting (think Crossfit), are susceptible to hip tendonitis as well.

Even those who regularly engage in spin classes or high-intensity interval training (HIIT) can suffer from the same hip problems.

You might also hear the phrase hip tendinosis, but there’s a significant distinction between tendonitis and tendinosis.

Hip tendonitis is acute, and the result of the tendon becoming inflamed and swollen.

Tendinosis, however, is chronic and is actually caused by a continually damaged tendon that’s scarred, thickened, and has jumbled fibers as a result of degeneration.

Common Hip Flexor Tendonitis Symptoms

Like tendonitis in other parts of the body (Shoulder Tendonitis or Hamstring Tendonitis), hip flexor tendonitis generally develops over time, as a result of repetitive movements.

A person might notice that they feel a little sore in that area, but if it’s early in the process, the pain might subside as their body warms-up and they continue to move. Unfortunately, this can often unwittingly make the issue worse.

Some people report a clicking or snapping in the front of the hip.

The primary symptoms of tendonitis in the hip include some of the following:

  • Pain when the hip is in use, as well as pain that worsens gradually
  • Soreness when flexing or stretching the tendon and muscles in the hip
  • Stiffness after a night’s sleep or after being idle for a period of time

Of course, athletes and active people like to push themselves and stay fit. This sometimes causes people to ignore the warning signs of hip tendonitis and not seek treatment until the symptoms turn into something more serious.

Left untreated, hip tendonitis will only get worse and can severely reduce a person’s range of motion or develop into tendinosis.

The condition is fairly easy to diagnose, especially for physicians that specialize in sports medicine. Physicians will talk to you about your physical activity and ask about your symptoms.

They will examine the hip for flexibility, stability, and range of motion, and might even order an x-ray to rule out bone issues.

An ultrasound or MRI will provide an even clearer picture of the condition to identify scars, tears, or thickening of the tendon.

If you are struggling with hip flexor tendonitis, don’t worry. You won’t be on the injury-reserved list forever, but you do need to undergo treatment.

What Are Typical Hip Tendonitis Treatment Methods?

Hip tendonitis treatment follows many of the same protocols as other soft tissue injuries. Here are some of the most common ways of treating it:

1. RICE Method

RICE stands for Rest, Ice, Compression, and Elevation

The very first thing to do after a hip tendonitis diagnosis, or even if you begin to notice symptoms without seeing a physician, is to take a break and rest.

This may mean abstaining from training altogether or limiting movements to only those that do not irritate the hip issues. Resting the hip will give inflammation and swelling in the tendon time to calm down and, hopefully, heal.

While resting, a combination of ice, a compression wrap, and elevating the hip can help reduce inflammation and ease the pain.

2. Anti-Inflammatory Medications

Over the counter non-steroidal, anti-inflammatory medications, such as ibuprofen (Advil, Motrin) will help relieve some of the pain and swelling.

Corticosteroids, like cortisone injections administered by a doctor, will help reduce inflammation, and pain when the inflammation subsides, although they might cause some discoloration and soreness near the injection site.

3. EPAT Therapy Treatment

EPAT Therapy Treatment is a non-invasive method for increasing the speed of healing. It also has the added benefit of limiting hip tendonitis downtime.

This highly effective, regenerative treatment delivers high-energy impulse pressure waves deep within damaged soft tissue.

EPAT Therapy Treatment stimulates blood flow to the hip tendon to reduce inflammation and pain associated with inflammation. Because it is non-surgical, no anesthesia is necessary, so there is no scarring or any risk of infection.

In some cases, athletes can undergo treatment sessions while still maintaining high levels of physical performance.

4. Physical Therapy

Physical therapy is a good option for learning how to strengthen the muscles in the hip, as well as learning stretches and warm-up techniques that will help avoid any further injury in the future.

It is also an excellent way to develop better form and techniques for highly specialized and repetitive movements in some activities like Olympic weightlifting, gymnastics, and sprinting.

5. Surgery

Surgery is usually not required for most cases of acute hip tendonitis, and is typically reserved for chronic hip tendinosis or extremely severe cases such as reattaching a tendon that’s torn away from the bone

It’s usually best to try other methods of treatment first and only consider surgery if they don’t provide proper relief, or pain and inflammations persists.

Understanding hip tendonitis symptoms can help professional and amateur athletes alike get ahead of any pain they might experience before it becomes more problematic.

It’s always recommended to speak with a medical professional at the first signs of pain in the hip that lasts for more than a few days.

Hip Muscles image courtesy of Beth Ohara.

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