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Jun 11

Hip Pain – why do women suffer more?

 

Studies have shown that about 1 in 4 women over the age of 50 suffer from lateral hip pain and that this is particularly true for active women – hands up runners and walkers if this has been you at some stage.

The lateral side of the hip includes any muscle or structure on the outside of the hip (see the image 1 below) that runs down to the outside side of your knee.

 

Image 1. The muscles on the lateral side of the hip including glute medius (and minimus which is deep in the hip), glute maximus (you’re biggest bottom muscle), the ITB (labelled as Fascia) and tensor fascia latae.

Image 1. The muscles on the lateral side of the hip including glute medius (and minimus which is deep in the hip), glute maximus (you’re biggest bottom muscle), the ITB (labelled as Fascia) and tensor fascia latae.Dr

Dr Henry Wajswelner, a specialist Sports Physiotherapist who is involved with a large study investigating gluteal tendinopathies, explains that it is likely the anatomy of the female pelvis (see image 2) and the shape of our hip bones (along with the hormones that influence the female body at this stage of life) that contribute to the risk of injury.

Image 2: The female pelvis (on the right) is wider than the male pelvis meaning that there is generally more risk for lateral hip pain as muscles stretch over a longer distance before they insert into the knee.

Image 2: The female pelvis (on the right) is wider than the male pelvis meaning that there is generally more risk for lateral hip pain as muscles stretch over a longer distance before they insert into the knee.

Lateral hip pain can present in a few different ways because the muscles that cross or start at your hip joint insert across or into your knee meaning that sometimes a tight hip muscle can be causing knee pain as well as hip pain.

The following are common symptoms of lateral hip pain:

  • Pain or achy feelings at the side of your hip that may or may not run down the outside of your thigh to your knee. Sometimes the pain will radiate into the groin also.
  • Feelings of tightness across the side of the hip and thigh
  • Pain walking up or down stairs
  • Pain sitting with legs crossed or for long periods of time
  • Pain lying on the affected side at night
  • Difficulties coping with your normal running or other physical activities even if the pain only occurs after and not during the activity.

One of the most common causes of this lateral hip pain in women is gluteal tendinopathy – an injury to the tendon. It typically occurs when we have tried to increase our level of exercise or increase our pace of exercise particularly with sports like running or hiking or stair walking on holidays! Or after an extended period of inactivity/ illness causing weakness.

When tendons become stressed from too much (relative) exercise, they sustain small tears, which encourage inflammatory chemicals and swelling, which can quickly heal (and become stronger) if managed appropriately.

However, if the load is continually applied to the tendon (working through the pain!), these small tears occurring in the tendon can exceed the rate of repair. The damage will progressively become worse, causing significant pain and dysfunction. The result is a tendinopathy or tendinosis and the well known symptoms of bursitis.

Unfortunately, it has been discovered that a lot of gluteal tendinopathies are missed and are instead incorrectly diagnosed and treated as bursitis (which is in fact a symptom of tendinopathy, not a diagnosis).

Bursitis is often managed with cortisone/steroid injections which do offer some temporary relief in symptoms but are really only a band-aid that covers a bigger problem. Cortisone has been shown to cause further degeneration of the tendon, and will usually then contribute to chronicity (on-going nature) of the problem. It must be said though with the temporary reduction in pain from the injection it can be useful if you then use that pain free time to exercise and strengthen the tendon appropriately!

Vital Core Physiotherapy can help

We love hips! Particularly middle aged and/or sporting hips! We have had so many training sessions on this area of the body because we love it so much. Why?

Because it is an area that is so often poorly managed and yet responds beautifully to the correct management!

What can you expect?

We will work out from questioning and thoroughly examining you, what exactly is causing your problem and why and most importantly, what are your goals! What can’t you do that you’d love to be able to do? Once we’re clear on this, then together we can formulate an accurate and complete treatment plan to get you back to your best as soon as possible.

We aren’t about the quick fix. We are about the long term resolution of dysfunction and the promotion of healthy, active living.

Vital Core physio’s can do all the fancy treatment techniques from dry needling to kinesiotape as well a number of old fashioned tried and tested techniques of mobilisation and massage. Most importantly though Vital Core physio’s will spend the time to develop a treatment plan with you that will include a progressive exercise plan. That is the ONLY way to ensure long term success.

Call 83310552 or book an appointment online.