Hip Pain – why do women suffer more?
Studies have shown that about 1 in 4 women over the age of 50 suffer from pain on the outside of the hip 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 a large number of structures (see the image 1 below) that start at the top of the pelvis and run down to the outside side of your knee.
Dr Henry Wajswelner, a specialist Sports Physiotherapist in Victoria, was involved with a large study investigating lateral hip pain and 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.
Hip pain can present in a number of different ways because of the large number of structures that are in, around and adjacent to the area.
The following are common symptoms of 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 or running up or down stairs/hills
- 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 lateral hip pain in women is gluteal tendinopathy – an injury (or pain) in the tendon of one of the most important controlling muscles of the hip. It typically occurs when we have increased the intensity, frequency or duration (or all three) excessively in activities such as running, walking, hiking, or even stair walking on holidays! It also commonly occurs after an extended period of inactivity/ illness causing weakness.
The tendon is the area of the muscle that inserts into the bone. With gradual and consistent loading a tendon can become very strong and resilient. However if over loaded (such as from activities above) it can become stressed and possibly sustain small areas of trauma. It the loads (amount of exercise) is not decreased to allow for recovery then the damage to the tendon can potentially become worse and longer lasting with pain and dysfunction occurring (see some of the potential symptoms above).
One of the common symptoms of Gluteal Tendinopathy is bursitis. Bursitis simply means inflamed Bursa. A Bursa is structure that sits between two structures (in this case the hip bone and the Gluteal muscle/tendon) and acts like a bit of a cushion or support structure so that the tendon doesn’t run directly over the bone and get damaged. Unfortunately quite often with a Gluteal tendinopathy the muscle becomes quite weak and doesn’t hold it’s position away from the bursa very well when being used – such as with walking or running. As a result the tendon compresses and irritates the bursa – causing the bursitis! Until you can improve the actual muscle/tendon strength and control it will continue to compress it and cause problems.
Bursitis has traditionally been managed with cortisone/steroid injections which do offer some temporary relief in symptoms. Unfortunately they are a band-aid that covers a bigger problem and may eventually cause more harm then good. Multiple cortisone has been shown to cause further degeneration of the tendon which can then contribute to chronicity (on-going nature) of the problem. It is only through the appropriate strengthening of the tendon (via exercise) that you can ‘cure’ Gluteal tendinopathy. However for some people the temporary reduction in pain from the injection may be useful to exercise and strengthen the tendon appropriately! For more information about tendinopathies please read our blog.
Vital Core Physiotherapy can help with hip pain
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 assessment and management – it’s so rewarding for us to help our patients achieve their goals
Through thorough questioning and examination we will strive to determine 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.