Since the beginning of the new year, many of us have embarked on an exercise program in an effort to drop unwanted weight. Often, however, despite our best intentions, we're left with sore knees or achy hips and become frustrated that our body seems to be breaking down rather than building up. Teressa Petosky, a physical therapist in our Shermans Dale office, says lateral hip pain- pain on the outside of the hip- is often the result of a rapid increase in physical activity, whether that means going from being a couch potato to power walking up and down hills or from a routine of walking to taking step aerobics classes. Teressa adds, "A typical picture of someone with lateral hip pain is a woman in the peri-menopausal years who has recently begun exercising or ramped up her exercise intensity in attempt to shed excess fat."
Traditionally, lateral hip pain has been diagnosed as hip bursitis; however, recent studies reveal degenerative changes in the tendons of the hip- and not the bursa- as the primary culprit. But just how do the tendons break down? Oddly enough, certain positions that we adopt throughout the day, such as crossing our feet when sitting or standing with our weight predominately on one leg, causes compression of the tendons on the outside of our hips. This compression weakens the tendon, making it more susceptible to injury. Once injured, the condition is referred to as tendonopathy.
If you have pain on the outside of your hip during the following activities, you may be suffering from lateral hip tendonopathy:
- Lying on your side (mostly on your affected side but also on your unaffected side if you allow your leg to drop down and cross your midline)
- Prolonged sitting, especially if the chair is deep
- Arising from a chair after prolonged sitting
- Standing on your affected leg (such as when putting on your pants)
- Walking up an incline or stairs
Start with these few simple tips to avoid further damage to the tendons of your lateral hip:
- Do not cross your feet when you sit.
- Sleep on your back with a small cushion under your knees. If you do sleep on your side, sleep on your unaffected side with a large cushion/pillow between your knees.
- Do not sit in chairs with deep seats. Consider using a wedge to prop your hips higher than your knees.
- Do not hang on your hip when you stand. Put weight equally on both legs.
- Avoid includes or fast-paced walking if this increases your pain.
- Do not perform ITM (Iliotibial band) or piriformis stretching, as this increases compression on the tendons.
- Do massage any painful areas on your hip or lateral thigh
Avoiding these provoking positions is just as important as performing targeted exercises to strengthen the lateral and posterior hip muscles, as weakness is a primary finding in lateral hip tendonopathy. You may even have weakness in your abdominal muscles/core that contributes to your hip pain. Seeking out the help of a physical therapist is always your best bet when it comes to selecting the most appropriate exercises for your individual case. As Teressa would say, "They don't call us 'movement specialists' for nothing!"
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