Hip Tendinopathy

General information

Be aware of other pathologies such as
  • Inguinal hernia
  • Femoral hernia
  • Hip pathology (OA/Labral tear)
  • Pain due to tendinopathy is usually worse during and after activity, and the tendon and joint area can become stiffer the following day as swelling impinges on the movement of the tendon. Recurrence of injury in the damaged region of tendon is common.

Symptoms and Signs

  • Pain on origin or proximal few centimetres of major tendons
    • Common adductors into groin that can radiate down the leg
    • Common flexors arising anteriorly
    • Common hamstring origin deep into buttocks off tuberosities
    • Pain on resisted movements at tendon origin
  • Difficulty in running especially sprinting or changing direction.
  • Injury suggestive of muscle/tendon injury
     

Initial Management

  •  Eccentric loading exercises currently advocated.
  • Analgesia & NSAIDs as appropriate
  • MSK Physiotherapy referral: Patients who fail to respond to 10-14 days relative rest/avoidance of aggravating exercise coupled with appropriate analgesia
  • Steroid injection if required by appropriately trained GP/Physiotherapist
  • Chronic presentation: The potential for chronicity is high as well as resistance to treatment.
     

Primary Care diagnostics

XR

Useful Resources

Who to Refer

Rarely needed. Primary care/MSK Physiotherapy management recommended

Who not to refer

Duration of symptoms less than 3 months with no conservative treatment tried

How to refer

SCI Gateway/MSK Physiotherapy