Ask the Expert: Jaime Edelstein, Physical Therapist, Answers Your Questions on Non-Operative Treatment for Hip Pain
Q1. My doctor diagnosed me with hip tendonitis. What steps should I take so I can return to running?
Depending on what kind of tendonitis (hip flexor versus gluteal) you were diagnosed with, your treatment may vary. Tendonitis around the hip often occurs due to an imbalance of muscle strength and stability and it is often related to a need to increase core and lumbo-pelvic stability. Performing exercises which focus on core stability and gluteal strength is helpful. Treatment under the guidance of a physical therapist would facilitate a quick return. Consult with your physician for the best course of treatment.
Q2. I have bursitis of the hip caused by running. Are there things I can do to reduce the pain?
Bursitis of the hip often occurs due to a lack of strength and stability of the lumbo-pelvic complex, such that when you put weight on the affected leg, there is a lack of strength to support this activity. Ultimately, determining the cause of the weakness is imperative. Treatment includes rest from the activity, ice and exercises that focus on strength and stability of the pelvis and core stabilizers and of the gluteals and hip abductors. Consult with your physician about treatment.
Q3. When I do squats, I have pain in my hips. What should I do to treat the pain?
If the pain is in the front of the hip or groin area, the squat should be modified so that you do not squat so low that it elicits pain. An effective squat may still be performed without moving deep into the range. If the pain is on the outside of the hips, this may be due to more of a motor control or strength issue. A physical therapy examination would then be prescribed. Talk with a physician before starting an exercise regimen.
Q4. I was told I have tightness in the iliotibial band (ITB). What should I do to ease the pain?
It is effective to address the muscles which feed into the ITB (gluteals, hamstrings and quadriceps). Therefore, lengthening these muscles through either stretching or soft tissue mobilization (massage) may help. Likewise, developing dynamic stability around the hip and pelvis will be effective. Consult with your physician for the best course of treatment.
Q5. I have groin pain when I run a few miles. Is this related to my hips? What can I do to treat this?
Groin pain may be the result of a few different diagnoses. It may be related to the hips or it could be related to a low back issue, hernia or other pelvic floor pathology. It would be best to have such pain examined by a physician to make a proper diagnosis.
Jaime Edelstein is a physical therapist at Hospital for Special Surgery.