I have pain on the side of my hip when I lie on my side. Help!

16th Sep, 2019

I have hip pain when I lie on my side. Help!

Furious about that pain you’re getting on the side of your hip that could sometimes travel down the outside of your leg, or even up into your lower back? Come along to find out what it could be and how Physiotherapy can help!

What the hip is going on?

The Gluteus Medius muscle (picture below), is one of the major hip muscles that is involved in the turning and sideways movement of your leg. It is also a key muscle that helps to support your pelvis during weight-bearing tasks. This muscle wraps around the side of your hip and its tendon inserts onto the bony protrusion at your outer hip bone (known as the greater trochanter).

Gluteal tendons help to transmit forces through your lower limb to your hip. When the tendon is overloaded, it gets weakened and becomes sensitised. Overtime, it loses its efficiency and capacity to withstand loads, resulting in the pain you get at the side of your hips. This condition is known as ‘Gluteal Tendinopathy’ or ‘Greater Trochanter Pain Syndrome’.

Gluteal Medius Muscle

Am I at risk of Gluteal Tendinopathy?

Women, especially those who are postmenopausal, are more likely to be predisposed to gluteal tendinopathy. Bone structure, muscular deficits, or a sudden increase in activity levels (i.e. long-distance running) may also put you at risk of gluteal tendon issues.

Postural habits that involve movement of your hip across your midline leads to compressive forces at the gluteus medius tendon, resulting in pain at the side of your hip. This might include postures such as sleeping on your side, walking up stairs or preferentially standing on one leg.

For example, the picture below shows how the gluteus medius tendon gets compressed when you stand in a ‘hip-hang’ position.

What can I do to manage my hip pain?

  1. Minimise provocative activities such as long-distance or hill running, especially with high speeds and loads.
  2. Reduce sustained postures with your hip crossing the midline eg. sitting with your legs crossed or adopting a ’hip-hang’ posture (especially on your painful side)
  3. Minimise sleeping on your side; or if you must, place a pillow between your thighs to reduce compression of the gluteal tendon on the greater trochanter.

Does this mean you should cease all activities and rest?

No! On the contrary, you should continue to load your tendon (at lower loads and within acceptable pain levels), as a period of under-loading before reloading it again is usually the cause of tendon issues!

How can Physiotherapy help with my hip pain?

Great news! Physiotherapists at PhysioX are able to assess and diagnose your hip pain and devise a treatment plan for your condition!

Your Physiotherapist will advise you on exercises for your hip pain to strengthen your hip muscles and improve pelvic control. This will allow your tendon to get accustomed to normal loading and regain its capacity to withstand loads.

To allow your pain to settle, you will start off with low and manageable loads initially. Gradual progression with increased loads and functional strengthening of your gluteal muscles will be introduced once you have adequate control of your gluteal muscles.

Here are some exercise examples (with progressions):

Bridge Progressions

Isometric Hip Abduction

Crab Walks

Mini Squats

Step Up

Step Down

Book now or give us a call at 6909 2240 to schedule an appointment to see our Physiotherapist who will be able to partner you to recovery as we address your hip pain!

DISCLAIMER: These advice and exercises should not replace the need for a consultation with a Physiotherapist especially if your condition doesn’t improve. Therapeutic exercise should be carefully selected to suit your condition.

Ref:

Brukner, P. (2017). Clinical Sports Medicine: Injuries. McGraw-Hill Education (Australia) Pty Limited.

Clinical Tests for Gluteal Tendinopathy in Patients with Lateral Hip Pain. (n.d.). Learn Muscles. https://learnmuscles.com/blog/2017/12/17/clinical-tests-gluteal-tendinopathy-patients-lateral-hip-pain/

Gluteal Tendinopathy, Trochanteric/Hip Bursitis, & Greater Trochanteric Pain Syndrome (GTPS): What’s the difference & what are the causes? (n.d.). Hip Pain HELP Is Here. https://hippainhelp.com/gluteal-tendinopathy-trochanteric-hip-bursitis-greater-trochanteric-pain-syndrome-gtps-whats-the-difference-what-are-the-causes/

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