Tendonitis is an inflammatory disease of the tendons, which are a connective tissue connection at the origin and insertion of a muscle. Tendons perform the function of power transmission.
The tendons can quickly be affected by excessive strain or overuse of the corresponding muscles. This is primarily expressed in tendinitis. In medicine, tendinitis is generally referred to as a "Tendonitis"(Lat."tendo"= Tendon, ending,"-it is“= Inflammation).
In the special case of tendinitis of the hip, the term "Trochanteric endinosis“ („Trochanter"=" Large roll mound ", protruding bone on the thigh bone; "Tendinosis“= Disease of the tendon).
The reason for this is that some tendons, grouped together in a tendon bundle, are attached to this protruding bone. This attachment of the muscles with their tendinous parts represents an exposed point for mechanical irritation, so that the development of tendinitis is very likely there.
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In most cases, tendinitis of the hip is ultimately based on a few, classic causes.
Most often, mechanical irritation of the tendons plays a role. The affected tendons arise bundled at the so-called Greater trochanter, a protruding bone on the thigh bone near the hip joint. The tendons at this point are heavily strained through heavy use, which leads to an inflammatory reaction. In addition, a tight tendon ligament that runs over the tendon attachments, the so-called Iliotibial band, when exerted pressure on the tendons.
Since this region around the greater trochanter is considered to be the key point for the development of tendinitis, one speaks of a "Trochanteric endinosis". This mechanical irritation can be provoked by forms of overload but also incorrect loading. Depending on the individual constitution, such an overload can manifest itself due to excessive training.
$config[ads_text2] not foundUltimately, however, unfamiliar everyday physical stress can also lead to tendinitis in the hip. Incorrect loading can result, among other things, from individual, previous physical illnesses of the hip, for example hip malpositions (med .: Hip dysplasia), or diseases in the musculoskeletal system, such as leg length differences or asymmetries in the gait pattern.
Please also read: Hip dysplasia in adults
The development of tendinitis of the hip is also provoked by wearing the wrong footwear during exercise. In addition to the more harmless causes mentioned so far, tendinitis in the hip can also be caused by the disease rheumatism to be responsible.
Tendonitis of the hip usually manifests itself with a typical symptom.
At the beginning, those affected complain of slight pain in the hip, which increases in intensity over time. The character of the pain is described as stabbing and burning.
The pain is on the outside of the hip, in the area of the palpable bony protrusion "Greater trochanter“, Localized. Typical pressure pain can be provoked there.
Read more about this at: Greater trochanter pain
The pain is also initially a purely stress-dependent pain. This can be so pronounced that it leads to a restriction of movement and a reduction in strength.
The pain tends to develop gradually or with a delay of around 24 hours and not immediately after exercise.
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As accompanying symptoms are one
In a chronic stage, movement may cause grinding noises due to calcium deposits on the hip. Typically, tendinitis of the hip also affects the surrounding bursa.
$config[ads_text2] not foundThe pressure of the Iliotibial band on the tendons and their mechanical friction on the greater trochanter are actually intercepted by bursa. With heavy or long-lasting strain, the bursa lose (lat .: bursa) to buffer function and take damage themselves. The trochanteric bursa is most commonly affected because it is closest to where the tendons begin. If this ignites, one speaks of a "Trochanteric bursitis'.
Read more about this at: Trochanteric bursitis
Ultimately, tendinitis in the hip can be followed by a tendon tear. Reasons can be particularly serious and long-lasting inflammation of the tendon, but also the lack of any necessary therapeutic treatment.
The hip is a very stressed joint and requires a large number of muscles to move. If the muscles are overloaded, tendinitis can lead to pain in the thigh. The localization and type of pain depend on the muscles affected.
The pain occurs mainly during movements that use the muscles heavily. The adductor muscles on the inside of the thigh are often affected, causing pain in the inside and when the legs are spread apart. Pain when climbing stairs or crouching is also typical for tendinitis in the hip.
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At the beginning of the diagnosis there is a detailed doctor-patient discussion.
Indicative information such as strong physical stress on the hips or previous illnesses can already be recognized.
This should be followed by a physical examination of the hip. This includes testing for tenderness over the tendon, pain from movement and restrictions. This can provide the doctor with further information that could suggest a tendinitis of the hip.
Both ultrasound and magnetic resonance tomography (= MRT) play a role as imaging methods. However, the MRI should only be used for more severe tendinitis with suspected more complex injury pattern.
In most cases, the ultrasound is sufficient to detect inflammation of the tendons in the form of swellings or calcifications.
Please also read: MRI of the hip
Tendonitis often occurs as a result of excessive stress, for example from long walks or jogging. Accidents and strains can also lead to it. Inflammation usually occurs very spontaneously, so that patients usually experience pain from one day to the next. In addition, both young and older people can be affected.
If the inflammation is severe, it can also lead to redness or fever. When the patient is immobilized, the tendinitis heals completely and the patient is symptom-free again.
Hip osteoarthritis is usually the result of years of wear and tear on the joint surface, so that mostly older people (from 45 years of age) are affected. Patients often complain months and years beforehand of the onset of pain when moving their hips.
Even after long breaks there is no real improvement and over time the symptoms get worse and often occur even at rest.
There are several bursae on the hip, the two most common being the affected Trochanteric bursa on the outside and the Bursa ilipectinea in the bar. Bursitis can be similar to tendinitis.
This often results in pain in the hip after increased exertion, which mainly occurs when moving. Later, the symptoms can also be felt at rest. Prolonged pressure on the area, for example when sleeping on your side, can also lead to discomfort.
This is what distinguishes bursitis from tendinitis. Bursitis on the hip is usually less common than tendinitis. Often there is no precise diagnosis to clearly differentiate the diseases from each other, because the treatment of both is similar: taking care of yourself and taking anti-inflammatory drugs.
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Treatment of tendinitis of the hip is conservative in most cases. The most important therapeutic measure for tendinitis is to immobilize and relieve the hip. This is the only way to achieve effective regeneration and rapid healing.
In acute situations, the symptoms of inflammation can be treated particularly well with the help of cold therapy. A large ice pack is suitable for cooling the hips, in order to bring about a local effect of the cold on the inflamed tendons. In the further healing process or in the event of long-lasting symptoms, however, heat therapy is indicated.
Drug therapy can be used to counteract tendinitis of the hip. Anti-inflammatory and pain-relieving medications such as ibuprofen or diclofenac (Voltaren®) are used.
As an alternative, those affected can also use homeopathic remedies. The globules in particular are very practical in terms of dosage and ingestion.
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Read also: Home remedies for tendinitis
After taking sufficient care of the hips, those affected must slowly start reloading. This means that light stretching exercises for the hip muscles are advisable first. Physiotherapeutic care is suitable here.
In general, conservative therapeutic approaches should include physiotherapy and / or walking school. These become more important if the tendinitis of the hip is due to a misalignment, a leg length difference or an asymmetrical gait pattern. Here it is important to treat specific causes. Possible triggering factors such as the difference in leg length can, for example, be taken care of by simply wearing insoles to compensate for the difference.
The treatment of tendinitis now includes electrical and shock wave therapy. With the help of electrotherapy, the use of low-frequency current flows can provide effective pain relief. Shock wave therapy, on the other hand, uses sound waves to provide regenerative support to the tendons by releasing hormones that promote the healing process.
As the last conservative treatment option, there are positive experience reports about acupuncture.
If any conservative measures are not helpful, surgical treatment may be necessary. As a rule, however, this only occurs in more serious individual cases. The aim of surgery is to treat factors that trigger tendinitis or any accompanying symptoms.
For example, this can be removing an irritated and painful bursa that has been compromised. It happens that the tendons of the hip are irritated by a shortened iliotibial tract, because the shortening of the tract causes increased frictional pressure on the tendon. In such a case, the Iliotibial band be incised to lengthen it. This will reduce the pressure on the tendons, resulting in pain relief.
The symptoms of tendinitis can be improved with the help of certain exercises.
The top priority is to keep the right amount of load. Especially at the beginning of the healing process, it is essential to only exercise the tendons of the hip very lightly.
The hips should be brought back to the load step by step.
In the case of tendinitis on the hip, careful stretching exercises of the hip muscles are particularly recommended.
Other exercises are best taught to those affected by a physiotherapist.
These stretching exercises are also particularly important for long-distance runners, as their muscles can otherwise cramp or tense, or tendon parts can sometimes even shorten. It is also useful to do exercises for the Iliotibial band execute.
The tract is shortened particularly frequently in runners and thus provokes increased irritation of the tendons. A great advantage of these exercises is that not only the iliotibial band is stretched, but that the hip muscles are also strengthened at the same time. ,
Finally, it should be mentioned that certain exercises can be used not only from a therapeutic point of view but also as prophylaxis. Before stressing the hips, for example, it makes sense to carry out a warm-up program with the above-described stretching exercises for the hip muscles, including their tendons, in order to get the tendons and muscles used to the upcoming stress.
Homeopathy as a part of complementary medicine is particularly suitable for the alternative treatment of tendinitis of the hip.
Homeopathy is now used in many other areas.
A very well-known remedy is arnica montana. In the case of tendinitis, it has primarily an analgesic and decongestant effect.
Other remedies are, for example, Rhus toxicodendron and Apis mellifica, which also counteract pain symptoms as well as swelling and possible redness.
The spectrum of homeopathic remedies is very broad, so that a list of all possible remedies for treating tendinitis of the hip would be too confusing.
In addition, the prescription is always based on the individual symptoms as well as the respective causes of the tendinitis.
The way in which the homeopathic remedies are used is variable. Typically, small globules, the so-called "Globules". Ideally, the application should be continued for 2 weeks. The daily dosage can vary individually. As a rule, however, a twice daily intake of 5 globules of the respective remedy is recommended.
Medicines play an important role in the treatment of tendinitis of the hip.
They serve to relieve pain and inflammation. In the case of clearly localizable pain, it makes sense to use pain relief ointments, creams or gels.
Voltaren® ointment as an example contains the active ingredient diclofenac from the substance group NSAIDs ("non-steroidal anti-inflammatory drugs"). This active ingredient can also be taken by mouth in tablet form.
Read more about this at: Voltaren® pain gel
Other painkillers that can be used contain active ingredients such as ibuprofen or aspirin.
The advantage of these drugs is that they are both pain-relieving (=analgesic) and anti-inflammatory (=anti-inflammatory) work and are therefore optimal for the symptoms of tendinitis.
Medicines such as Paracetamol or Novalgin® can also be taken, but these only counteract the pain, but not the inflammation. They play a subordinate role as they do not affect the cause of the pain.
Stronger painkillers from the group of opioids such as tilidine or tramadol are actually not prescribed for tendinitis, as the symptoms rarely take on extreme proportions that would make these drugs necessary.
An additional drug treatment option is the injection of certain substances.
In the case of severe tendinitis, the drug cortisone from the group of glucocorticoids can be injected. On the other hand, especially in the acute stage, there is the possibility of injecting local anesthetics such as xylocaine or procaine.
In very rare cases, antibiotics may be necessary if the tendon on the hip has become infected due to an infection. However, an infection that triggers tendinitis is very atypical.
In the acute stage, the symptoms usually only last a few days.
Exactly how long sufferers have to struggle with tendinitis ultimately varies individually depending on the severity of the inflammation and personal constitution.
Personal constitution means possible pre-existing conditions such as hip misalignment or an asymmetrical gait pattern. These circumstances can prolong the healing time as they require a comparatively more time-consuming and specialized treatment.
If the symptoms of tendinitis of the hip, starting from the acute stage, persist for a longer period of time, even if therapeutic measures have been taken, a medical examination is necessary.
Classic tendinitis of the hip typically does not last longer than a week.
Incidentally, the duration of tendinitis can be significantly influenced by those affected. If therapeutic measures such as protecting the hips are not followed, the duration of the tendinitis can be very prolonged.
At the same time, there is a risk that chronic inflammation will develop in the hip. Once the tendons of the hip have reached this state, healing is much more difficult and protracted.
There is also the risk that the inflamed tendons may even tear. This would take several weeks to months to heal. In addition, surgical treatment may be necessary in such cases.
Running or jogging can lead to tendinitis. Due to the typical stress pattern of the thigh and hip muscles when running, jogging is a predisposed sport for developing tendinitis on the hips.
This is because most of the tendons and muscles that can be affected by inflammation begin at the great rolling hill, the greater trochanter. Continuous stress, such as constant rubbing for several kilometers when running, leads to irritation of the tendon attachments and, in the long term, or insufficient rest periods, to tendonitis.
Pain that occurs during or after jogging can therefore often be traced back to an inflammation of the tendons in the area of the greater trochanter. The decisive factor is the intensity and duration of the load.
Overuse increases the risk of tendinitis enormously. The same applies to the development of bursitis, especially the one Trochanteric bursa at the height of the large rolling mound.
At the beginning, runners only feel the pain of tendinitis under load on the outside of the thigh and immediately in the area of the greater trochanter. Resting pain only occurs when the tendons are very inflamed.
For runners in particular, as a risk group, it is therefore important not to strain the hip muscles too much. In addition, subsequent stretching exercises are helpful to counteract the development of such tendinitis.
If runners suffer from known pre-existing conditions of the hip such as hip malpositions or a leg length difference, this can result in increased stress and irritation of the tendons. These runners are therefore even more susceptible to hip tendinitis. The wrong footwear can also lead to tendinitis of the hip.
If there are symptoms of tendinitis on the hip, further stress is in any case not advisable: jogging must be paused for a few days to give the tendon time to regenerate and the inflammation to subside. In addition, pain relievers and anti-inflammatory drugs, such as ibuprofen, can also be taken to further accelerate the healing process.
If the symptoms finally recede, you should not start again with full exertion: You should first run smaller distances without a lot of difference in incline in order to get the muscles and tendons used to the stress little by little. This also prevents the development of further tendinitis.
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