Muscle Strains

A tear in the muscle fibers caused by either a fall or direct blow to the muscle, overstretching and overuse injury is called a strain. Muscle strains often occur in the hip region whenever a muscle contracts suddenly from its stretched position. It can be mild, moderate or severe and depends on the level of injury. The chances of having a hip muscle strain becomes high if you have had a previous injury in the area or if there is no warm-up before exercising. The most common symptom of hip strain is pain and swelling in the area of injury. Pain may worsen on using the injured muscle and the strength in the muscle may also decrease.

Apart from physical examination of your hip and leg, your doctor may order an X-ray to rule out a stress fracture of the hip and confirm the diagnosis. Initial treatment aims at relieving pain and swelling. RICE protocol should be followed for mild to moderate strains. It includes:

• R-Rest: Avoid bearing excess weight on your hip. You should use crutches for the first 1-2 days after injury.
• I- Ice: Gently rub the area with ice. This decreases the swelling.
• C-Compression: Wrap a bandage over the area to help decrease the swelling.
• E-Elevation: Elevate the injured area above heart level.

Anti-inflammatory medications may also be prescribed to reduce swelling and pain. In the initial two days, your doctor may recommend application of heat to the area using hot soaks or heating pads. It is beneficial to be away from activities that causes the strain for 2 weeks. During this period, simple stretching and strengthening exercises can be done to regain muscle strength.

Preventing Hip Strains

You can practice certain techniques to avoid straining the muscles around your hip. Stretching your muscles before starting any exercise or sport activity significantly reduces your risk. Also, remember to stretch the muscles slowly and hold the stretch for some time instead of making large number of rapid stretches.  Warm up every time before you stretch. Participate in conditioning program to keep your muscles flexible and fit always. Use protective gear that is appropriate for the sports activity you are involved.

Hip Bursitis

Hip bursitis is a painful condition caused by inflammation of a bursa in the hip. Bursae are fluid filled sacs present in joints between bone and soft tissue to reduce friction and provide cushioning during movement.

The bony prominence of the hip is called greater trochanter and is present on the outer side of the upper thigh bone or femur. The bursa overlying it is called trochanteric bursa. Another bursa is located towards the groin region and is called iliopsoas bursa. Bursitis of the trochanteric bursa is more common than that of iliopsoas bursa.

Causes

Trochanteric bursitis is often seen in people involved in sports such as football and soccer which involve a lot of running. This can lead to overuse and irritation of the bursa causing inflammation. Bursitis may sometimes result from an injury or fall to the hip or after a surgical procedure of the hip. Spine disease, rheumatoid arthritis and leg length inequality increases the risk for developing hip bursitis.

Symptoms

Trochanteric bursitis results in pain on the outer side of the hip which usually increases with prolonged walking or climbing stairs. The pain is felt more while getting up from a chair and in the night when lying on the affected side. Inflammation of the iliopsoas bursa however results in pain in the groin region.

Diagnosis

Tenderness and swelling in the area of pain over the bursa during the physical examination of the hip confirms the diagnosis of Hip Bursitis. To check for any bone spurs that could be causing irritation of the bursa your doctor may order an X-ray. If the reason for the pain is not very clear the doctor may order an MRI to view the soft tissues and structures not visible on X-ray.

Conservative Treatment Options

Treatment goals for bursitis are focused on resolving the inflammation and pain. Rest is advised and activities causing the bursitis pain are restricted. Anti-inflammatory medications are prescribed to reduce the inflammation and pain. Physical therapy and treatments with heat, ice and ultrasound sometimes are recommended. An injection of corticosteroid medicine may be administered to reduce the inflammation. Sometimes a second injection is necessary if the pain returns after a few months. These nonsurgical treatments provide relief from hip bursitis in most cases. 

Surgery

Sometimes, however, your doctor may recommend surgical removal of the bursa if you do not respond to conservative treatment measures.