Russell Ellis, MD

How to deal with hip tightness

How to deal with hip tightness

Hip tightness is one of the few physical ailments that impact both athletes and desk jockeys alike. That familiar tightness across the hips is usually caused by tension in the hip flexors, a group of muscles that connect your upper leg to your hip that let you bend at the waist and raise your legs.

This muscle tightness can be caused by sitting at a desk all day, repetitious exercises such as cycling, or a simple tendency toward muscular tension. Regardless of the cause, tension in your hip flexors puts you at increased risk of injury simply because your tissues don’t move properly.

There are three types of hip flexor issues: Hip flexor tendonitis, iliopsoas syndrome, and hip flexor strains.

Hip Flexor Tendonitis

Hip tendonitis is inflammation of any of the hip tendons (the thick cords that attach muscles to bone). Similar to strains, hip tendonitis is commonly caused by overuse and frequently affects the same population—athletes who participate in cycling, swimming, running, and other sports that repeatedly stress the hip. High-intensity interval training (HIIT) workouts and other activities that involve a high volume of kicking, squatting, and jumping can also lead to tendon inflammation.

Iliopsoas Syndrome (Psoas Syndrome)
The iliopsoas muscles are a group of two muscles located toward the front of the inner hip. They are the primary hip flexors, pulling the knee up off the ground when it contracts. The psoas muscle — located in the lumbar (lower) region of the spine extending through the pelvis to the femur — also contributes to upright posture, assists in lumbar spine movement, and influences the spine’s curve.

Hip Flexor Strains
Hip flexor strains occur when the hip flexor muscles are stretched or torn. Tears are classified into three grades depending on their severity:

• Grade I – Mild stretching and microscopic tears in muscle fiber which cause some pain. The hip functions normally.
• Grade II – Moderate stretching and tears in muscle fiber which cause pain. The hip may periodically give out while standing or walking.
• Grade III – Muscle fibers are completely torn or ruptured. The hip can no longer bear weight.

A hip sprain typically starts as a microscopic tear and gradually grows with repetitive use. These tears are caused by direct trauma to the hip or overuse of the hip flexors and are most common in sports like cycling, running, swimming, baseball, and golf. They can also be caused by osteoarthritis.

Because Grade I and Grade II strains can be effectively treated with rest and other conservative treatments with early diagnosis, it’s important to watch for early signs and symptoms of hip flexor strain:

• Pain in the front of the hip or in the groin
• Pain, tenderness, and weakness when walking or climbing stairs
• Pain when lifting the knee toward the chest
• Pulling sensation in the front of the hip or in the groin
• Swelling and inflammation
• Bruising
• Muscle spasms
• A limp while walking
• A visible muscle deformity

If you notice any of these early signs or symptoms that may indicate a hip flexor injury, it’s important to speak to your physician or orthopaedist to determine the severity and begin treatment quickly to avoid further damage. With Grade I or Grade II injuries, you can expect relatively conservative treatment options. In the meantime, you can begin implementing the RICE Method (rest, ice, compress, elevate) for simple, at-home treatment to relieve mild pain and inflammation.

• Rest the Hip: Take a break from unnecessary activities. You may also consider crutches for a short time to take stress off of your hips.
• Ice the Hip: Apply ice or a cold pack to the hip immediately following an injury. Do not apply ice directly to your skin. Instead, place a towel between the ice or cold pack and your hip. You can continue to apply ice for up to 30 minutes at a time 3-4 times a day.
• Compress the Hip: Wrap your hip with an elastic bandage to reduce swelling. Make sure that the bandage is moderately tight, but not too tight otherwise it will cause additional swelling.
• Elevate the Hip: Elevate your hip on a pillow when you are lying down. Try to keep your hip above the level of your heart to help minimize swelling.

Severe Injuries
Unfortunately, some hip flexor injuries are so severe that they may require professional treatment from an orthopaedist or hip specialist. You should immediately contact an orthopedist if you experience any of the following:

• Inability to bear weight on your hip
• Decreased range of motion in your hip
• Hip pain and swelling that does not subside

Remember that some injuries, including a Grade III strain, may also occur without any obvious symptoms. If you sustain direct trauma to your hip, it’s important that you see a physician for a professional evaluation.

If you have been experiencing hip tightness or pain from an ongoing problem or recent injury, your next step may be orthopaedic treatment that can provide long-term relief from painful symptoms. Working with a specialized practice like DOC Orthopaedics and Sports Medicine in Decatur, you can take advantage of the expertise of its ten providers including Dr. Russell Ellis.
Raised in Morgan County, Dr. Ellis received his Doctor of Medicine degree from the University of Alabama School of Medicine at Birmingham. Following graduation, he completed his residency at the University of Tennessee College of Medicine at Chattanooga in the field of Physical Medicine and Rehabilitation while serving as Chief Resident his final year. After residency, Dr. Ellis spent an additional year as a Sports Medicine Fellow at the American Sports Medicine Institute in Birmingham where he trained under Dr. Tracy Ray and renowned sports medicine physician, Dr. James Andrews. He currently serves as team physician for several area high schools and Calhoun Community College.

Since 1972, DOC Orthopaedics and Sports Medicine has been committed to providing exceptional orthopaedic care through innovative techniques, quality services, patient communication, and education. With specialties ranging from general orthopaedics and physical therapy to sports medicine, joint replacement, and more, the doctors at DOC Orthopaedics and Sports Medicine can provide local expert care for any orthopaedic disorder or injury and help put your life back in motion.

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