How do the hip abductors work?
The hip abductors (comprised of the gluteus medius and gluteus minimus muscles) are often referred to as the “rotator cuff” of the hip. They function to abduct the hip and also to stabilize the pelvis while in single-leg stance (during running, jumping, pivoting, cutting or when going up and down the stairs…).
How are hip abductor injuries diagnosed?
Hip abductor tendon injuries or tears are diagnosed by combining clinical symptoms (pain, weakness) with MRI findings indicative of tendon degeneration, partial thickness tearing, or complete tearing.
How are hip abductor injuries treated?
The most common hip abductor injury is a muscle strain due to repetitive or prolonged contraction without proper conditioning (long distance running, cycling, swimming). In general, abductor strains take 2 – 4 weeks for full recovery and proper stretching and conditioning is the best method of preventing future injuries.
Hip abductor tendon injuries are different from muscle injuries, and are divided into two types: acute and chronic.
Acute Abductor Tendon Injury
Acute tendon tears occur due to forceful contraction while bracing to prevent a fall or injury. Most tendon tears are partial thickness, incompletely involving the width of the tendon, and do have the potential to heal without surgery. Occasionally the healing process needs to be supplemented with a series of PRP injections. Complete tears involving both tendons tend to retract (pull away from the bone) and have a lower likelihood of successful healing, typically necessitating surgical hip abductor tendon repair.
Chronic Hip Abductor Tendinosis and Trochanteric Bursitis
Tendinosis refers to an age related degeneration of tendon quality that renders the tissue more susceptible to injury with every day activities. Unlike the case for acute tears, chronic tendinosis can develop without a discrete injury and typically affects patients > 50 years of age. Progressive delamination of the fibers within the tendon can lead to partial thickness tearing. The body’s natural healing response is often inadequate and results in chronic inflammation and painful scarring. In the absence of a frank tear, PRP injections into the abductor tendons are effective at stimulating a healing response and can significantly reduce pain and improve function. Given that this condition tends to co-exist with trochanteric bursitis, corticosteroid injections to the trochanteric bursa may also be of benefit. If injections fail to provide adequate improvement or there is a frank tear, surgical hip abductor tendon repair is the most reliable means of achieving successful healing and return to function.