The lateral hip is the crossroads of many important structures. Gluteal muscles on the back of the hip wrap around the side and attach to an area of the hip bone or femur, called the greater trochanter. Underneath each of these muscles lies a bursa to help them glide along. In addition, the iliotibial (IT) band and the tensor fasciae latae also cross over the area.
The good news is that pain within the hip joint most often radiates to the front of the hip or groin area. So, pain on the lateral or outside of the hip is usually due to something going on outside the joint. Pain on the outside of your hip during or after hiking, sitting with crossed legs, or pressing on the area can be attributed to several factors:
Greater trochanteric bursitis – This syndrome, caused by a taut iliotibial (IT) band or gluteal tendon, which irritates the underlying bursa, is a far less common cause of lateral hip pain than originally thought.
Gluteal medius or minimus tendinopathy or tear – The gluteal tendon is strained or torn at its insertion into the greater trochanter. This problem may present as a dull ache that is always there or an acute discomfort when moving your leg out to the side.
Snapping hip syndrome – The gluteus maximus tendon becomes thickened and rubs over the greater trochanter causing a snapping sound or feeling. This situation is usually benign and doesn’t cause future problems even though you might not like the sound it makes.
Meralgia Paresthetica – This pain stems from the entrapment of a sensory nerve, usually caused by scar tissue from previous surgery. It is accompanied by other sensory disruptions such as numbness, tingling, or burning.
Referred back pain – Spinal disc protrusion can also refer pain to the outside of the hip.
Other – More rare but serious pathologies can also cause lateral hip pain. Therefore, it’s always a good idea to consult with a medical professional when experiencing pain and before beginning any exercise program.
Causes of lateral hip pain
Women over 50 are the most susceptible to lateral hip pain. They most likely develop lateral hip pain due to overuse or overstress to the area by changing a training variable too quickly. These changes can include pace, distance, terrain, pitch, or elevation. You may have an underlying weakness, postural instability or deviation, or even a leg length discrepancy that requires the tendon to function beyond its capacity. If it’s been going on for a while, you may be stuck in a pain cycle. Because the hip hurts, you don’t move as much, and the muscle further weakens from disuse. The next time you use the muscle, it strains again because it’s not as strong as it used to be, and the pain cycle continues. Therefore, strengthening is an essential part of the solution for lateral hip pain. You can also avoid positions of stress, such as sitting with legs crossed and lying on the painful side during sleep. Hike with poles to decrease the stress on the hip and progress training slowly monitoring how the body responds to each variable change.
Rebuilding the capacity for the tissues to handle the load is a key part of hiking pain-free. The Healthy Hiker Training Program provides a hip and knee pain strengthening protocol that helps hikers develop the strength to hike without pain. If you’re ready to bust out of the pain cycle and finally build the strength you need to conquer your dream trails, schedule a consultation!