Hip Pain

Muscles, tendons, bursa and fascia – the soft tissue structures of the hip and pelvis

Soft tissue related pain refers to pain in the ‘soft tissues’. But what are the ‘soft tissues’ – what on earth does that mean?  

When referring to the human body, the term ‘soft tissues’ refers to non-bony structures that connect, support, or surround other structures. Soft tissues then include: 

• the muscles, which allow you to move 
• the tendons, which connect your muscles to the bone 
• the bursae – small, flat pockets of fluid that help all these things slide and glide against one another, reducing friction. There are bursae are all around the body in places where different structures may rub against one another, for example where a tendon runs around a bone. 
• the fascia – stretchy, thin, white fibrous tissue. All our muscles are enveloped in fascia, like stretchy stockings that help transfer energy from muscle and movement. Fascia also forms sheaths or tunnels for safe passage of blood vessels and nerves and wraps and supports all our bodily organs.   

Soft Tissue Related Pain of the Hip and Pelvis 

Pain around the hip and pelvis may be related to any of the extensive soft tissues surrounding the hip and pelvis that are essential to postural support and movement. Soft tissue related pain may develop in association with: 

1. An acute trauma 

• A single large physical effort that pushed the tissues past their maximum capacity e.g. associated with maximum sprinting, kicking, lifting 
• An large accidental overload or impact e.g. slip or fall, car accident 

2. Repetitive irritating loads leading to a gradual onset of symptoms 

• High levels of a particular sport or physical activity that repetitively loads the same soft tissues 
• Certain postural positions or movement habits that load tissues in ways that may reduce their health over time 
• Stiffness or weakness in other regions that result in higher than normal loads of the soft tissues of the hip and pelvis e.g. stiffness or weakness at the back, knee or ankle may change loads at the hip 

Visit our Pain Locator Map to learn more about soft tissue related pain in different regions around the hip and pelvis. 

How a Hip Pain Professional Can Help in the Treatment of Soft Tissue Injuries:

• assess the various soft tissues likely to be related to your pain or contributing to the development of pain in other regions  
• provide important advice about sporting, recreational and work related physical activities, for example: 
• advice re ‘how much is too much’ 
• allowing adequate recovery between physical loading sessions 
• temporary reduction in activity levels may be required 
• rest from particular actions that place highest load across the soft tissues 
• determine whether everyday postures or movement habits may be contributing to the development of soft tissue related pain around the hip and pelvis 
• provide or send you for rehabilitation to optimise postural and movement habits 
• provide or send you for rehabilitation to improve function of muscles in which impairments have been identified – strength, endurance, patterns or coordination of muscle activity, length/flexibility 

Don’t miss our next blog……

Next week we look more specifically at the soft tissue structures on the outside of the hip, including the hip abductor muscles (including gluteus medius and minimus), and the trochanteric bursa. We examine how these structures may be involved with your pain. Lastly we look at some key consideration for treatment when you have pain in this area, that is, on the outside of the hip. Check out our blog next week to find out more!

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