Hip Abductor muscles muscles on the outside of the hip

The Hip Abductor Muscles, Trochanteric Bursa and Lateral (Outside) Hip Pain

What And Where Are The Hip Abductor Muscles and Trochanteric Bursa

The muscles that sit around the side of the hip are called the hip abductor muscles. Their main functions are to move your leg out away from the midline of your body (abduction) and to anchor your pelvis to your femur when standing on one leg. This allows you to keep your pelvis fairly level and maintain your balance. The trochanteric bursa is involved with these layers.

The 3 main layers of hip abductor muscles: 

1. Deepest layer of the hip abductor muscles

Gluteus minimus (smallest muscle), which joins into the hip joint capsule and is thought to have an important role in supporting this joint. It runs from the outer side of the pelvis to its anchor-point on the femur (greater trochanter) (see below). 

2. Middle Layer of the hip abductor muscles

Gluteus medius (middle sized muscle), which also joins the pelvis to the top of the femur (greater trochanter) and is one of the main muscles that helps control pelvic position (see below). 

Hip abductor muscles gluteus medius and gluteus minimus and the trochanteric bursa of hip
Hip abductor muscles gluteus medius and gluteus minimus and the trochanteric bursa of hip
3. Superficial Layer (nearest the surface) of the hip abductor muscles

The upper part of the gluteus maximus (largest gluteal muscle) and the tensor fascia lata (TFL) muscle. These muscles create their effect at the lateral hip through their connections to a long fibrous band that runs down the outside of the hip, thigh and knee, called the iliotibial band (ITB) (see below). 

Superficial Layer of Hip Abductor Muscles Gluteus Maximus and TFL
Superficial Layer of Hip Abductor Muscles Gluteus Maximus and TFL

Trochanteric Bursa: Its Role With The Hip Abductor Muscles

With all these muscles (gluteus minimus, gluteus medius, gluteus Maximus and TFL) and their tendons moving over each other and the underlying bones, a number of small flat, fluid-filled cushions (bursae) are present, to help everything slide freely. The main bursae are the trochanteric bursa, the subgluteus medius bursa and the subgluteus minimus bursa. Inflammation of these bursa is often referred to as trochanteric bursitis

Pain At The Side of The Hip: Lateral Hip Pain 

Acute muscle tears or strains occur in the hip abductor muscles most frequently in the gluteus maximus and gluteus medius muscles and occasionally in the tensor fascia lata muscle. This is more likely to occur during rapid sidestepping or change of direction when running. Tears in these muscles are however relatively rare compared to thigh and groin strains. 

Pain over the side of the hip that develops more gradually is most commonly related to the health of the soft tissues at the anchor-point for the gluteus medius and minimus on the femur (the greater trochanter). You may receive a diagnosis of: 

lady with pain over the hip abductor muscles

Watch out for our upcoming blog on terms used for lateral hip pain, including gluteal tendinopathy, trochanteric bursitis, and greater trochanteric pain syndrome.  

Pain in this area is often attributed to tightness of the ITB and therefore you may read much advice to stretch the ITB as a self-help strategy. 

There is however NO evidence to support stretching the ITB as a self-help strategy. In fact, expert Hip Pain Professionals agree that people with gluteal tendon or bursal problems are much more likely to be longer than average, rather than short in the ITB.  Stretching may actually provoke the pain, rather than settle it. 

avoid this ITB stretch for pain at the side of the hip
avoid this ITB stretch for pain at the side of the hip

There will be more information in an upcoming blog on the high-quality scientific evidence that is now available on successful management of this condition (with NO ITB stretching!).

Visit our Pain Locator Map to learn more about other causes of lateral hip pain. 

How a Hip Pain Professional Can Help

Seek the assistance of a Hip Pain Professional to:   

 

  • test if your hip abductors are short & tight or actually too long – many people who have poor control of their hip, especially in single leg weight bearing activities, actually drop their hip out too far, their muscles feeling tight as they work overtime to try to provide support. Stretching will not help and may make things worse.  
  • work out if your hip abductors have any part to play in your problem and provide a plan for recovery  
  • test if your ITB or hip abductors are tight (shortened) or not, and provide guidance as to whether stretching will help or aggravate the problem  
  • provide simple advice for controlling aggravating positions and actions that can immediately help you to start getting your pain under control 
  • provide or direct you towards a high-quality rehabilitation program that has been shown to be successful under rigorous scientific conditions 
  • Provide advice regarding the use of steroids or other injections in cases of severe pain or pain unresponsive to evidence-based rehabilitation 

 

References 

hip pain help is here

Don’t miss our next blog……

You may have been diagnosed with Gluteal Tendinopathy, Trochanteric Bursitis or Greater Trochanteric Pain Syndrome (GTPS) or if you’ve seen more than one health professional, you may well have been given two different diagnoses. Or maybe you’ve just been searching the internet to make your own diagnosis and are confused about the different terminology. Check out our blog next week to learn more about these terms and their causes!

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