Hip Abductor Injury

Hip Abductor Anatomy and Function

The hip abductors (comprising 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…).

Hip Abductor Injury Diagnosis

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.

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 full width or length of the tendon, and do have the potential to heal or scar without surgery to the point where symptoms are manageable. Occasionally the healing process would benefit from being supplemented with a series of PRP injections. Complete tears of either tendon 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 and pain with everyday 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 detached tear, PRP injections into the abductor tendons are effective at stimulating a healing response and can significantly reduce pain and improve function, saving some patients from a need for a surgical solution. Given that this condition tends to co-exist with (or cause also) trochanteric bursitis, corticosteroid injections to the trochanteric bursa can improve inflammation and pain but may also lead to further tendon weakening and tears. 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.

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