Arthritis develops when the cartilage responsible for covering and protecting the bones of a joint degenerates.   Then the cartilage no longer can prevent development of friction between the bones. This breakdown of cartilage occurs for a variety of reasons, including, wear-and-tear on the joints, carrying excess weight, cartilage defects and/or malformed hip joints. There are two categories used when diagnosing arthritis, primary and secondary.

Primary – a generalized degeneration of the cartilage within a joint leading to osteoarthritis affecting the hips, knees, spine, thumbs or fingers.

Secondary – the osteoarthritis is brought on by an injury, joint inflammation or due to a condition affecting the composition of the cartilage (e.g., infection, hemochromatosis).

Individuals with hip joint arthritis may experience difficulty walking, pain in various areas, including the buttocks, thigh, knee and especially the groin. This pain may be sharp, stabbing or a dull ache: Other symptoms include swelling, stiffness and, as time passes, the joint may become deformed.

Labral Tears

When an individual is diagnosed with a hip labral tear, he or she has sustained damage to the fibrous cartilage lining the inner rim of the hip’s socket (i.e., the acetabular labrum). While labral tears can happen to anyone, athletes participating in soccer, golf, ice hockey, ballet and football are at an increased risk of sustaining a hip labral tear.

If the acetabular labrum becomes injured, the individual may experience stiffness, limited range of motion, pain in the groin or in the hip as well as mechanical issues. These mechanical issues may include a clicking, locking or catching sensation in the joint when the joint moves within its normal range of motion. A labral tear can sometimes heal with rest, but if the injury persists, surgical intervention may be necessary. A hip labral tear may increase the likelihood of the individual developing secondary osteoarthritis in that joint at some point in the future.

Hip Tendonitis

Hip tendonitis occurs when the thick, rope-like cords that connect the muscles to the bones of the hip become inflamed. Hip tendonitis can result from a sudden injury; however, sometimes, this condition arises for no discernable reason. Some known causes of hip tendonitis include overuse, performing twisting motions and repetitive stress being placed on the tendon. For example, individuals who run on a regular basis may develop hip tendonitis due to the repetitive stress being placed on their tendons. Symptoms of hip tendonitis may include limited mobility or range of motion and pain in the area of the affected tendon.

Greater Trochanteric Pain Syndrome (GTPS)/Trochanteric Bursitis

GTPS occurs when the trochanteric bursa becomes inflamed, causing pain and tenderness in the lateral or outer side of the hip.

The trochanteric bursae are located on the outer sides at the top of each femur. Each of these bursae are located between the gluteus tendons (medius and minimus) and the greater trochanter of the femur. The trochanteric bursae function as other bursae do, acting as a shock absorber and lubricant as the tendons adjacent to bones and other tendons move across one another. On occasion, the gluteus medius or minimus tendons at the insertion onto the greater trochanter may become inflamed due to a sudden injury or repetitive motion leading to the pain commonly referred to as trochanteric bursitis.  In actuality this pain is more of a tendonitis than a true bursitis.

Gluteus Medius and Minimus Tendinitis

One of the most common orthopaedic complaints is pain in the lateral hip commonly called greater trochanteric bursitis: Previously, it was believed that this pain resulted from an unexplained irritation of the bursa located on the outside of the hip joint; however, it has recently been discovered that many of the hip bursitis cases are actually tendinosis cases that are caused by wear-and-tear, partial tears or complete tears of the gluteus tendons.

The gluteus tendons (medius and minimus) attach to the greater trochanteric bursa. Therefore, the irritated bursa may be secondary to the partial or complete tears of the gluteus tendons: Since this discovery, many medical professionals have started to use the term greater trochanteric pain syndrome as opposed to “greater trochanteric bursitis.”  The proper name is gluteus medius or minimus tendinosis instead of greater trochanteric bursitis.

Request Consultation

If you are suffering with lingering or unexplained hip pain, contact Dr. Joshua G. Hackel to schedule an initial consultation. Dr. Hackel provides patients with non-surgical and minimally-invasive procedures for pain relief and regeneration. He specializes in musculoskeletal ultrasound for the diagnosis and treatment of orthopaedic and musculoskeletal injuries.

Dr. Hackel is a dedicated physician who concentrates on providing his patients with the most innovative diagnostic and pain relief treatment options available. Each patient receives a custom-tailored treatment plan that is specifically designed to meet his or her needs. The caring staff and medical professionals at the Andrews Institute in Gulf Breeze, Florida, work together to create coordinating multidisciplinary rehabilitative treatment programs utilizing a variety of procedures and techniques.

Treatment programs may include bone marrow- and adipose-derived stem-cell therapy, platelet-rich plasma injections, and ultrasound-guided diagnostic and/or therapeutic injections to the tendon sheaths, muscles, joints and/or the bursae. Dr. Hackel also offers detailed physical rehabilitation plans, prescriptions and can recommend nutritional supplements to maximize your health and wellness. To schedule an initial consultation with Dr. Joshua G. Hackel at the Andrews Institute, please call 850-916-8783. The address for Dr. Hackel’s office at the Andrews Institute is 1040 Gulf Breeze Parkway, Suite 200, Gulf Breeze, Florida 32561.

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