Condition of the Month – Hip Abductor Weakness

Hip Muscles Maintain Leg Alignment

One very important job of your hip muscles is to maintain the alignment of your leg when
you move. One of the primary hip muscles, the gluteus medius, plays an especially
important stabilizing role when you walk, run, or squat. The gluteus medius attaches
your thigh bone to the crest of your hip. When you lift your left leg, your right gluteus
medius must contract in order to keep your body from tipping toward the left. And when
you are standing on a bent leg, your gluteus medius prevents that knee from diving into
a “knock knee” or “valgus” position.
Weakness of the gluteus medius allows your pelvis to drop and your knee to dive inward
when you walk or run. This places tremendous strain on your hip and knee and may
cause other problems too. When your knee dives inward, your kneecap is forced
outward, causing it to rub harder against your thigh bone- creating a painful irritation and
eventually arthritis. Walking and running with a relative “knock knee” position places
tremendous stress on the ligaments around your knee and is a known cause of
“sprains”. Downstream, a “knock knee” position puts additional stress on the arch of your
foot, leading to other painful problems, like plantar fasciitis. Upstream, weak hips allow
your pelvis to roll forward which forces your spine into a “sway back” posture. This is a
known cause of lower back pain. Hip muscle weakness seems to be more common in
females, especially athletes.
You should avoid activities that cause prolonged stretching of the hip abductors, like
“hanging on one hip” while standing, sitting crossed legged, and sleeping in a side-lying
position with your top knee flexed and touching the bed. Patients with fallen arches may
benefit from arch supports or orthotics. Obesity causes more stress to the hip muscles,
so overweight patients may benefit from a diet and exercise program. The most
important treatment for hip abductor weakness is strength training. Hip strengthening is
directly linked to symptom improvement. Moreover, people with stronger hip muscles are
less likely to become injured in the first place. The exercises listed below are critical for
your recovery.
Here is a brief description of the tools we can use to help correct Hip Abductor
Myofascial Release
Overworked muscles often become tight and develop knots or “trigger points”. Chronic
tightness produces inflammation and swelling that ultimately leads to the formation of
“adhesions” between tissues. Your chiropractor will apply pressure with their hands, or
with specialized tools, in order to release muscle tightness and soft-tissue adhesions.
This will help to improve your circulation, relieve pain and restore flexibility.
Therapeutic Exercise
Muscle tightness or weakness causes discomfort and alters normal joint function,
leading to additional problems. Your chiropractor will target tight or weak muscles with
specific therapeutic stretching and strengthening to help increase tissue flexibility, build
strength, and ease pain. Healthy, strong, and flexible muscles may help prevent reinjury.
If you or someone you know suffers from back, hip, knee or leg problems, call our office
today to see if your problem could be related to hip abductor weakness.

A thorough evaluation is necessary and often includes X-rays and other studies, such as an MRI or bone scan. As with all injuries, the absence of pain does not mean that all is well. Strength and flexibility deficits must be addressed to allow a healthy return to running.

Tendinitis treatment includes decreasing training, applying ice, strengthening, and stretching. How much you decrease your training is based on the severity of your symptoms. If there is pain with walking, then cross train in a pool. Cycling, rowing machines, stair steppers, and elliptical trainers may also be used if they do not cause pain. In less severe cases, cut back on mileage by 25 to 50 percent and eliminate speed training and hill work.

Treatment for greater trochanteric bursitis includes stretching and strengthening your IT band, hip abductors, and gluteal muscles, all while avoiding running on banked surfaces. Applying ice to the painful area for 15 minutes, three to four times per day can help, too. A cortisone injection may be beneficial if your injury is severe. Worsening pain should raise suspicion for a stress fracture, in which case you should see your doctor right away.

For strains and tendinitis at the top of the hamstrings, treatment is the same as that used for hip flexor problems. Hamstring stretching and strengthening—such as side lunges, inward leg raises, and backward leg raises—is important. Deep tissue massage may also be beneficial, but in general, this is a difficult problem that usually takes a while to resolve.

Hip Pain Prevention

To prevent any hip injury, strengthening and stretching your hip flexors is key. And while stretching your hip flexors can be difficult, here are two that work well:

  1. Lie on your back on the edge of a table or high bed, and drop your outside leg off the edge.
  2. Lunge with your back leg fully extended. Lifrt arms up overhead and extend slightly backward if possible.

Adding leg lifts into your routine is an easy way to strengthen your hip flexors—you can add in weights or a resistance band to make this exercise harder. To maximize strength throughout the hip, do leg raises in each direction—back, forward, in, and out.

Issues in the hips are often related to weak glutes. Strengthening your gluteal muscles with squats and exercises like bridge pose can help. Finally, foam rolling daily will help keep your hip flexors loose and relaxed and less prone to injury.

5 Common Hip Injuries You Can Fix

Hip injuries can be tricky — just ask Clint Verran, a 2:14 marathoner who struggled for months to resolve his mysterious hip pain (and he’s a physical therapist). That’s because the symptoms of different injuries can be very similar, he says. Here, Verran sorts through the hip issues that strike runners most.

You Feel

A pain on the front of your hip that travels to your groin, back, or leg

It May Be a Stress Fracture

A fracture occurs when the bone can’t handle the forces placed on it or if it’s weak from lack of calcium or poor bone density.

How to Fix It

Three months of rest and physical therapy. Pool running and swimming are the best cross-training options.

Anatomy 101: Knowing about the runner’s body can help you stay injury-free.

A stab near your leg crease while running and it hurts if you lie down and pull your knee to your chest

It May Be a Hip Flexor Strain

The hip flexors lift your thigh when you run. A tear in the muscle (strain) or an inflamed tendon (tendinitis) is often from an abrupt increase in mileage or speedwork.

How to Fix It

At the first sign of pain, rest and ice for a week. When symptoms are gone, stretch the hip flexors (see “Knee Lean”), and gradually rebuild your mileage.

An ache in the front of your hip or near your groin. It worsens postrun.

It May Be Femoral Acetabular Impingement (FAI)

FAI occurs when the ball of the hip joint doesn’t fit into the socket; the grinding tears the cartilage lining the socket.

How to Fix It

FAI usually requires eight weeks of physical therapy; sometimes surgery is necessary.

An achy, burning sensation on the side of your hip during or after a run

It May Be Bursitis

This occurs when the liquid-filled sac (bursa) that separates your hip bone from the iliotibial band is inflamed. It’s confused with ITB syndrome, but ITB’s main symptom is knee pain.

How to Fix It

Ice and strengthen the gluteus medius (Hip Hike) and hip abductors (Leg Raise) found in the Never Get Hurt Workout.

A sharp pain in your buttocks during a run and it lingers afterward

It May Be Piriformis Syndrome

When the piriformis — a muscle deep in the hip — is tight, it rubs against the sciatic nerve. The result is pain deep in the buttocks, or radiating pain down the leg or back.

How to Fix It

Rest for two weeks, and ice the area. After the first week, get deep-tissue massage to help relieve tightness, or do self-massage by sitting on a tennis ball. When the pain lessens, stretch the muscle regularly (Yoga Pigeon from the Yoga for Runners Workout). If this doesn’t help, a strain may have occurred, which will require more rest and physical therapy.

Understanding Hip Flexor Strain


It’s important to rest the affected muscles if you have hip flexor strain. One thing you can do is change up your normal activities to avoid overstretching the muscle. For example, you could try swimming instead of riding a bicycle.

Home remedies

Most instances of hip flexor strain can be treated at home without the need for prescription medications or more invasive treatments. Here are some home remedies that can help relieve the pain of hip flexor strain:

1. Apply a cloth-covered ice pack to the affected area for 10- to 15-minute time increments.

Keep reading: How to make a cold compress “

2. Alternate ice packs with moist heat applications starting at about 72 hours after the initial injury. These include heat patches, moist heating pads, or a warm, wet washcloth. A hot shower can have a similar effect in reducing muscle tightness.

3. Take an over-the-counter pain reliever. Any of the following can help:

  • acetaminophen (Tylenol)
  • ibuprofen (Advil, Motrin)
  • naproxen sodium (Aleve)

However, unless directed by your doctor, you shouldn’t take these medicines for longer than 10 days due to risks for stomach bleeding.

4. Rest and avoid activities that will overuse your hip flexors for 10 to 14 days after injury (or longer if directed by your doctor).


Gentle stretching exercises can help reduce hip flexor muscle tension as well as reduce the likelihood for future injury. Try these hip flexor stretches, but make sure you don’t push too hard — these stretches should be gentle.

It can help to reduce the risk for hip flexor strain if you apply moist heat and warm up your muscles with a gentle walk for about three minutes before stretching.

In severe cases

If your hip flexor strain is so severe that it results in a large muscle tear, your doctor may recommend seeing a physical therapist. On occasion, surgery to repair the ruptured muscle may be recommended. However, this is a very rare occurrence.

The relationship between hip abductor muscle strength and iliotibial band tightness in individuals with low back pain

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Hip Abductor Tears

Hip abductors are a major group of muscles found in the buttocks. It includes the gluteus maximus, gluteus medius, gluteus minimus, and tensor fascia lata muscles.

The Gluteus medius arises at the top of the pelvic bone and runs to attach on the outer side of the thighbone or femur. The muscle controls side-to-side movement of the hip and stabilizes hip movement.

Gluteus medius tear is a condition characterized by severe strain of the gluteus medius muscle that results in partial or complete rupture of the muscle. It is also referred to as rotator cuff tear of the hip.


The tear or rupture of the gluteus medius muscle is commonly seen in runners and athletes involved in high-impact sports such as soccer or basketball due to sudden bursts of activity or poor flexibility of the gluteus muscle. Any traumatic or overuse injury, or degenerative changes may lead to partial or complete tear of the gluteus muscle.


The symptoms include pain and tenderness over the lateral aspect of the hip which may aggravate with activities such as running, climbing stairs, prolonged sitting or walking, and lying on the affected side of the hip. One of the main symptoms of gluteus medius tear is the presence of Trendelenburg sign – dropping of the pelvis towards the unaffected side by being unable to bear weight on the affected limb.


The diagnosis of gluteus medius tear is based on physical examination of the patient, followed by palpation of the affected muscle, testing muscle power and assessing walking pattern or gait of the patient. Certain special tests such as single-leg squat test or a positive Trendelenburg sign confirm the diagnosis of gluteus medius tear. Sometimes, MRI or ultrasound may be helpful to show the pathological changes of the muscle.


The aim of treatment is to restore the normal function of the gluteus medius tendon.

  • Immediately following the rupture of the tendon, RICE therapy is advised which involves:
    • Rest your hip by refraining from activities until it is healed.
    • Apply ice to your hip to reduce pain and inflammation caused by injury.
    • Compression with an ACE bandage helps to reduce tenderness and swelling.
    • Elevation involves keeping the affected hip raised above your heart to minimize swelling.
  • Medications such as non-steroidal anti-inflammatory drugs (NSAIDs) or steroid injections may be given to reduce the pain and inflammation.
  • Assistive devices such as a cane or crutch may be used temporarily to facilitate pain free ambulation.
  • Dr. Mansour may recommend physical therapy to strengthen the muscles and increase stability of the hip.
  • Surgical treatment may be recommended to repair a complete, full-thickness gluteus medius tear. The rupture can be repaired arthroscopically to help restore the strength and function of the gluteus medius.

Untreated cases of gluteus medius tear may result in gait disturbance and disability.

Weak Hip Abductors Can Be an Actual Pain In the Butt for Runners

Corbis Images

Most runners live in perpetual fear of injury. And so we strength train, stretch, and foam roll to help keep our lower half healthy. But there may be a muscle group we’re overlooking: Weak hip abductors are linked with hip tendonitis, according to a new study in Medicine & Science in Sports & Exercise, which can seriously hamper your stride.

Australian researchers looked at hip strength in people with gluteal tendinopathy, or hip tendinitis, which is inflammation in the tendons that connect your gluteal muscle to your hip bone. Compared to those who were injury-free, people with the troubled area had weak hip abductors. (Read up on these 6 Imbalances That Cause Pain-and How to Fix Them.)

Since this study was just observational, researchers aren’t entirely sure how weak hip abductors causes inflammation and pain, but a study published in Sports Medicine earlier this year by the same team earlier points to a pretty viable culprit. If your muscles are weak, it’s likely that the deep fibers of the gluteal tendons can’t withstand the compression and pressure load that comes with every stride and muscle contraction. This potentially causes the tendons to break down over time, which in turn would causes pain and, if left untreated, injury.

And it doesn’t just sound scary: “Weakness in your glutes can cause different running injuries such as IT band syndrome, or knee pain like patellofemoral syndrome and patellar tendonitis (runner’s knee),” says New York-based physical therapist and medical coordinator for Major League Soccer John Gallucci, Jr. (Watch out for these 7 Workout Routines Secretly Causing Knee Pain.)

Plus, that study in Sports Medicine found that inflammation in the gluteal muscles is more common in woman than men.

But if running strengthens your quads, calves, and the like, shouldn’t the workout itself help strengthen your hips? Not so much. “Running is pretty much a straight ahead movement and your gluteal muscles control side-to-side movements (as well as posture),” says study author Bill Vicenzino, Ph.D., director of Sports Injuries Rehabilitation and Prevention for Health at the University of Queensland. (And that would lead to the dreaded Dead Butt Syndrome.)

The good news? The research suggests specifically strengthening your hip and gluteal muscles can help with the pain and inflammation-something Vicenzino’s team is currently studying to confirm. (Don’t forget about these 6 Strength Exercises Every Runner Should Be Doing.)

Try these two exercises from Galluci to strengthen your hip abduction.

Lying Hip Abduction: Lie on right side, both legs outstretched. Raise right leg straight up in the air, forming “V” with legs. Lower to start position. Repeat on the other side.

Heel Bridge: Lie faceup with knees bent and feet flexed so that just heels remain on the ground, arms down by sides. Engage abs and lift hips off the floor. Slowly lower tailbone to the floor and lightly tap down before lifting back up into bridge.

  • By Rachael Schultz @_RSchultz

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Weak hip abductor symptoms

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