Hip Tendonitis Overview and Recovery Strategies

Whether you’re an athlete, an active walker, or someone who spends long hours seated at a desk, hip tendonitis can sneak up on you causing stiffness, discomfort, and pain that interferes with daily life. Fortunately, with the right treatment plan and mindful movement, recovery is not only possible it’s expected.

Here’s everything you need to know about hip tendonitis, including causes, symptoms, treatment options, and how to return to activity safely.

What Is Hip Tendonitis?

Hip tendonitis refers to inflammation of the tendons that attach the hip flexor muscles to the bones of the hip and thigh. Most often, this affects the iliopsoas tendon, which plays a major role in lifting the leg, stabilizing the torso, and supporting posture.

Tendonitis is considered an overuse injury meaning the tendon has been subjected to repetitive strain without enough recovery time. The result? Microtears that trigger pain, swelling, and reduced mobility.

Common Sites of Tendonitis Include:

• Wrist tendons (tennis or golfer’s elbow)

• Achilles tendon

• Patellar tendon (jumper’s knee)

• Thumb tendons (De Quervain’s tenosynovitis)

Hip Tendonitis vs. Bursitis: What’s the Difference?

While tendonitis involves inflammation of a tendon, bursitis affects the fluid-filled sacs (bursae) that cushion joints. Because the iliopsoas tendon is located near a major bursa, both conditions often occur together, making symptoms more complex.

What Causes Hip Tendonitis?

The iliopsoas muscle group which includes the iliacus, psoas major, and psoas minor originates from the pelvis and lower spine and connects to the top of the thigh bone.

These muscles are heavily involved in movements like:

• Running and sprinting

• Jumping

• Kicking (in sports like soccer or martial arts)

• Climbing stairs

• Cycling

Overtraining, improper warm-ups, or poor biomechanics can lead to excessive strain on the hip flexors, especially when adequate rest isn’t part of your routine.

Other potential causes include:

• Post-surgical changes after hip arthroscopy

• Weakness in surrounding muscles (like glutes or core)

• Tight hip flexors or limited joint mobility

Symptoms of Hip Tendonitis

Most people experience:

• A deep ache or soreness in the front of the hip

• Pain that worsens after physical activity or prolonged sitting

• Tenderness to the touch in the hip crease

• Tightness or stiffness in the hip flexors

• Low back pain or pelvic tilt (from compensation)

• Altered gait with shortened stride

• Decreased hip range of motion

If these symptoms persist or worsen with activity, it’s a good idea to consult a healthcare provider.

Diagnosing Hip Tendonitis

Diagnosis is typically made with a physical exam and a review of your symptoms and activity level. An X-ray may be used to rule out fractures, arthritis, or alignment issues, while MRI or ultrasound may be used to assess soft tissue inflammation in more severe cases.

Treatment Options

The good news? Most cases of hip tendonitis resolve with conservative treatment.

First-Line Treatments Include:

• Rest and activity modification: Stop or reduce high-impact activities that cause pain.

• Ice therapy: Apply ice to the front of the hip for 15–20 minutes, several times a day.

• NSAIDs: Nonsteroidal anti-inflammatory drugs like ibuprofen can reduce pain and inflammation.

• Gentle stretching: Focus on light hip flexor and quad stretches without forcing the range.

• Physical therapy: A structured program that includes strengthening the glutes, core, and hip flexors helps restore balance and mobility.

For Chronic Cases:

• Cortisone injections: These may be used to reduce persistent inflammation in the tendon or surrounding bursa.

• Tenotomy surgery: In rare cases, a surgical release of the iliopsoas tendon (tenotomy) may be performed to reduce tightness and improve mobility. Full recovery typically takes 3–6 months, and strength usually returns after healing.

Recovery and Prognosis

Most people make a full recovery from hip tendonitis with rest, physical therapy, and proper muscle reconditioning. The key is to address it early pushing through pain or continuing high-impact activity too soon can worsen symptoms or lead to chronic issues.

Once symptoms improve, gradually reintroduce activity while maintaining hip mobility and strength to prevent future flare-ups.

Prevention Tips

• Warm up before activity with dynamic stretches

• Strengthen your glutes and core to reduce strain on hip flexors

• Avoid overtraining follow the 10% rule when increasing mileage or intensity

• Practice good posture during workouts and daily activities

• Cross-train with low-impact exercise like swimming or yoga

The Bottom Line

Hip tendonitis can be frustrating, but it’s highly treatable. With the right mix of rest, gentle movement, and targeted strengthening, you can restore hip function and return to activity with confidence.

If you’re dealing with persistent hip pain, don’t ignore it early intervention can make all the difference.

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