What should I do next if I have a muscle strain at my hip for more than a month?

From your description, it's likely that you are suffering from Trochanteric bursitis - it means there is inflammation of the bursa (which is a cushion) between the thigh bone and the iliotibial band which is a large muscle connecting the pelvis all the way to the knee. Typically it's a combination of tight muscle and excessive repetitive exercises that caused the inflammation (you can try rubbing your hands forcefully for 1000 times, I am sure you will feel some discomfort).

Of course, there are many other causes of hip pain:

1. Muscle tear

2. Hip joint problem (arthritis/ Avascular necrosis of the hip/ Labral Tear)

3. Fracture of the bone

4. Any kind of abnormal growth

5. Referred pain from the Spine

I'd recommend you to see an Orthopaedic Surgeon, we will take a detailed clinical history and careful clinical examinations and some forms of imaging (X rays/ MRI) to fully evaluate your condition, only when the cause of the symptoms are confirmed, then we can tailor our treatment to target at the root cause of your symptoms.

The initial treatment will include anti-inflammatory medication, stretching and ultrasound therapy by the physiotherapists. However, if the pain persists despite these treatment, then the patient may need a anti-inflammatory medication injection or even surgery for recalcitrant cases. Hope this clear some doubts for you.

Cheers,

Dr. Henry Chan

Sorry to hear about your injury. It seems you may have injured your tensor fascia latae (TFL), which Is near your hip area on the outside thigh.

It is a band of connective tissue that stretches from the outside of the hip down to the outside of the knee/ upper leg.

You would need to see either a sports doctor/ orthopaedic surgeon. A thorough examination will be done, followed by an MRI to delineate the damage. A proper treatment plan can then be instituted to help you with the problem. Hope this is useful, and best regards!

Dr Sean Ng

Thanks for reaching out and thanks to my colleagues Dr Henry and Dr Sean for their excellent answers. I’ll try to add something from a Sports Medicine/MSK/Rehab perspective that adds to theirs.

As Dr Henry suggests, you could see a physiotherapist in the first instance for stretching of the ITB, strengthening the gluts and working on pelvic stability. They are excellent at assessing you from a functional perspective.

Another option is to visit your local Sports Medicine/MSK clinic. Here, with a multi-disciplinary approach, you might be assessed by a physician in the first case, with an MSK ultrasound scan which is good for many outer hip issues, followed by treatments from a physiotherapist or podiatrist. Sometimes acupuncture can also help with niggling pain symptoms.

As your symptoms came on with running, a gait analysis maybe a key step and might identify “why” your symptoms developed. Some patients require guided injections or shockwave therapy for tendon or bursal pain that is not settling, and in other situations, further assessment might include an MRI/arthrogram and referral for a surgical opinion.

Things to consider when you consult someone are:

1. Changes to your running (distance, frequency, route etc)

2. Changes to footwear

3. Whether you have back pain symptoms

4. What treatments you have already tried

Hope this adds further to the earlier posts. Bw

Dr Dinesh