Tendonitis is a condition that involves inflammation of the tendons, which are thick cords of soft tissue that connect muscle to bone. Hip flexor tendonitis describes inflammation of the tendon sheaths, namely the iliopsoas and/or rectus.
Hip flexor tendonitis is most often caused by minor injuries to the affected area, repetitive movements, overuse, and occasionally acute trauma. It often occurs when an individual begins a new type of exercise or sport because the muscles and tendons may not be accustomed to the movements required. It can also occur as a reflection of compensation for an underlying hip problem, for example a labral tear and femoroacetabular impingement or osteoarthritis.
Sports that can contribute to hip flexor tendonitis include cycling, running, swimming, hockey, and baseball. Spin classes, high-intensity interval training workouts, and activities involving kicking, squatting, and jumping can also leave you at risk for this type of injury.
Initially, a medical history and physical examination by a musculoskeletal expert should be completed. Diagnostic imaging like x-rays or MRI may be ordered to rule out other conditions. An EMG may be used to rule out nerve compression. Additionally, an image-guided injection may be recommended as well.
Non-surgical treatment includes limiting or stopping the activities that cause the pain and inflammation, using anti-inflammatory medication, and icing the affected area. Image-guided cortisone injections may also be used to decrease inflammation and pain. Physical therapy typically is recommended as well.
If the conservative treatments are ineffective, surgery is usually recommended. Surgery to address hip flexor tendonitis may be performed arthroscopically, minimizing scaring and trauma to surrounding structures. This may lead to a faster and more complete recovery. After surgery, a course of physical therapy is usually prescribed to help restore strength and function. A qualified orthopedic surgeon will review your options and help you make the decision that is best for you.