Fixing Lateral Hip Pain (Greater Trochanteric Bursitis) |
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- เผยแพร่เมื่อ 6 ม.ค. 2018
- In this episode, Dr. Aaron Horschig dives deep into lateral hip pain. He talks about greater trochanteric bursitis and gluteal tendinopathy - WHY you may have developed this pain and HOW to fix it!
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Dr. Aaron Horschig is the founder of SquatUniversity.com. A physical therapist, coach, speaker, and author of 'The Squat Bible', Dr. Horschig is a certified strength and conditioning specialist (CSCS) through the National Strength and Conditioning Association. He works with such athletes as international soccer players, MLB and NFL athletes, national-level Olympic weightlifters, and youth athletes.
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The first proper explanation I've found for the pain in my hip. My doctor, other physios didn't have a clue.
I have been dealing with this pain for months. I didn’t know what it was until a friend who’s a physical therapist told me it was gluteal tendinopathy and hip bursitis. I use to squat regularly for years before this pain, I think it was caused because I implemented skipping the rope as my cardio (this is a common injury amongst runners) and it all went south from there. I have been so miserable not being able to be physically active until I found the article from Squat University and this video. I’ve been doing isometric exercise for a week now and my pain has decreased a lot! I will keep on following the recommendations! Thanks a lot!
Thank you
I’ve been searching for explanation for my lateral hip pain for very long, and this confirms my suspicion that hip shift is the cause. My hip shift has always been very evident. Now I need to address the hip shift. Many tks SquatU
Glad to have your channel in my life right now, this info is gold! Thanks so much!
This is gold! I’m a regular lifter and love squats and flute workouts. I’m on week 2 of resting and rehabilitating my hip, trying to pint point my pain and the reason, thank you this video I know!!! Thank u 😊
Love me a nice flute workout too!
Best video I’ve seen yet for this issue. I had a herniated disc, 2 bulging discs and an annular tear about 2 years ago. As a result of the pain, I compensated and started having side hip pain. Been struggling for a year or so with this. These tips have helped ease the pain and build better techniques and strength in the areas where I was weak.
I have been dealing with this for 3 yrs and this Doc nailed it on the head. I had no idea what muscle or what was causing this and everything he just said makes so much sense. Thanks man
Well did it work?!
what this guy said⬆️⬆️
Have been in pain for two weeks now, these are the first exercises to really make a difference for my gluteal tendinopathy
Just bought your book because of this video. Absolutely nailed the cause of my hip pain.
the one thing I learned here is how the smaller glut muscles are often effected and that they mostly stabilize the hip. As a dancer, this explained why my outer hip pain hurts a lot when I try to straighten my standing(effected hip)leg while lifting the other leg to the side. In ballet, it's a leg extension to the side. The standing leg/hip has to work hard to stay stable. On me, it hurts while trying to stabilize.
I always check out your site first for muscle problems. Your explanations and exercise have always been very useful.
I have been suffering from this chronically for four years, and even had unsuccessful physical therapy for it and a cortisone shot. I felt immediate improvement after one day of these exercises and my hope is with daily use I can recover. Squats are important to me and I imagine my form was not good as you stated, which caused the initial and ongoing injuries. Thank you for your help and for giving me hope.
How’s the progress?
I swear you can’t be an athlete without following this page. This info is golden. I had this last year and it turned into sciatic pain bc I didn’t know what to do. Just got it again on my other hip and now doing these exercises I feel like I will be good.
Did it turn into sciatic pain in the same leg? Did you also have back pain? Cause I'm dealing with something similar :(
@@francescov01 yeah I had to change how was sleeping and a couple new movements I was doing. I also had to sit less to get it to heal. Prolonged sitting/laying down is not your friend
thanks man this has given me something to think about, i'll give it a go
great video, very informative. Will start incorporating into my training!
I’ll definitely be trying this out! I been having this hip problem for over a year now! It won’t go away
When he did Band Walk, do we do it to the side we have pain.I mean towards the side we have pain or towards the side which is good? I don't understand the trailing leg?
It was hip shift that did this for me. Great video. Thanks for this.
I’m thankful for this video. Very informative.Thank you
Best video on this topic. Thanks!
As a physio student, this explanation couldn't be any more perfect; The anatomy and clinical feature explanation!
" aS A PsYsIO..."
@@sabertoothwallaby2937 AKA someone who understand anatomy and body mechanics
Wonderful video . Going through this right now .
Aaron is the best!
1. lying isometric glute med hold 30 sec, standing in squat position 10 sec
2. banded monster walks, initiate movement with leg opposite of direction of movement
3. banded squats to turn on glutes
Thank you a lot for this vedio 🙏 🙏 🙏 🙏 Dr. Horschig!
Wonderful!! Thank you so much, I had no idea what and why hurt when i slept!
You are amazing bro! Help a lot
I,ve been looking for this for months, thanks coach
Hey there if you understand the video, can you tell me please what side should we be doing band walks. Towards the side we have pain or the opposite?
Thank you! This advice is good. I hope to get back to lifting with weights using my legs in a better way soon.
Awesome video. Thank u!
very well done, already helped
Nice video..to lift pain free would be my resolution..
That's a good resolution!
Thanks for this. My hip has been a big issue and now I know the cause and the cure.
This is me! I have a hip shift when the weight is very heavy and that's when this problem started
That's what I needed. Love it. Is there a video you share some tips about foam rollers, it's quality and variations?!
I covered it a little in the "how to warm up before squat day" video a few back.
I love that animation! Really helps me “picture it”. Thank you for another helpful video
You're very welcome!
the animation is absolutely needed. i just found this channel and is literally all I wanted. everything bio mechanics and fixing improper technique. im not a huge lifter but even small weights can cause injury when performed incorrectly (as in my case). im watching every video you made and I feel like finally someone reliable is explaining these things the proper way and not just "do this this and that". Big Thank you
Dr.Aaron thank you for this video.!It was the best most simple explanation for the pain I have had for months.I stretch the IT band and Piriforms muscle every other day and that brings me a lot of relief!Now I saw you using that stretch band so I am buying one to do these exercises.Thank you again.It was very helpful.I am a 67 years old woman and I am in great shape.I also love to hike.Would this problem be caused by too much hiking?
great video!
Thank you!
Hey Aaron, I've been following for a couple of years now, this one video seriously helped with this issue I was dealing with for month.
Is there a preferred way I can show my appreciation, with a donation or something? Seriously, thank you.
Great video !! This is very helpful and might explain why my left hip flares up if I ramp up my squats, and I do shift to that side under heavy load and am weaker on that side in abduction, so it makes sense. But I am concerned that I might have osteoarthritis in that hip from going through this cycle too many times because the latest episode was really bad. I have recently started work on strengthening the lateral glutes on that side especially but if I have OA then it would mean that I cannot return to squatting even after the root cause of weakness has been fixed, right? How would I go about distinguishing between OA and tendinopathy/bursitis?
im sure thats exactly my problem... thanks a lot
You're welcome! Happy to help
I can't stress enough how much home this hit :D I'm not female but my hip area is quite wide, also I'm always standing on 1 of my legs and the 1 leg over another? That's how I sit often haha. Finally I know the reason of this pain and how to fix it. Thank you very much! Liked and subscribed!!!
Thank you 🙏🏽
I’m gonna give this a shot. Hope it helps!
did it work?
Thanks for this; very useful! Question on frequency: every other day, daily, other?? Thanks again.
I do the mobility exercises and piriformis stretches, but the banded squats seem like the key to getting the femur to rotate while moving laterally. My hips feel better, but I now have to address the upper back mobility.
Thoracic spine tightness has a direct impact on lower back pressure/pain and hip impingement during the squat. I'm guessing that this mobility issue progressed into my hip mobility and manifested itself into the squat issues and pain.
Would like Dr. Horschig to weigh in with his thoughts.
Thanks!
Thank you for this very useful video!
You're so welcome! I'm glad you enjoyed it!
Not only did I enjoy the video, but I have applied the exercises you suggest, mainly abducting, and my right hip pain has vanished! :D
Could this issue your explaining also involve some sort of snapping in that glute medius/minimum area as you walk?
1- Isometric exercise 8:14 Hold 10 sec, eventually hold up to 30 sec
2- Isotonic exercise 9:04
3- RNT 10:10
Thanks
how many sets?
Finally found out what my hip pain is !!
I'm glad this video could help!
Very good explanation! I'm wondering if this is my problem. If I press with my thumb right behind the greater trochanter, I can feel pain below my patella. It also feels like my thigh is not functioning at full capacity, but if I press right behind the greater trochanter, my thigh immediately feels unrestricted and "normal". Additionally, every morning I'll have pain down my thigh and below the knee. After walking for just 10-20secs it almost disappears. Does that make sense? :)
Great job with this video Aaron. Concise and has the best evidence based advice I have seen. I think I developed GTPS from prolonged sitting from work. It flared up a couple times over the past 2 years but only after days of 9 plus hours a day for 3 weeks on an office chair. It never occured to me that sitting could be harmful but I know now. Prior to these pain bouts I was active all day 8 plus hours hiking/walking. After 3 weeks with hard core prolonged sitting I am in this boat again. Now that I am sure prolonged sitting is the issue I will cut back.The thing I find difficult is figuring out when and how much I should do in terms of stretching and exercise to balance healing versus longer term recovery. If it flares should I step back and do nothing for some time....days or week(s)? or should try some of the stretches, foam rolling, strengthening through the flares? The last 2 times I mostly went back to the other active job and eventually the symptoms went away after about 2 months. I wasn't consistent with the exercises to determine if they were the reason for recovery. Anyways I suspect that every person is different but I wish someone who has more experience with this could tell me. It took me 3 bouts of this to figure out sitting was the cause it will take similar trial and error to determine the correct recovery balance.
Chris did you make a full recovery?
@@KennyGuyte I now believe I had gluteal tendinopathy not GTBS. It's caused by inflammation from muscle compression so once I limited compression by sitting on a couch, which is less ridged than an office chair, and limiting time sitting the tendinopathy goes away. I now believe that exercises/stretches probably did not stop the issue rather preventing the cause was my solution. If I use an office chair I believe GT will come back regardless if I do any exercises or stretching.
@@ChrisVanSlykeCVS Thanks this is why I resigned from Engineering because I sit all day. I hope his isn’t chronic.
@@KennyGuyte I wondered the same thing re whether it was chronic. My pain never went away it was constant and unrelenting which nothing could stop from pain killers to ice. I discovered after 2 years with no help from my doctor and by coincidence it definitely is not chronic for me. I suggest get a standing desk, limit sitting time, get a very soft couch/chair. I have learned to almost completely avoid it from happening and hope you can do the same.
@@ChrisVanSlykeCVS Thanks bro seriously 🙏🏾💪🏾✊🏾
DUDE I HEARD 2 POPS ON MY HIP AND I FREAKED OUT THINKING I HURT MSYELF EVEN MORE BUT WHEN I TRIED TO DO THE SAME TEST MOVEMENT THAT ALWAYS HURT ME FOR THE LAST 4 YEARS ITS NOT THERE ANYMORE. IM FREAKING OUT RN!!!
Thanks so much for these helpful vids! I have a pain there for over a month, it's quite enough, especially for 3-4 days after squats. I dig my thumb and i get a bloody pinchy pain that goes about 20cm down on my side quad! (Pain in side quad is there as well when hip hurts). It's not sciatica (because it's not on the back of the leg) and i think it's not the IT band because i have no lateral knee pain. Can the GT bursitis has symptoms such as lateral quad pain? It gets really painful while sitting in chair with my knees at 90* angle and push through the floor. Also hurts while push through the floor on bench press. Any advice would be helpful, thanks and keep up the great work!
Nice video! Do you recommend to put the toes outward during a squat and deadlift? I suffer from gluteal tendinopathy as well
It helps to learn all those words
I have this from squatting on both sides equally and severely. I think it's from my belt pinching into the glute medius and minimus at the bottom of the movement.
I have no pain during the external de-rotation test, but if you apply resistance in the exact opposite direction, internal rotation, that’s when I get my bad hip pain. The pain is in the exact same place you describe. I thought my pain was from pushing my knees out during heavy squats. That’s when it hurt the worst. What helped for a while was to stop pushing the knees out, and keeping a narrower stance with toes pointing more forward. The pain finally caught back up with me (during my calorie cut phase, even with lower volume workouts), so I’m now taking a break from deadlifts and squats. Thoughts? Same rehab protocol?
Side note. A month before I started cutting, I switched from a strength routine 5X3 style to a higher rep routine. And the pain comes at the bottom of the squat, especially in a wider stance and/or pushing knees out. It feels like a pinch. And when I used to push my knees out, I started to get really bad knee pain. Just didn’t seem like a natural movement. If my issue is from overuse, would it be smart to do more glute-med work like the exercises mentioned in this video? Should I let it rest, then when the pain is gone, start strengthening the hip muscles? I’d hate to work out an already irritated muscle and tendon.
So for some not pushing the knees out too much is definitely a good idea. You may be putting too much pressure on the lateral part of your hip joint from doing that which is causing the pain. Have you tried doing the banded joint mobilizations for the pinch sensation you feel?
Squat University I took a little time off and then after that, I started with the mobility and glute med work. Three days ago, I warmed up good and got the glutes firing, and deadlifted with no pain. There still seems to be a little dull pain when I test it and sit (only body weight) in a deep squat, but not bad. But the stance has to be perfect and very narrow. And of course that’s when I haven’t stretched or warmed up. Another thing I noticed was that I didn’t have good ankle dorsiflexion in my left foot. I was like 3 inches from the wall when testing it, when my right knee easily touches the wall. Could mean I’m sinking a little further on my right side in the squat causing my femur to bottom out. Idk. I always videotape myself from the side to check my form, but I’m going to get some front facing footage to see what’s going on. If I still have pain, I’ll let it rest more and then rehab it longer. Still pain, then I’ll go see my A.R.T. person. Thanks for the reply. I’ll post a follow up eventually.
I messed up my bursa bad man,I played computer games for years in a tub chair,I used to lean on one side (left)of my pelvis.This put HUGE pressure for a prolonged time on my bursa,I didn't notice it until I usually went to bed,Then I'd sleep on it.It was fine for a few years ago but now,man,I'm 40 and my left hip bursa is really sore,If I step the wrong way it triggers a pain that actually feels like it is in my hip socket.I realised my muscles are triggering far too early and tensing up my hip which triggers the condition. I have started to stretch this area every day and have had two weeks of "ok" feeling in my bursa/hip.I sit on a flat wooden chair,back straight, I put one of my ankles on top of the opposite knee and gently push down on the knee joint of the folded leg (use a water bottle to make this easier),then I do the other side,3 minutes each side twice a day.It is amazing the freedom and relief I get in the area of my bursa.
Should these be done daily or with days off? Also how many reps/sets? Ive been dealing with chronic lateral hip pain and lower back pain for a year
So does the pain eventually go away after doing those exercises and movement corrections? Also should you ice the area when it feels irritated after a workout?
I've been going pretty hard at the gym for almost a year now working out lower body 3 days per week - however I feel I've injured myself. The pain is where you describe only a little more toward the back of the hip as well as a burning pain in the tendon that attaches the lower glute to the femur in the back. I've stopped my workout for two weeks now and have applied ice and heat which help but the pain is still pretty bad. I had a rod placed and removed on the affected side 30 years ago due to a shattered femur bone so have a hard time stretching that side because of the damage from the large incision at the top of that hip
Any suggestions?
As a CrossFit Athlete I struggled with gluteal tendinopathy for years triggered by heavy back squats. Strengthening the glute medius with internal hip rotation exercises like the reverse clam completely fixed this. the hip abduction exercises did not help as much.
hip abduction isn’t helping me i’ll try reverse clam
does the internal rotation work the glute medius?
Did you also experience the pain in the glute medius?
Thats a great video thank you so much.
Do you believe that foam rolling the TFL would be good in cases of overactive TFL?
Thank you! And yes it can be very helpful at times. Make sure to always hit lateral glute activation after so you address not only the stiff tissues but the often underachieve ones as well for a comprehensive treatment.
I recently have been using hip bands to create a better symmetry, what is your take on squatting using bands?
Late to the conversation but I have a question I hope you get to answer. The hip shift- when the upper leg rotates in, appears very similar to someone who is knock-kneed.
In your opinion, If someone is knock-kneed could it be causing the same glute tendon strain as you’re describing?
Hope that made sense.
madcow 5x5 squatting in briefs, old age and a back injury............then hip pain led me here. it really bothers me if a lay down and cross my lower legs, left over right
Extremely painful now!!! Do i stretch if inflamed? Sitting on the bowl in the morning is torture. putting shoes on is impossible.
Thanks for the video. Question though, would it be wise to probably stop working on improving internal rotation while I work on that hip pain?
Good question - it depends really on the person. Internal rotation stiffness may be a byproduct or a cause of the pain so there's not a right or wrong answer. I would say if you stretch and feel better afterwards it's probably okay to continue.
You're a god man thank you
I'm glad to help Chris! Thanks for checking out the video today!
For whatever reason the one lower body movement that never causes this problem for me is a rear-foot-elevated split squat.
Since in every exercise you insist on the leg internal rotation in order to activate glutes medium and turn off the TFL i must ask: isn't it the TFL that internally rotate the leg? (Mine shows contraction when i head my toes inwards) so i wonder if i keep my toes inward during the exercises why should it turn off? , if anything the opposite! Really interested in your clear response thanks (i'm facing with this too)
Update: maybe active insufficiency has got to do with it?
Ive had really bad hip tightness and cramps just below my hip bone for years as a result from rowing with a bad technique, I had to give it up as i could no longer go up the slide fully. They are too tight to squat past the knees, as well as cramping up when benching and doing mat-work. I get strong resistance and pain when trying to stretch them and I am concerned as I am only 22 and fairly active. I have been to a physiotherapist who didnt really listen and just told me to keep stretching and that was a few months ago. any advice?
I am not sure how to describe this I have cramp like feeling on the lateral hips when I internally rotate the hips like doing 90 90 , pigeon good morning, and even sometimes while sitting in the passenger seat of a motorcycle.
Interesting. Everything I’ve seen says to avoid deep squats at all costs, in fact the moment I lower into a squat the hip pain is so intense I can’t go lower 😮
Hi Dr.horschig
One question
Should i stretch glute med after these exercises or leave it alone for now ?
How did stiffer get to know so much about physiology and anatomy?
what about tg in the glute minor? althean x, have a good video about glute medium tg, and how to fix it, but mines looks to be in the minor ones, some strech helps, but this quarentine actually have flare up a lot of it, i cant stand the pain some times, i am a digital artist as well so u kinda have an idea of my background pain
I get this sharp pain in left lateral hip when I run or do skipping. I can't even walk after that. If I put pressure on left leg or simply stand ,it hurts there . I mean the pain doesn't continue. But when I try to stand and put left foot on ground it causes sharp stabbing pain and when I left foot off the ground it stops.
I have the same issue as of a few weeks ago. Did you ever figure out what it was?
Hey! Would you mind just putting up some of the references to the articles about most glute tendonitis being misdiagnosed as bursitis? I just can't find it anywhere and would love to have a read!
Here's my blog post on the topic with references: squatuniversity.com/2018/02/04/fixing-lateral-hip-pain/
I think I may have the issue after a squat injury where my knee collapsed
Do you have any advice for SI joint pain please?
I have no pain with deadlifts can I still do them heavy?
What kind of cardio I can do while I’m having this pain?
Alyona Alyona Maybe skiing (on a skierg) and static biking (echo, assault or bike erg)
Great content but struggled to understand some rehabilitation instructions!! Would be unreal if you could add some augmented instructions for slow learners like me 👍🏻
I'll see what I can do! Thanks for checking out the show!
mate, I am suffering from osteitis pubic due to overuse of my adductors, do you have any recommendation I could do? The chiropractor asked me to rest for a week doing nothing and wait until the pain dial down but I still believe there must be something i can work on. Thanks in advance.
I'd personally recommend going to get a hands on evaluation with a sports physical therapist that can help you walk through a full progression back to 100%
Does this mean any heavy lifting like squatting and deadlifting should be stopped, while you carry out the correction exercises.
Muito Bom!!!
the knee collapse is apart of the golf swing which is probably where my pain is coming from...this sucks
i've stopped squating because of lateral hip pain.... my trochanter is still too inflamed and e can't get better. Could this be because of heavy conventional deadlifts?
would a glute medius injury also cause low back pain also?
What brand/size bands are you using in this vid?
hi, i have hypermovily sindrom, it seems that my glute pain (some times
sciatica sintoms) are coming from my si joints, can i do this exercices?, some times i have lateral pelvic thighness or pain as well. so i guess that my GT could have issues agian for the same joint issue i was doing a lot of glute medium excercices that work for some time,
as well that my mri cames okey, so i dont hae any disk issues as well that my pt tells me that its not pyriform simdron cause i really have a good
range of motion in both legs, so everything points that could be that my SI joints are flare upt thanks to that hiperlaxity of the joints it
selft? thanks c:
Is it ok if i just do the lateral bandwalk, not the other exercises?
I'm in a situation where I have progressive joint pain fibromyalgia I just got diagnosed with and now I have something going on with my hip along with the joints in my toes and everything else there's a lot going on. I adapted to an extremely active lifestyle a few years back I already had progressive joint disorders happening even when I was at my lowest weight in really good shape able to actually intermittent jog and stay active 4 to 5 days out of my week my doctor had the nerve to say maybe I should drop some weight when I literally was in really good shape now I'm about 15 to 20 lb heavier a lot has happened the pandemic but I never stopped being active the problem is is that what's happening to me is progressing badly I am currently off of work I still try to stay active I can't do hardly any of the things I used to be able to do I'm supposed to have some physical therapy I've been doing daily activities going on walks everything I do agitates my hip joint they say it's not arthritic but I don't know your video is very helpful I'm beginning to wonder if I have a tendon injury you know how doctors are I'm going to have to advocate for myself in order to have it further investigated other than x-rays
Which leg is trail lag? Is that which moves sideway or stands?
I get this ONLY when I try to work on my mobility! I don't even lift weights, and I don't get it in general :'(
Weak glute medium can be a cause? The touch down squat can be useful?
Hey Doc keep up the good work. I've just been diagnosed with early stage hip osteoarthritis on one side. I'm 40. I asked the doctor if I can continue to do weighted squats and he said to listen to my body. The truth is weighted back squats cause me no discomfort even when I'm having a flare up. Walking is painful but little else. I want to keep squatting but I don't want to increase the damage. What's your opinion on this?
I'd incorporate other movements that stress the hip in mobility and stability but don't flair it up. For example, single leg squats, bulgarian split squats, etc. Seeing a physical therapist for a hands on evaluation may also be a good idea to find any other weak links you may have that could contribute to more issues.
Hi doc ! I have a pain on outside of knee that arises at some points only like internally rotation of knees. Should i keep doings legs or not ? Please answer
I would not push weights if the technique breakdown leads to pain. Take some time off to fix the problem and then when you get back to it, work up to the point where you can still maintain good technique pain free.
How many times a week should this be done ?