When hip tendinitis causes symptoms, it may be referred to as hip impingement syndrome. The main symptoms are stiffness in the groin or front of the thigh and/or a loss of your hip’s full range of motion. As the condition progresses you may feel pain with more subtle activities, such as sitting for a long time or walking up a hill. Pain that occurs at night or when walking on flat ground suggests that the cartilage cushioning the ball and socket has begun to break down and wear away, a condition known as osteoarthritis.
There are two main causes of hip impingement:
- A deformity of the ball at the top of the femur (called cam impingement). If the head is not shaped normally, the abnormal part of the head can jam in the socket when the hip is bent. This may occur during activities such as riding a bicycle or tying your shoes.
- A deformity of the socket (pincer impingement). If the front rim of the socket (called the acetabulum) sticks out too far, the area of the thigh bone (femur) just below the ball, called the neck of the femur, may bump into the rim of the socket during normal hip flexion movement.
Your doctor may recommend hip impingement surgery. The type of surgery needed will depend on the problem causing hip impingement and how much cartilage damage has occurred. If the affected hip does not have too much cartilage damage, the surgeon may use tools to reshape the ball and/or the outside edge of the socket that is catching on the thigh bone.
Often, surgery for hip impingement can be performed arthroscopically. This technique involves inserting a lighted scope and thin tools through small incisions over your hip instead of making a large incision. The earlier you have surgery, the greater your chances of a complete recovery. But even if cartilage has been damaged, surgery may still reduce pain and improve range of motion.
If cartilage damage is severe, however, hip replacement may be the only treatment that will relieve pain and improve function.