Advertisement

Hip Tendinopathies

  • Alessandro ApratoEmail author
  • Andrea D’Amelio
  • Alessandro Bistolfi
  • Luigi Sabatini
  • Alessandro Massè
Chapter

Abstract

Acute groin injuries and chronic groin pain are quite frequent among athletes and active people. Nowadays the diagnosis of hip tendinopathies became easy and accurate with the improvement of the imaging techniques. Acute groin injuries occur in high-intensity sports, and adductor injuries account for the majority of these. Iliopsoas and proximal rectus femoris injuries are also common. In the presence of chronic groin pain, the index cause may be a hip joint pathology, such as femoroacetabular impingement (FAI), labral tears or osteoarthritis, but secondary tendinopathies are often present. Conservative therapy is the most recommended treatment and in the past open surgery was indicated only in recalcitrant cases. In the last decade regenerative medicine and endoscopic surgical procedures have greatly expanded the indication for minimally invasive treatments. In this chapter, muscles and tendons pathologies have been divided into four groups, according to the different anatomical areas around the hip: medial, anterior, lateral and posterior.

Keywords

Sciatic Nerve Biceps Femoris Ischial Tuberosity Gluteus Maximus Gluteus Medius 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. Anderson CN (2016) Iliopsoas: pathology, diagnosis, and treatment. Clin Sports Med 35(3):419–433PubMedCrossRefGoogle Scholar
  2. Andersson E, Oddsson L, Grundström H et al (1995) The role of the psoas and iliacus muscles for stability and movement of the lumbar spine, pelvis and hip. Scand J Med Sci Sports 5(1):10–16PubMedCrossRefGoogle Scholar
  3. Aprato A, Jayasekera N, Bajwa A, Villar RN (2014) Peri-articular diseases of the hip: emerging frontiers in arthroscopic and endoscopic treatments. J Orthop Traumatol 15(1):1–11PubMedCrossRefGoogle Scholar
  4. Atkinson HD, Johal P, Falworth MS et al (2010) Adductor tenotomy: its role in the management of sports-related chronic groin pain. Arch Orthop Trauma Surg 130(8):965–970PubMedCrossRefGoogle Scholar
  5. Bird PA, Oakley SP, Shnier R, Kirkham BW (2001) Prospective evaluation of magnetic resonance imaging and physical examination findings in patients with greater trochanteric pain syndrome. Arthritis Rheum 44(9):2138–2145PubMedCrossRefGoogle Scholar
  6. Bisciotti GN, Volpi P, Zini R, et al (2016) Groin Pain Syndrome Italian Consensus Conference on terminology, clinical evaluation and imaging assessment in groin pain in athlete. BMJ Open Sport & Exercise Medicine 2:e000142. doi:  10.1136/bmjsem-2016-000142
  7. Blankenbaker DG, De Smet AA, Keene JS et al (2007 May) Classification and localization of acetabular labral tears. Skelet Radiol 36(5):391–397CrossRefGoogle Scholar
  8. Blankenbaker DG, Tuite MJ, Keene JS et al (2012 Oct) Labral injuries due to iliopsoas impingement: can they be diagnosed on MR arthrography? AJR Am J Roentgenol 199(4):894–900PubMedCrossRefGoogle Scholar
  9. Blankenbaker DG, Ullrick SR, Davis KW et al (2008) Correlation of MRI findings with clinical findings of trochanteric pain syndrome. Skelet Radiol 37(10):903–909CrossRefGoogle Scholar
  10. Byrd JW (2006) Evaluation and management of the snapping iliopsoas tendon. Instr Course Lect 55:347–355PubMedGoogle Scholar
  11. Byrd JW (2015) Disorders of the peritrochanteric and deep gluteal space: new frontiers for arthroscopy. Sports Med Arthrosc 23(4):221–231PubMedCrossRefGoogle Scholar
  12. Cacchio A, Rompe JD, Furia JP et al (2011) Shockwave therapy for the treatment of chronic proximal hamstring tendinopathy in professional athletes. Am J Sports Med 39(1):146–153PubMedCrossRefGoogle Scholar
  13. Cascio BM, King D, Yen Y-M (2013) Psoas impingement causing labrum tear: a series from three tertiary hip arthroscopy centres. J La State Med Soc 165(2):88–93PubMedGoogle Scholar
  14. Chandrasekaran S, Lodhia P, Gui C et al (2015) Outcomes of open versus endoscopic repair of abductor muscle tears of the hip: a systematic review. Arthroscopy 31(10):2057–2067PubMedCrossRefGoogle Scholar
  15. Cook JL, Purdam C (2012) Is compressive load a factor in the development of tendinopathy? Br J Sports Med 46(3):163–168PubMedCrossRefGoogle Scholar
  16. Davies JF, Stiehl JB, Davies JA, Geiger PB (2013) Surgical treatment of hip abductor tendon tears. J Bone Joint Surg Am 95(15):1420–1425PubMedCrossRefGoogle Scholar
  17. Dean CS, Arbeloa-Gutierrez L, Chahla J, Pascual-Garrido C (2016) Proximal rectus femoris avulsion repair. Arthrosc Tech 5(3):e545–e549PubMedPubMedCentralCrossRefGoogle Scholar
  18. Docking S, Samiric T, Scase E et al (2013) Relationship between compressive loading and ECM changes in tendons. Muscles Ligaments Tendons J 3:7–11PubMedPubMedCentralGoogle Scholar
  19. Domb BG, Shindle MK, McArthur B et al (2011) Iliopsoas impingement: a newly identified cause of labral pathology in the hip. HSS J 7(2):145–150PubMedPubMedCentralCrossRefGoogle Scholar
  20. Dunn T, Heller CA, McCarthy SW et al (2003) Anatomical study of the “trochanteric bursa”. Clin Anat 16(3):233–240PubMedCrossRefGoogle Scholar
  21. Elattar O, Choi HR, Dills VD, Busconi B (2016) Groin injuries (Athletic Pubalgia) and return to play. Sports Health 8(4):313–323PubMedCrossRefGoogle Scholar
  22. Filler AG, Haynes J, Jordan SE et al (2005) Sciatica of nondisc origin and piriformis syndrome: diagnosis by magnetic resonance neurography and interventional magnetic resonance imaging with outcome study of resulting treatment. J Neurosurg Spine 2(2):99–115PubMedCrossRefGoogle Scholar
  23. Fitzgerald P (1969) The action of the iliopsoas muscle. Ir J Med Sci 8(1):31–33PubMedCrossRefGoogle Scholar
  24. Fitzpatrick J, Bulsara M, Zheng MH. The effectiveness of platelet-rich plasma in the treatment of tendinopathy: a meta-analysis of randomized controlled clinical trials. June 2016;pii:0363546516643716. [Epub ahead of print]Google Scholar
  25. Fricker PA (1997) Management of groin pain in athletes. Br J Sports Med 31(2):97–101PubMedPubMedCentralCrossRefGoogle Scholar
  26. Gill TJ, Carroll KM, Makani A et al (2014) Surgical technique for treatment of recalcitrant adductor longus tendinopathy. Arthrosc Tech 3(2):e293–e297PubMedPubMedCentralCrossRefGoogle Scholar
  27. Goom TS, Malliaras P, Reiman MP, Purdam CR (2016) Proximal hamstring tendinopathy: clinical aspects of assessment and management. J Orthop Sports Phys Ther 46(6):483–493PubMedCrossRefGoogle Scholar
  28. Guanche CA (2015) Hamstring injuries. J Hip Preserv Surg 2(2):116–122PubMedPubMedCentralCrossRefGoogle Scholar
  29. Hasselman CT, Best TM, Hughes C et al (1995) An explanation for various rectus femoris strain injuries using previously undescribed muscle architecture. Am J Sports Med 23(4):493–499PubMedCrossRefGoogle Scholar
  30. Hetsroni I, Larson CM, Dela Torre K et al (2012) Anterior inferior iliac spine deformity as an extra-articular source for hip impingement: a series of 10 patients treated with arthroscopic decompression. Arthroscopy 28(11):1644–1653PubMedCrossRefGoogle Scholar
  31. Heyworth BE, Shindle MK, Voos JE et al (2007 Dec) Radiologic and intraoperative findings in revision hip arthroscopy. Arthroscopy 23(12):1295–1302PubMedCrossRefGoogle Scholar
  32. Ho GW, Howard TM (2012) Greater trochanteric pain syndrome: more than bursitis and iliotibial tract friction. Curr Sports Med Rep 11(5):232–238PubMedCrossRefGoogle Scholar
  33. Holmich P (2007) Long-standing groin pain in sportspeople falls into three primary patterns, a “clinical entity” approach: a prospective study of 207 patients. Br J Sports Med 41(4):247–252PubMedPubMedCentralCrossRefGoogle Scholar
  34. Holmich P, Thorborg K, Dehlendorff C et al (2014) Incidence and clinical presentation of groin injuries in sub-elite male soccer. Br J Sports Med 48(16):1245–1250PubMedCrossRefGoogle Scholar
  35. Holmich P, Uhrskou P, Ulnits L et al (1999) Effectiveness of active physical training as treatment for long-standing adductor-related groin pain in athletes: randomised trial. Lancet 353(9151):439–443PubMedCrossRefGoogle Scholar
  36. Hrysomallis C (2009) Hip adductors’ strength, flexibility, and injury risk. J Strength Cond Res 23(5):1514–1517PubMedCrossRefGoogle Scholar
  37. IKobayashi H, Kaneko H, Homma Y et al (2015) Acute calcific tendinitis of the rectus femoris: a case series. J Orthop Case Rep 5(3):32–34PubMedGoogle Scholar
  38. Ilizaliturri VM Jr, Buganza-Tepole M, Olivos-Meza A et al (2014) Central compartment release versus lesser trochanter release of the iliopsoas tendon for the treatment of internal snapping hip: a comparative study. Arthroscopy 30(7):790–795PubMedCrossRefGoogle Scholar
  39. Ilizaliturri VM Jr, Camacho-Galindo J (2010 Jun) Endoscopic treatment of snapping hips, iliotibial band, and iliopsoas tendon. Sports Med Arthrosc 18(2):120–127PubMedCrossRefGoogle Scholar
  40. Ilizaliturri VM Jr, Martinez-Escalante FA, Chaidez PA, Camacho-Galindo J (2006) Endoscopic iliotibial band release for external snapping hip syndrome. Arthroscopy 22(5):505–510PubMedCrossRefGoogle Scholar
  41. Ilizaliturri VM Jr, Villalobos FE, Chaidez PA et al (2005) Internal snapping hip syndrome: treatment by endoscopic release of the iliopsoas tendon. Arthroscopy 21(11):1375–1380PubMedCrossRefGoogle Scholar
  42. Jankovic D, Peng P, van Zundert A (2013) Brief review: Piriformis syndrome: etiology, diagnosis, and management. Can J Anaesth 60(10):1003–1012PubMedCrossRefGoogle Scholar
  43. Jayaseelan DJ, Moats N, Ricardo CR (2013) Rehabilitation of proximal hamstring tendinopathy utilizing eccentric training, lumbopelvic stabilization, and trigger point dry needling: 2 case reports. J Orthop Sports Phys Ther 44(3):198–205PubMedCrossRefGoogle Scholar
  44. Johnston CA, Wiley JP, Lindsay DM et al (1998) Iliopsoas bursitis and tendinitis. A review. Sports Med 25(4):271–283PubMedCrossRefGoogle Scholar
  45. Joseph MF, Denegar CR (2015) Treating tendinopathy: perspective on anti-inflammatory intervention and therapeutic exercise. Clin Sports Med 34(2):363–374PubMedCrossRefGoogle Scholar
  46. Kagan A (1999) Rotator cuff tears of the hip. Clin Orthop Relat Res 368:135–140CrossRefGoogle Scholar
  47. Kaltenborn A, Bourg CM, Gutzeit A, Kalberer F (2014) The Hip Lag Sign-prospective blinded trial of a new clinical sign to predict hip abductor damage. PLoS One 9(3):e91560.ùCrossRefGoogle Scholar
  48. Kaux JF, Forthomme B, Le Goff C et al (2011) Current opinions on tendinopathy. J Sports Sci Med 10(2):238–253PubMedPubMedCentralGoogle Scholar
  49. Kaux JF, Samson A, Crielaard JM (2016 Feb) Hyaluronic acid and tendon lesions. Muscles Ligaments Tendons J 5(4):264–269PubMedPubMedCentralGoogle Scholar
  50. Khan M, Adamich J, Simunovic N et al (2013) Surgical management of internal snapping hip syndrome: a systematic review evaluating open and arthroscopic approaches. Arthroscopy 29(5):942–948PubMedCrossRefGoogle Scholar
  51. Leighton RD (2006) A functional model to describe the action of the adductor muscles at the hip in the transverse plane. Physiother Theory Pract 22(5):251–262PubMedCrossRefGoogle Scholar
  52. Lempainen L, Johansson K, Banke IJ et al (2015) Expert opinion: diagnosis and treatment of proximal hamstring tendinopathy. Muscles Ligaments Tendons J 5(1):23–28PubMedPubMedCentralGoogle Scholar
  53. Lempainen L, Sarimo J, Mattila K et al (2009) Proximal hamstring tendinopathy: results of surgical management and histopathologic findings. Am J Sports Med 37(4):727–734PubMedCrossRefGoogle Scholar
  54. Lequesne M, Mathieu P, Vuillemin-Bodaghi V et al (2008) Gluteal tendinopathy in refractory greater trochanter pain syndrome: diagnostic value of two clinical tests. Arthritis Rheum 59(2):241–246PubMedCrossRefGoogle Scholar
  55. Levangie PK, Norkin CC (2005) Joint structure and function: a comprehensive analysis, 4th edn. F.A. Davis Company, Philadelphia, PA, p 375Google Scholar
  56. Lyons JC, Peterson LF (1984 May) The snapping iliopsoas tendon. Mayo Clin Proc 59:327–329PubMedCrossRefGoogle Scholar
  57. Malanga G, Nakamura R (2014 Nov) The role of regenerative medicine in the treatment of sports injuries. Phys Med Rehabil Clin N Am 25(4):881–895PubMedCrossRefGoogle Scholar
  58. Mani-Babu S, Morrissey D, Waugh C et al (2015) The effectiveness and dose-response relationship of extracorporeal shock wave therapy in lower limb tendinopathy: a systematic review. Am J Sports Med 43(3):752–761PubMedCrossRefGoogle Scholar
  59. Mendiguchia J, Alentorn-Geli E, Idoate F, Myer GD (2013 Apr) Rectus femoris muscle injuries in football: a clinically relevant review of mechanisms of injury, risk factors and preventive strategies. Br J Sports Med 47(6):359–366PubMedCrossRefGoogle Scholar
  60. Michel F, Decavel P, Toussirot E et al (2013) The piriformis muscle syndrome: an exploration of anatomical context, pathophysiological hypotheses and diagnostic criteria. Ann Phys Rehabil Med 56(4):300–311PubMedCrossRefGoogle Scholar
  61. Miller SL, Gill J, Webb GR (2007) The proximal origin of the hamstrings and surrounding anatomy encountered during repair. A cadaveric study. J Bone Joint Surg Am 89(1):44–48PubMedGoogle Scholar
  62. Morelli V, Espinoza L (2005) Groin injuries and groin pain in athletes: part 2. Prim Care 32(1):185–200PubMedCrossRefGoogle Scholar
  63. Morelli V, Weaver V (2005) Groin injuries and groin pain in athletes: part 1. Prim Care 32(1):163–183PubMedCrossRefGoogle Scholar
  64. Moriguchi CS, Carnaz L, Silva LC et al (2009) Reliability of intra- and inter-rater palpation discrepancy and estimation of its effects on joint angle measurements. Man Ther 14(3):299–305PubMedCrossRefGoogle Scholar
  65. Mulligan EP, Middleton EF, Brunette M (2015) Evaluation and management of greater trochanter pain syndrome. Phys Ther Sport 16(3):205–214PubMedCrossRefGoogle Scholar
  66. Nicholas SJ, Tyler TF (2002) Adductor muscle strains in sport. Sports Med 32(5):339–344PubMedCrossRefGoogle Scholar
  67. Ouellette H, Thomas BJ, Nelson E, Torriani M (2006) MR imaging of rectus femoris origin injuries. Skelet Radiol 35(9):665–672CrossRefGoogle Scholar
  68. Pecina HI, Boric I, Smoljanovic T et al (2008) Surgical evaluation of magnetic resonance imaging findings in piriformis muscle syndrome. Skelet Radiol 37(11):1019–1023CrossRefGoogle Scholar
  69. Pesquer L, Poussange N, Sonnery-Cottet B et al (2016) Imaging of rectus femoris proximal tendinopathies. Skelet Radiol 45(7):889–897CrossRefGoogle Scholar
  70. Polesello GC, Queiroz MC, Domb BG et al (2013) Surgical technique: endoscopic gluteus maximus tendon release for external snapping hip syndrome. Clin Orthop Relat Res 471(8):2471–2476PubMedCrossRefGoogle Scholar
  71. Rankin AT, Bleakley CM, Cullen M (2015) Hip joint pathology as a leading cause of groin pain in the sporting population: a 6-year review of 894 cases. Am J Sports Med 43(7):1698–1703PubMedCrossRefGoogle Scholar
  72. Reich MS, Shannon C, Tsai E, Salata MJ (2013) Hip arthroscopy for extra-articular hip disease. Curr Rev Musculoskelet Med 6(3):250–257PubMedPubMedCentralCrossRefGoogle Scholar
  73. Reid D (2016) The management of greater trochanteric pain syndrome: a systematic literature review. J Orthop 13(1):15–28PubMedPubMedCentralCrossRefGoogle Scholar
  74. Reiman MP, Goode AP, Hegedus EJ et al (2013) Diagnostic accuracy of clinical tests of the hip: a systematic review with meta-analysis. Br J Sports Med 47(12):893–902PubMedCrossRefGoogle Scholar
  75. Reiman MP, Mather RC III, Cook CE (2015) Physical examination tests for hip dysfunction and injury. Br J Sports Med 49(6):357–361PubMedCrossRefGoogle Scholar
  76. Robinson DR (1947) Piriformis syndrome in relation to sciatic pain. Am J Surg 73(3):355–358PubMedCrossRefGoogle Scholar
  77. Rompe JD, Segal NA, Cacchio A et al (2009) Home training, local corticosteroid injection, or radial shock wave therapy for greater trochanter pain syndrome. Am J Sports Med 37(10):1981–1989PubMedCrossRefGoogle Scholar
  78. de SA D, Hölmich P, Phillips M et al (2016) Athletic groin pain: a systematic review of surgical diagnoses, investigations and treatment. Br J Sports Med 50(19):1181–1186PubMedCrossRefGoogle Scholar
  79. Saikku K, Vasenius J, Saar P (2010) Entrapment of the proximal sciatic nerve by the hamstring tendons. Acta Orthop Belg 76(3):321–324PubMedGoogle Scholar
  80. Schuett DJ, Bomar JD, Pennock AT (2015) Pelvic apophyseal avulsion fractures: a retrospective review of 228 cases. J Pediatr Orthop 35(6):617–623PubMedCrossRefGoogle Scholar
  81. Segal NA, Felson DT, Torner JC et al (2007) Greater trochanteric pain syndrome: epidemiology and associated factors. Arch Phys Med Rehabil 88(8):988–992PubMedPubMedCentralCrossRefGoogle Scholar
  82. Serner A, Tol JL, Jomaah N et al (2015) Diagnosis of acute groin injuries: a prospective study of 110 athletes. Am J Sports Med 43(8):1857–1864PubMedCrossRefGoogle Scholar
  83. Silva F, Adams T, Feinstein J et al (2008) Trochanteric bursitis: refuting the myth of inflammation. J Clin Rheumatol 14(2):82–86PubMedCrossRefGoogle Scholar
  84. Snijders CJ, Hermans PFG, Kleinrensink GJ (2006) Functional aspects of cross-legged sitting with special attention to piriformis muscles and sacroiliac joints. Clin Biomech 21(2):116–121CrossRefGoogle Scholar
  85. Strauss EJ, Nho SJ, Kelly BT (2010) Greater trochanteric pain syndrome. Sports Med Arthrosc 18(2):113–119PubMedCrossRefGoogle Scholar
  86. Tatu L, Parratte B, Vuillier F et al (2001) Descriptive anatomy of the femoral portion of the iliopsoas muscle. Anatomical basis of anterior snapping of the hip. Surg Radiol Anat 23(6):371–374PubMedCrossRefGoogle Scholar
  87. Verrall GM, Slavotinek JP, Barnes PG et al (2005) Description of pain provocation tests used for the diagnosis of sports-related chronic groin pain: relationship of tests to defined clinical (pain and tenderness) and MRI (pubic bone marrow oedema) criteria. Scand J Med Sci Sports 15(1):36–42PubMedCrossRefGoogle Scholar
  88. Walsh MJ, Walton JR, Walsh NA (2011) Surgical repair of the gluteal tendons. A report of 72 cases. J Arthroplast 26(8):1514–1519CrossRefGoogle Scholar
  89. Watanabe W, Sato K, Itoi E et al (2002) Posterior pelvic tilt in patients with decreased lumbar lordosis decreases acetabular femoral head covering. Orthopedics 25(3):321–324PubMedGoogle Scholar
  90. Weir A, Hölmich P, Schache AG et al (2015 Jun) Terminology and definitions on groin pain in athletes: building agreement using a short Delphi method. Br J Sports Med 49(12):825–827PubMedPubMedCentralCrossRefGoogle Scholar
  91. Werner J, Hägglund M, Waldén M et al (2009) UEFA injury study: a prospective study of hip and groin injuries in professional football over seven consecutive seasons. Br J Sports Med 43(13):1036–1040PubMedCrossRefGoogle Scholar
  92. Wetzel RJ, Patel RM, Terry MA (2013) Platelet-rich plasma as an effective treatment for proximal hamstring injuries. Orthopedics 36(1):e64–e70PubMedCrossRefGoogle Scholar
  93. Yen YM, Lewis CL, Kim YJ (2015) Understanding and treating the snapping hip. Sports Med Arthrosc 23(4):194–199PubMedPubMedCentralCrossRefGoogle Scholar
  94. Yoshio M, Murakami G, Sato T et al (2002) The function of the psoas major muscle: passive kinetics and morphological studies using donated cadavers. J Orthop Sci 7(2):199–207PubMedCrossRefGoogle Scholar
  95. Zhou Y, Wang JH (2016) PRP treatment efficacy for tendinopathy: a review of basic science studies. Biomed Res Int 2016:9103792PubMedPubMedCentralGoogle Scholar
  96. Zini R, Panascì M, Papalia R et al (2014) Rectus femoris tendon calcification: arthroscopic excision in 6 top amateur athletes. Orthop J Sports Med 2(12):2325967114561585PubMedPubMedCentralCrossRefGoogle Scholar
  97. Zissen MH, Wallace G, Steven KJ et al (2010) High hamstring tendinopathy: MRI and ultrasound imaging and therapeutic efficacy of percutaneous corticosteroid injection. AJR Am J Roentgenol 195(4):993–998PubMedCrossRefGoogle Scholar

Copyright information

© ISAKOS 2017

Authors and Affiliations

  • Alessandro Aprato
    • 1
    Email author
  • Andrea D’Amelio
    • 1
  • Alessandro Bistolfi
    • 1
  • Luigi Sabatini
    • 1
  • Alessandro Massè
    • 1
  1. 1.Università degli Studi di Torino, S.C.D.U. Ortopedia e Traumatologia 1AOU Città della Salute e della Scienza di TorinoTorinoItaly

Personalised recommendations