Hip Tendon Injuries

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Dr Kau Chung Yuan (许医生)


MRCS (Ireland)

MMed (Ortho)

FRCSEd (Ortho)


What are Hip Tendon Injuries?

Hip tendon injuries refer to damage or strain in the tendons surrounding the hip joint.  Tendons are strong, fibrous tissues that connect muscles to bones, playing a crucial role in facilitating movement. In the hip, they are integral to the stability and mobility of the joint, allowing for activities such as walking, running, and jumping.

These injuries can range from mild strains to severe tears and can occur due to a variety of factors, including overuse, acute injury, or degenerative conditions. They often result in pain, reduced mobility, and a decrease in the ability to perform everyday activities effectively.

Common Types of Hip Tendon Injuries

The hip joint is susceptible to various tendon injuries, each with distinctive characteristics. The most prevalent types include:

  • Trochanteric Bursitis
    This condition involves inflammation of the bursa near the greater trochanter, often occurring alongside tendinitis. It is typically caused by repetitive friction or direct pressure on the area, leading to pain and discomfort around the hip.
  • Tendinopathy
    Commonly affecting the iliopsoas or gluteal tendons, hip tendinopathy is marked by tendon degeneration due to chronic overuse. Athletes and individuals engaging in repetitive hip activities are more prone to this condition, which develops gradually.
  • Hip Flexor Strain
    Strains or tears in the hip flexors, especially the iliopsoas muscle, arise from sudden movements involving hip flexion or excessive stretching. This injury is prevalent in sports and activities requiring quick hip movements.
  • Snapping Hip Syndrome (Coxa Saltans)
    Characterised by a tendon snapping over a bony prominence in the hip, this condition often produces a noticeable ‘snap’ during certain movements. While it can be painless, some individuals may experience discomfort or pain.

Causes of Hip Tendon Injuries

Hip tendon injuries can result from a variety of factors, often involving a combination of internal and external elements. Key causes include:

Overuse and Repetitive Stress

Frequent and repetitive activities, especially those involving the hip joint, can lead to overuse injuries. Athletes, dancers, and individuals in occupations requiring repetitive hip motions are particularly at risk.

Acute Trauma or Injury

Sudden impacts or accidents, such as falls, direct blows to the hip, or abrupt movements during sports, can cause immediate tendon damage.

Age-Related Degeneration

As individuals age, tendons can lose their elasticity and strength, making them more susceptible to injuries. This degeneration is a common cause of tendon injuries in older adults.

Improper Technique or Equipment Use

Incorrect posture or technique during physical activities and sports, as well as using inappropriate equipment, can increase the risk of hip tendon injuries.

Underlying Medical Conditions

Conditions such as arthritis, gout, or infections, can weaken tendons and make them more prone to injuries.


The symptoms of hip tendon injuries can vary depending on the type and severity of the injury. Common signs include:

  • Pain and Tenderness: One of the most notable symptoms is pain in the hip area, which may worsen with activity or when pressure is applied.
  • Swelling and Inflammation: Injured tendons can lead to swelling around the hip joint, often accompanied by inflammation.
  • Reduced Range of Motion: Individuals may experience a decrease in their ability to move the hip joint, particularly in certain directions.
  • Stiffness: Morning stiffness or stiffness after periods of inactivity is common.
  • Weakness: The affected hip may feel weaker, impacting the ability to perform certain activities.
  • Audible Snapping or Popping Sounds: Particularly in cases of snapping hip syndrome, individuals might hear snapping or popping sounds during movement.

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Diagnosing hip tendon injuries involves a combination of clinical assessment and imaging techniques. The process typically includes:

  • Medical History And Physical Examination
    A detailed medical history is taken, focusing on the onset of symptoms, activity levels, and any history of hip problems. The physical examination assesses pain, swelling, range of motion, and strength in the hip.
  • Imaging Tests
    Imaging techniques such as X-rays can rule out bone-related problems, while MRI (Magnetic Resonance Imaging) and ultrasound are more effective in visualising soft tissue injuries like tendon damage.
  • Movement Tests
    Specific tests that involve moving the hip joint can help pinpoint the injured tendon and assess the severity of the injury.
  • Differential Diagnosis
    It is important to differentiate hip tendon injuries from other conditions that can cause similar symptoms, such as arthritis or hip fractures.

Non-Surgical Treatment Options

The initial approach to treating hip tendon injuries typically involves non-surgical methods, focusing on alleviating symptoms and promoting healing. These include:

  • Rest and Activity Modification: Essential in the early stages to prevent further injury. Activities that exacerbate the pain should be avoided, and a gradual return to normal activities is recommended as symptoms improve.
  • Pain Management: Over-the-counter pain relievers like ibuprofen or acetaminophen are often used to reduce pain and inflammation. In some cases, prescription pain medications may be necessary.
  • Physical Therapy: Customised exercises and therapy can help strengthen the muscles around the hip, improve flexibility, and decrease stress on the injured tendon.
  • Corticosteroid Injections: Used to reduce severe inflammation. These injections provide temporary pain relief but are generally used sparingly due to potential side effects.

Surgical Treatment Options

Surgery is considered when non-surgical treatments fail to provide relief or in cases of severe tendon damage. Surgical options include:

Tendon Repair

Involves surgically repairing the torn or damaged tendon. This is more common in cases of acute tears or severe degeneration.

Tendon Reconstruction

In cases where the tendon is severely damaged, reconstruction using a graft from another tendon may be necessary.

Debridement and Repair

For tendinopathy, the surgeon may remove the damaged tissue and repair the remaining tendon.


In some cases, releasing tension in the tendon through a procedure called tenotomy is beneficial.


Dr. Kau Chung Yuan

MBBS (S’pore)

MRCS (Ireland)

MMed (Ortho)

FRCSEd (Ortho)

Dr Kau (许医生) is a Fellowship trained Orthopaedic Surgeon with a subspecialty interest in Hip and Knee surgery and has been in practice for more than 15 years.

He is experienced in trauma and fracture management, sports injuries, and joint replacement surgery.

  • Fellow of the Royal College of Surgeons Edinburgh, Orthopaedics (FRCS, Edin) 2014
  • Master of Medicine (Orthopaedics), Singapore (MMed) 2013
  • Member of the Royal College of Surgeons Ireland (MRCS, Ire) 2009
  • Bachelor of Medicine and Surgery (MBBS, Singapore) 2004

Prevention Strategies

Preventing hip tendon injuries involves a combination of lifestyle modifications, exercise techniques, and awareness. Key strategies include:

  • Proper Warm-Up and Cool-Down
    Engaging in adequate warm-up exercises before physical activity and cool-down routines afterwards can help prepare the muscles and tendons for exertion and reduce the risk of injury.
  • Strength and Flexibility Training
    Regular exercises that strengthen the muscles around the hip and improve flexibility can decrease the stress on the tendons.
  • Correct Technique and Posture
    Learning and maintaining proper technique and posture during activities, especially sports and exercises, can prevent undue strain on the hip tendons.
  • Use of Appropriate Equipment
    Ensuring that any equipment used, such as athletic shoes, is suitable for the specific activity and fits well can help in injury prevention.
  • Gradual Increase in Activity Levels
    Avoid sudden increases in the intensity, duration, or frequency of activities. Gradually building up allows the tendons to adapt and strengthen.
  • Maintaining a Healthy Weight
    Extra weight can put additional stress on the tendons. Maintaining a healthy weight helps reduce this strain.
  • Regular Breaks and Rest
    Taking breaks during prolonged activities and ensuring adequate rest can prevent overuse injuries.

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Patient Feedback

Ethan Chan
Dr. Kau is an exemplary doctor who is experienced in his field and is very patient with his patients. He walked me through the details of my knee condition and addressed all my concerns. Thanks to Dr. Kau, I had a better understanding of my ACL and MCL injury and the various treatment options available. His advice and treatment have been very valuable to me.
Ming Lee Chua
Dr Kau was very careful and explained clearly the surgery procedures. After surgery, the care while I was in hospital was closely monitored and he even came during weekends! The hip so far has recovered and healed. His ‘predictions’ of when what can happen are so accurate. Trust him.
Teo Pek Suan Diana
I had a very successful total hip replacement done by Dr Kau 4 years ago. 4 months after the operation I was back walking, cycling and swimming. The beautiful job gave me much confidence Dr Kau is most professional and has such great doctor patient communication.

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    Frequently Asked Questions (FAQs)

    Can hip tendon injuries heal on their own?

    Some minor hip tendon injuries may heal with appropriate rest and care, but medical consultation is advised to assess the need for intervention. For more severe injuries, such as significant tears or chronic tendinopathy, medical intervention is usually required for effective healing. This may include physical therapy, targeted exercises, or, in some cases, surgical repair.

    How long does it take to recover from a hip tendon injury?

    The recovery time for a hip tendon injury varies significantly based on the injury’s severity and the individual’s overall health and response to treatment. For minor injuries, such as slight strains or mild tendinopathy, recovery can take a few weeks to a couple of months, provided the injury is managed correctly with rest, physical therapy, and a gradual return to activity.

    More severe injuries, including complete tears or advanced tendinopathy, may require several months to heal fully, and this process could be longer if surgery is necessary.

    Is surgery always necessary for hip tendon injuries?

    Surgery is not a universal requirement for hip tendon injuries. Many of these injuries, especially those that are less severe, can be effectively managed with non-surgical treatments such as physical therapy, rest, pain management, and other conservative methods.

    Surgical intervention is typically considered a last resort, reserved for cases where conservative treatments have failed to provide relief or improve function, or in situations involving severe tendon damage, such as complete tears or significant degeneration. Consult your orthopaedic surgeon for advice on treatment options best suited for you.

    Can hip tendon injuries recur?

    There is a risk of recurrence with hip tendon injuries, especially if the factors contributing to the initial injury are not adequately addressed. Recurrence is more likely in cases of chronic overuse or repetitive strain, improper healing from a previous injury, or failure to modify risk factors such as poor biomechanics, inadequate equipment, or insufficient strength and flexibility.