Hip Abductor Dysfunction Symptoms and Treatment

The hip joint is made up of a ball and socket joint. The bones are supported by multiple ligaments, tendons, and muscles that provide stability to the joint and allow movement. 

One movement that the muscles perform is called hip abduction. Abduction involves moving the hip joint away from the body, such as lifting your leg sideways. Hip abduction is performed by three main muscles: gluteus medius, gluteus minimus, and the tensor fascia latae. These muscles also work together to stabilize the hip while walking or standing on one leg. 

When these muscles are not working properly, they can cause hip and knee pain. Other orthopedic problems such as IT band syndrome, trochanteric bursitis, and patellofemoral knee pain can also be linked to weakness and dysfunction of the hip abductors.

Hip Abductor Dysfunction Symptoms

Symptoms of abductor dysfunction can include the following:

• Deep buttock pain that is worse with sitting or lying on your side
• One or both of your hips swinging to the side with walking
• Pain to the outside or back of the hip
• Difficulty performing physical activities such as running
• Pain to the front of the knee, behind the knee cap
• Knee on the affected side will cave in during squatting activities

Diagnosing Hip Abductor Dysfunction

Abductor dysfunction can usually be diagnosed based on your physical exam. Patients may have a positive “Trendelenburg Sign” while walking. This is when one side of your pelvis drops below horizontal. You may have tenderness along the hip abductor muscles, sometimes with palpable muscle trigger points. Patients are usually weak with strength testing of the hip abductor muscles.

An MRI is sometimes ordered to confirm the diagnosis and rule out any other possible causes for your symptoms. If symptoms have been going on for a long time, some patients may develop changes in the abductor tendons. The MRI can sometimes show irritation around the hip abductor muscles, but it can also look normal. This does not necessarily mean that nothing is wrong with your hip. Many patients with hip abductor dysfunction have difficultly activating the muscles properly, which would not show any abnormalities on an MRI.

Rarely, an MRI can show more severe changes in the abductor tendons. These can include partial or complete tearing of the tendons. This can be a reason as to why patients do not progress with conservative treatment.

Hip Abductor Dysfunction Treatment

Hip-focused physical therapy is the main course of action for the treatment of hip abductor dysfunction. Stretching and strengthening the muscles of the back, core and hip will help the abductor muscles work properly. Therapy is typically ordered for at least six to eight weeks, but depends on the severity of the muscle dysfunction.

If your pain is too severe to tolerate therapy, we may recommend an injection of a strong anti-inflammatory called cortisone. Cortisone can help calm down a trigger point in a muscle and “reset” the muscle to help get it out of a dysfunctional pattern. The injection is done using ultrasound to guide the needle and medication to the right location.

Unless there is another underlying cause for your symptoms, surgery is not needed for abductor dysfunction. If abductor tendon tearing is the cause of your dysfunction, you may need minimally invasive or open surgery to repair the injury to the tendons.