Tendonitis involves the swelling of the tendons. Tendons are thick cords of soft tissue which connect the bone and muscle.
Hip flexor tendonitis refers to the swelling of the tendon sheaths of the rectus and/or iliopsoas.
A hip flexor strain is a tear in the muscles, and these tears can be categorized from mild to severe:
- Grade I Tear: This is a minor tear with damage to a few fibers only.
- Grade II Tear: Multiple muscle fibers sustain damage, and the patient has a moderate hip flexor function loss.
- Grade III Tear: The muscle tears or ruptures completely, and the patient is unable to walk without limping. In a few cases, orthopedic surgery may be required.
Southern California Hip Institute (SCHI), led by board certified orthopedic surgeon Dr. Tigran Garabekyan, provides safe and proven treatments for the hip, knee and shoulder to patients in Los Angeles, Century City, CA, and surrounding locations.
Diagnosis and Examination
At the outset, a musculoskeletal expert should complete a health history and physical exam. The doctor may order diagnostic imaging tests such as x-rays or MRI to rule out the possibility of other conditions. The patient may undergo an EMG to rule out nerve compression. The doctor may also recommend an image-guided injection.
Mild stretching exercises can help in the reduction of hip flexor muscle tension and the possibility of an injury in the future. The patient can try these hip flexor stretches but ensure that they are not too vigorous as these stretches must be gentle.
The application of moist heat and warming up the muscles with a gentle walk for around three minutes prior to stretching can help reduce the risk of a hip flexor strain.
Psoas Tendonitis Treatment
Psoas tendinopathy, also known as tendonitis, refers to the swelling and/or partial tearing of the psoas tendon. This tendon is located deep within the hip joint connected to the lesser trochanter (a tiny bony prominence adjacent to the hip).The psoas is a vital hip flexor.
If the tendon becomes irritated or inflamed, it can lead to hip pain. This pain is typically felt in the inner thigh or groin. Furthermore, the psoas may also become swollen after a total hip replacement.
The treatment goals will include a reduction in pain and swelling, preservation or mobility, and prevention of recurrence and disability.
The doctor may recommend a combination of physiotherapy, massages, rest, cold application, and heat to address this condition. Advanced treatment options include:
- Non-steroidal anti-inflammatory medications, such as naproxen or ibuprofen
- PRP (Protein Rich Plasma) or Corticosteroid injections administered by the patient’s medical care provider. The injections rapidly reduce the swelling and pain.
- Physical therapy including a range of stretches, motion exercises, and hydrotherapy can be quite beneficial.
When other treatment options are ineffective, only then orthopedic surgery may be recommended. Arthroscopic (keyhole surgery) psoas tenotomy can effectively treat Recalcitrant psoas tendinopathy.
This procedure lengthens the tendon enabling it to heal in a lengthened position within the tendon sheath. This inhibits tendon irritation. A local anesthetic is injected around the wound prior to the procedure to ensure that the patient remains comfortable.
Recovery after Psoas Tenotomy
The wound may take between seven to ten days to heal. A majority of patients experience dramatic improvements within the initial six weeks. At times, there are periods in which the hip feels sore and then resettles.
This is nothing to be alarmed about and is a part of the normal healing process. It takes around three months for the hip to heal following a hip arthroscopy procedure.
Dr. Tigran Garabekyan is a board certified orthopedic surgeon specializing in hip preservation. To learn more about Southern California Hip Institute or to schedule a consultation, click here to contact us or call:
Century City / Los Angeles: 310.595.1030
Serving patients in Encino, Sherman Oaks, Van Nuys, North Hollywood, Burbank, Glendale, West Hollywood, Century City, Beverly Hills, Santa Monica, Los Angeles, and other neighboring cities in the greater Los Angeles, California area.
Also visit http://www.drgorthopedics.com/