A hip abductor tear is a common source of pain located on the outer side of the hip, which can significantly limit mobility and daily activities. This condition involves the tendons that attach the powerful stabilizing muscles of the pelvis to the upper thigh bone. This type of tear is frequently misdiagnosed, often initially mistaken for simple bursitis, making accurate identification a necessary first step toward effective management.
Understanding the Hip Abductor Muscles and Tears
The hip abductor group is comprised mainly of the gluteus medius and gluteus minimus muscles, which act as the primary stabilizers of the pelvis. These muscles exert force to keep the pelvis level when standing on one leg, a function that is performed repeatedly during walking and running. The tendons of these muscles attach directly onto the greater trochanter, the prominent bony bump located on the side of the upper femur or thigh bone.
When an injury occurs, it is typically the tendon structure at this attachment site that sustains damage, often referred to as a “rotator cuff tear of the hip.” Injuries can range from tendinopathy, which is chronic degeneration, to an actual tear of the tendon fibers. Tears are categorized by their extent: a partial-thickness tear involves only some of the tendon fibers, while a full-thickness tear means the tendon has completely ruptured from the bone.
Recognizing Symptoms, Causes, and Diagnosis
The most recognizable symptom of a hip abductor tear is persistent pain on the outside of the hip, known as lateral hip pain, which may radiate down the thigh. This discomfort is often aggravated by activities that strain the muscle, such as climbing stairs, walking for long distances, or standing for prolonged periods. Many individuals also report difficulty sleeping, as lying on the affected side can place direct pressure on the injured tendons.
A noticeable weakness or an altered walking pattern, sometimes referred to as a Trendelenburg gait, is another common sign. This gait involves the pelvis dropping toward the unaffected side when the injured leg is bearing weight, a visible manifestation of the weakened stabilizing muscles. Tears can result from an acute traumatic event, such as a fall, but they are more commonly the result of chronic degeneration and repetitive micro-trauma, often seen in older individuals.
Diagnosis begins with a thorough physical examination, where a doctor will perform specific strength tests and palpate the area for tenderness over the greater trochanter. If a tear is suspected, imaging is necessary to confirm the injury and determine its extent. Magnetic Resonance Imaging (MRI) is considered the most accurate method for visualizing the soft tissues of the hip and characterizing the tear as partial or full-thickness.
Non-Surgical Treatment Pathways
For most mild-to-moderate hip abductor tears, particularly partial-thickness injuries, a conservative, non-surgical approach is the initial management strategy. This pathway prioritizes reducing inflammation, managing pain, and restoring muscle function. Rest and activity modification are necessary first steps to prevent further strain on the injured tendon, which may include temporarily using an assistive device like a cane.
Non-steroidal anti-inflammatory drugs (NSAIDs) are often used to help control pain and inflammation associated with the tear. The primary component of non-operative care is a physical therapy program. Physical therapy focuses on a progressive strengthening regimen for the gluteal muscles and the surrounding core stabilizers to improve hip stability and normalize the walking pattern.
When pain is severe and limits participation in physical therapy, injectable treatments may be considered to accelerate healing and reduce discomfort. Corticosteroid injections, delivered under ultrasound guidance, can provide temporary pain relief by reducing local inflammation, which allows the patient to engage more effectively in rehabilitation exercises. Alternatively, Platelet-Rich Plasma (PRP) injections, which use the patient’s own platelets to stimulate natural healing, are reserved for patients who have not responded to initial conservative measures.
Surgical Repair and Rehabilitation Timeline
Surgery is typically reserved for full-thickness tears, large partial tears that have failed conservative management, or tears that have significantly retracted from the bone. The goal of the procedure is to reattach the torn tendon securely back to its insertion point on the greater trochanter. This can be accomplished through either a minimally invasive arthroscopic technique or a traditional open surgical approach, depending on the tear’s complexity and chronicity.
Post-operative recovery for a hip abductor repair is extensive. A period of restricted weight-bearing is immediately required, often lasting six to eight weeks, during which the patient uses crutches or a walker to protect the healing tendon. Active hip abduction and passive hip adduction must be strictly avoided for the first six weeks to prevent undoing the surgical repair.
Formal physical therapy usually begins cautiously during this initial non-weight-bearing period, focusing on gentle range-of-motion exercises and isometric strengthening of surrounding muscles. The transition to full weight-bearing and more intensive strengthening occurs gradually after the first two months. A return to unrestricted activities and sports can take six months or longer, ensuring the tendon has fully integrated and muscle strength is restored.