Radiating pain from the hip muscles

Many people may have pain radiating down the leg, yet when they go to hospital, X-rays and MRI scans show nothing wrong with the back or the nerves. So what causes hip pain that radiates down the leg?

Pain radiating down the leg is sometimes not caused by the back or by a nerve injury, but by the hip or buttock muscles. Let's get to know the hip muscles.   

The hip is made up of many muscles. We will divide the muscles around the hip by function into 3 groups, including the hip extensor group and the hip abductor group,  as follows.

Hip extensor group

This group consists of just one muscle, the gluteus maximus. It is the largest and heaviest of all the hip muscles and has the coarsest muscle fibres. It is also the largest muscle in the body and is roughly triangular in shape.

Attachments of the gluteus maximus

Origin : the lower posterior part of the iliac crest, the posterior surface of the sacrum and coccyx (tailbone), and the sacrotuberous ligament

Insertion : the iliotibial band of the fascia lata and the gluteal tuberosity

Function : its main function is hip extension. During normal walking, the gluteus maximus helps rotate the thigh outwards. This muscle works little when standing, but works hard when running or climbing stairs. 

(Function : Extension , External rotation , and some abduction of the hip joint)

Referred pain of Gluteus maximus

A trigger point (a painful or tender spot that refers pain) in the gluteus maximus can cause pain that radiates through the body, as shown in the picture.

Hip abductor group

This group consists of 2 muscles, Gluteus medius and Gluteus minimus. They are smaller than the gluteus maximus, fan-shaped, with muscle fibres running in the same direction, and lie deep to the gluteus maximus on the outer surface of the ilium. They abduct the thigh and rotate the leg inwards, and play an important role in movement, especially in stabilising the pelvis when walking.

Attachments of the gluteus medius

Origin : the outer surface of the ilium

Insertion : the greater trochanter of the femur (thigh bone)

Function : abducts the thigh and rotates the thigh inwards

(Function: Hip abduction and internal rotation; maintains level pelvis in single-limb stance)

Referred pain of Gluteus medius

A trigger point (a painful or tender spot that refers pain) in the gluteus medius can cause pain that radiates through the body, as shown in the picture.

The gluteus minimus is the smallest of the hip muscles. It works in a similar way to the gluteus medius.

Attachments of the gluteus minimus

Origin : the outer surface of the ilium

Insertion : anterior surface of the greater trochanter of the femur (thigh bone)

Function : abducts the hip joint and thigh, and rotates the thigh inwards

(Function: Hip abduction and internal rotation; maintains level pelvis in single-limb stance)

Referred pain of Gluteus minimus

A trigger point (a painful or tender spot that refers pain) in the gluteus minimus can cause pain that radiates through the body, as shown in the picture.

Hip muscle stretches

1. Knee to the opposite shoulder

How to do it : Lie on your back and lift the leg you want to stretch. Hold the knee with your hands and pull it towards the opposite shoulder, as shown in the picture, until you feel a stretch in the buttock but no pain. Hold for 15–20 seconds and repeat 5 times.

2. Figure 4 stretching 

How to do it : Lie on your back with both knees bent. Cross the leg you want to stretch over the other to form a figure 4, as shown in the picture. Then hold under the knee with both hands and pull the legs towards your chest until you feel a stretch in the buttock but no pain. Hold for 15–20 seconds and repeat 5 times (do not lift your head or shoulders).

3.  Foam Roller 

How to do it : Place a foam roller under your buttock, then press down with your body weight and roll back and forth to release the tight muscles, as shown in the picture.

REHAB CARE CLINIC
Hip pain may also be caused by the tendon attachments of the hip muscles. An ultrasound machine can be used to scan the painful area and the tendon attachments to look for abnormalities such as calcification of the tendons, inflammation of the bursae around the tendons, tendon degeneration or tendon tears. Ultrasound can also be used to guide injections accurately, precisely on target and with a high level of safety.

The picture shows the tendon attachment of the gluteus medius and the bursa around the muscle 
on ultrasound

For more information, contact "Rehab Care Clinic"
Address: 423 Phetkasem Road, Bang Wa, Phasi Charoen, Bangkok (inside Kanari Sports Center, before Seacon Bang Khae) ? 061-801-2482 Line ID : @rehabcare