Deep hip rotator overload – “So that explains it!”

Deep hip muscle pain
  • Deep hip rotator overload causes a diffuse deep hip muscle pain, felt centrally in the buttock
  • It is caused by excessive fatigue of one or more of the six small muscles that sit underneath the gluteal muscles and rotate the hip laterally (outwards)
  • Soreness often peaks the day after exercise and causes pain on stretching (eg. sitting) and activation (eg. squats, walking upstairs)

TIPS

  • Stretching can be effective ONLY if it’s gentle and comfortable!
    • As the muscles involved are very short, they go from mild stretch to over-stretched very quickly
  • A trigger point ball is more effective than a foam roller as the muscles are positioned in a bony recess and are hard to access with the broader surface of a roller
  • This is one of those injuries that you can actually “run it out”, kinda
    • Overloading the muscles or generating fatigue will make it worse but gentle exercise including easy yoga, walking and small amounts of light jogging can help gently stretch the muscles and relieve soreness

MYTHS

  • Trigger point pressures shouldn’t be painful – harder pressure isn’t better
    • Firm pressure can be uncomfortable but if you perceive it as pain, the protective response from the brain is to activate and tighten the muscle to avoid damage. So it’ll actually have the opposite effect and worsens the issue
  • Strength exercises are not a solution for muscles that are already overloaded
    • We can always be stronger but strengthening these muscles while they’re fatigued and sore will only worsen the pain and extend your recovery
  • Ice and heat are ineffective
    • The muscles are too deep to be affected by the thermal effects of ice and heat, so the best they can do is distract you from the deeper pain

WHAT ELSE COULD IT BE?

  • Bone stress – this can cause deep hip “muscle” pain similar to sacral and hip bone stress injuries, although those injuries behave differently in response to loading
  • Low back pain – lumbar pain can refer into the buttock and may worsen after exercise
  • Sciatica – Sciatic nerve irritations may be felt in the buttock but commonly progress to pain spreading down the leg
  • Muscle tear – a tear of any buttock muscle can occur with the same overload but it’s often associated with sharp pain on initial loading

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