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Hip abductor muscle volume in women with lateral hip pain: a case-controlled study

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Abstract

Pathology of the hip abductor muscles and their associated tendons is implicated in the aetiology of lateral hip pain (LHP). Muscle atrophy is an important factor to consider in the diagnosis of this condition as it could result in reduced muscle volume and associated decreases in strength.

Purpose

(1) To estimate the volumes of the gluteus medius (GMed), gluteus minimus (GMin) and tensor fascia lata (TFL) muscles, and (2) to examine pathological changes of the soft tissues in the vicinity of the hip joint, in women with and without LHP.

Methods

Twenty female participants (10 with LHP and 10 age-matched controls) underwent magnetic resonance imaging. Two radiologists reviewed the images for signs of pathological changes. Hip abductor muscle volumes were estimated using cross-sectional areas and Cavalieri’s method. Differences in volume between sides, study groups and the three muscles were assessed.

Results

The volume of GMed was the largest (292.5 ± 33.3 cm3), followed by GMin (82.1 ± 12.1 cm3), then TFL (49.7 ± 18.9 cm3). No differences were evident in the volumes of the hip abductor muscles in individuals with LHP when compared to age- and sex-matched controls (GMed, p = 0.30; GMin, p = 0.40; TFL, p = 0.90). Pathology of the soft tissues was not specific to the symptomatic hips.

Conclusions

Novel muscle volume data are presented for GMed, GMin and TFL in the context of LHP. Further research is needed to determine if symptom severity and duration have an impact on the extent of muscle atrophy in this population.

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Abbreviations

AControl:

The hip of a control participant matched to the same side as the asymptomatic hip of the age-matched individual with LHP

ALHP:

The asymptomatic hip of an individual with LHP

GMed:

Gluteus medius

GMin:

Gluteus minimus

LHP:

Lateral hip pain

SControl:

The hip of a control participant matched to the same side as the symptomatic hip of the age-matched individual with LHP

SLHP:

The symptomatic hip of an individual with LHP

TFL:

Tensor fascia lata

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Acknowledgments

We thank Karen Rowe and Phillipa Nelson at Otago Radiology in Marinoto Hospital for their technical assistance. This study was supported by the New Zealand Society of Physiotherapists Scholarship Trust Fund and a University of Otago Dean’s Bequest Research Grant.

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Anatomy, University of Otago, Dunedin, New Zealand

    N. A. M. S. Flack, H. D. Nicholson & S. J. Woodley

  2. Department of Radiology, Dunedin Public Hospital, Dunedin, New Zealand

    G. R. Meikle & M. Reddy

  3. Otago Radiology, Marinoto Clinic, Dunedin, New Zealand

    G. R. Meikle & M. Reddy

  4. Department of Medicine, University of Otago, Dunedin, New Zealand

    G. R. Meikle

  5. School of Medical Sciences, University of Otago, Dunedin, New Zealand

    H. D. Nicholson

Authors
  1. N. A. M. S. Flack
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  2. G. R. Meikle
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  3. M. Reddy
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  4. H. D. Nicholson
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  5. S. J. Woodley
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Corresponding author

Correspondence to N. A. M. S. Flack.

Appendix

Appendix

List of questions asked of participants with LHP

  1. 1.

    How heavy is the work at your normal occupation? (sedentary, light, moderate, heavy)

  2. 2.

    What is your current work situation? (paid employment/self employment, unemployed/jobless, at home parenting/housewife/retired, other—please state)

  3. 3.

    How long have you had this episode of hip pain? (1 day–4 weeks, 1–3 months, 4–6 months, 7–12 months, longer than 1 year, longer than 5 years)

  4. 4.

    Can you identify a specific incident that caused your current hip pain? (yes, no)

    1. a.

      If yes, please explain:

  5. 5.

    Compared to when your pain first started, is it now: (all gone, better, the same, worse)

  6. 6.

    Is your current hip pain: (constant—24 h a day, 7 days a week, intermittent—some periods without pain)

  7. 7.

    How would you describe your pain? (ache, sharp, other—please describe)

  8. 8.

    Does your pain feel: (deep, superficial—close to the surface)

  9. 9.

    Has the pain that you feel in your hip ever spread down the outside of your leg? (yes, no)

  10. 10.

    What types of activities cause your current pain to increase? (standing for longer than a few minutes, sitting for longer than a few minutes, walking for longer than a few minutes, walking downstairs, walking upstairs, lying on affected side, other—please describe)

  11. 11.

    Can you do anything to help reduce your current pain when it’s present? (yes, no)

  12. 12.

    Have you had similar hip pain before? (yes, no)

    1. a.

      If yes: did it affect the same hip? (yes, no)

    2. b.

      How long did you have your last episode of hip pain for? (1 day–4 weeks, 1–3 months, 4–6 months, 7–12 months, longer than 1 year, longer than 5 years)

  13. 13.

    How much exercise do you regularly do currently, or until very recently? Exercise includes walking, sports, gardening, or other activity that raises your heart-rate or body temperature, for 30 min or more. (I exercise 3 or more times per week, I exercise 1 or 2 times per week, I do no exercise)

  14. 14.

    What sort of exercise and/or sports do you normally do?

  15. 15.

    Have you ever suffered an injury to either of your legs? For example your hip, thigh, knee, calf or ankle (yes, no)

    1. a.

      If yes, which leg did you injure? (left, right, both)

    2. b.

      What body part did the injury/injuries involve?

    3. c.

      What type of injury was it? (e.g. sprain, rupture, fracture)

    4. d.

      In what year did the injury/injuries occur?

  16. 16.

    Do you use a walking aid? (yes, no)

    1. a.

      If yes, what do you use?

  17. 17.

    Have you suffered an episode of lower back pain in the last two years? (yes, no)

  18. 18.

    Do you have lower back pain at the moment? (yes, no)

    1. a.

      If yes, how long have you had this episode of back pain for?

  19. 19.

    Menopausal status: (pre-menopausal, menopausal, post-menopausal)

  20. 20.

    Have you ever had a steroid injection in your painful hip? (yes, no)

    1. a.

      If yes, how many?

    2. b.

      How long ago was the last injection?

NB: questions also asked of control participants are highlighted in bold.

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Flack, N.A.M.S., Meikle, G.R., Reddy, M. et al. Hip abductor muscle volume in women with lateral hip pain: a case-controlled study. Surg Radiol Anat 34, 847–855 (2012). https://doi.org/10.1007/s00276-012-0970-7

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  • DOI: https://doi.org/10.1007/s00276-012-0970-7

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