Hip Abductor Tears

The hip abductors are critical muscles that stabilize the pelvis and control movement of the leg away from the body. When the tendons of these muscles become torn or damaged, it can lead to pain on the outside of the hip, weakness, and difficulty with everyday activities like walking or climbing stairs.

Hip abductor tears, sometimes referred to as "rotator cuff tears of the hip," are a common but often underdiagnosed cause of lateral hip pain, especially in middle-aged and older adults.

Hip Abductor Anatomy

The main hip abductor muscles include:

• Gluteus medius

• Gluteus minimus

These muscles originate from the pelvis and insert onto the greater trochanter of the femur (the bony prominence on the outside of the hip).

Their primary functions are to:

• Stabilize the pelvis during walking

• Move the leg away from the body (hip abduction)

• Maintain balance and proper gait mechanics

When the tendons of these muscles are injured, it can compromise stability and lead to pain with movement.

What Causes Hip Abductor Tears?

Hip abductor tears can develop from:

• Chronic degeneration: Wear and tear over time, especially in middle-aged or older adults.

• Acute injury: A sudden slip, fall, or twisting motion.

• Overuse: Repetitive strain from activities or altered gait mechanics.

• Associated conditions: Prior hip surgery, hip impingement, or leg length discrepancies may increase the risk.

Most tears occur gradually due to tendon degeneration rather than sudden trauma.

Symptoms of Hip Abductor Tears

Common symptoms include:

• Pain on the outside of the hip, especially when lying on the affected side

• Weakness when lifting the leg sideways

• Difficulty walking, climbing stairs, or rising from a seated position

• Limping or a "waddling" gait

• Tenderness over the greater trochanter

• In chronic cases, noticeable muscle wasting or imbalance

Diagnosis

Diagnosis involves:

• Physical examination: Testing hip strength and movement, and checking for tenderness.

• Imaging: MRI is the most effective tool to visualize tendon tears, evaluate the extent of damage, and check for associated bursitis (inflammation of the fluid-filled sac near the tendon).

Accurate diagnosis is important, as hip abductor tears are often mistaken for trochanteric bursitis.

Treatment Options

Treatment depends on the severity of the tear and patient activity level.

• Non-Surgical Treatment:

  • Activity modification

  • Physical therapy focusing on strengthening surrounding muscles and improving gait

  • Anti-inflammatory medications

  • Injections (such as corticosteroid or biologics) for pain relief and inflammation control

• Surgical Treatment:

  • For full-thickness tears or cases not responding to conservative care, surgical repair of the torn tendon is considered.

  • Surgery involves reattaching the torn tendon to the greater trochanter with sutures and anchors.

  • In some cases, augmentation with graft tissue may be used to reinforce the repair.

The goal of treatment is to relieve pain, restore hip function, and improve quality of life.

Recovery and Outlook

• Non-Surgical:
  Many partial tears or mild cases respond well to therapy and activity modification over time.

• Surgical:
  Recovery after surgical repair typically involves:

  • Protected weight-bearing early in recovery

  • Physical therapy to regain strength and balance

  • Return to normal activities usually around 3–6 months, depending on healing and progress

Commitment to rehabilitation is important for optimal outcomes.

Conclusion

Hip abductor tears are a common and often overlooked cause of hip pain and weakness. Early diagnosis and appropriate treatment can help reduce pain, improve mobility, and restore function.

If you are experiencing pain on the outside of your hip or difficulty with walking and balance, contact our office for a full evaluation and personalized treatment plan.