So wanted to throw this out there: I had a bad fall (not riding, skiing) that resulted in a ton of muscle and ligament damage all the way from my back to my SI joint. I couldn’t control my torso at all for a couple months. It was pretty epic. Anyway, it settled into my hip and I had pretty intractable hip pain for a long time. I have a history of bursitis and IT band issues in that leg. I developed severe anterior pelvic tilt which I never had before and started wrecking the front of my hip.
Finally my PT, who is magic, said she wanted to treat it as if it’s messed up muscle patterns/ referred pain from my lumbar spine which was already kinda fubar but had been so for a long time and didn’t really hurt so we hadn’t been considering the “new” pain as particularly related. Hips look good on xray but I definitely had impingement. You could see it and feel it. I couldn’t fold my knee up to my chest, whereas formerly I could easily touch my nose to my knee while standing.
So she has me doing MacKenzie exercises and damn if it isn’t working. I can walk with a normal gait for long periods again at least half the time and sleep on my side. They are very simple and you can buy a book or youtube them to try it out. The theory behind them is vague to say the least but they seem to re-set the hip/ spine/ pelvis alignment by tricking your lower back and pelvis muscles into relaxing. I can feel it go ploop into place. You still need to build strength after but it was shockingly effective for me to fix my posture and the anterior pelvic tilt which we hadn’t been able to correct before. If it works you’ll know. Never in a million years did I think this would work.
One modification I have to make is to do something to relax my low back muscles first if they are in a particularly bad spasm. PT can poke at it or I can lay on an acupressure mat for a few minutes or take some advil. 100% worth a try. I do them 8 times a day
That combined with yoga focused on my hips has helped a ton. We choose yoga because I used to do it a lot and I can be trusted to do the poses correctly (don’t hyper extend your knees!!! a lot of people with weak hips do and it’s the worst thing ever for your hips and back). And I am riding dressage in a GP dressage saddle which helps because I can ride shorter. I already disliked saddles that forced you to hyper extend your leg and now I really hate them. I’m also a big proponent of riding with a properly aligned spine and bent hip for shock absorption.
I’m currently riding after what ended up being diagnosed as a near-totally degenerated disc in my lumbar spine which is also herniated (different incident), a badly torn rotator cuff, two ribs with facet joint damage that used to visibly move around until PT fixed them and hurt so bad it made me angry, “severe” multifidous tear (it’s a muscle that holds your spine together- don’t tear it!), a torn SI ligament, torn lumbar something-ligament (attaches your pelvis to your back) and something-something hip/IT band/bursitis/impingement. No surgery (yet)! I did give up running but maybe someday… I have had bone spurs in my back since my 20s, have had a half dozen knee surgeries from a car wreck 20 years ago and have nerve damage in my leg from a bad cut on my upper thigh 10 years ago plus numerous other healed-ish injuries, mostly stupid in nature. Riding horses is the safest thing I do.
This hip pain was getting me down. It’s miserable. Good luck to you all and don’t be afraid to try different treatments. If it doesn’t work, move on. A coworker had TKR and is back Latin dancing after years of hobbling around. A good friend of mine had three labrum surgeries at Steadman and finally her PT just said she needed to push through the pain and get really, really strong to prevent re-tearing it. She was skeptical, she was royally pissed off actually and came over and cried at my kitchen table, but she did it and is back to winning in her sport in her 40s. Not competing, winning. And smashing records. So hang in there.