I’ve been struggling with hip pain for a number of years, following a fall where I had a suspected fractured neck of femur. Like a typical, stubborn horse rider, I walked on it despite the pain, and by the time I got an MRI, it was already healing. I had recent X-Rays and the radiologist looked at the films and asked if I’d ever broken it - so, it doesn’t look great.
I was often in a lot of pain - unable to sleep, couldn’t swing my leg over the horse, really struggle to dismount - but taking the weight off it didn’t decrease the pain. I talked with a physio and she suggested I try stretches that would loosen the tendons and ligaments around the joint - and so reduce the pressure my strong muscles (because horse rider and farmer) were putting on my joint. She suggested I try lying on my back with two yoga blocks under my buttocks. This stretches the tendons and ligaments down the front of my pelvis and in my groin. Initially it was extremely painful. I could only use one block - but I got an immediate reduction in pain. I now use 2 blocks and sometimes need to do the stretches up to 3x / day and have to do them before bed each night, but I can function without pain meds all the time now. I also do a variety of other back and hip stretches which help me to continue to function, but this has been the best for my hip pain - although it has not increase my ROM by much!!!
Thanks for this! Had forgotten you can piggyback them together. It does help.
I injured my hip in a fall when I was 18 and have had hip pain my entire life. What was a turning point for me was finding a fantastic chiropractor who I have to go see every 3-4 weeks. Because my gait is abnormal for compensating from the hip pain everything else is out of whack. He keeps everything else aligned and loose and has a number of hip specific adjustments he does. I went from not riding, chronic daily pain that over the counter meds couldn’t touch, not able to sleep through the night to relatively normal, hiking, riding, sleeping etc pain free unless I over exert myself or lift something really heavy. He did also give me stretches to do that help a lot.
What hoopoe said. Do not underestimate the contribution of pelvic floor dysfunction to pelvic/hip pain, and to sitting asymmetrically.
I just had a follow up with the UG for my pelvic floor dysfunction. I will continue working with PT on core breathing and relaxation. Hip pain cycle can be part of this.
Local muscle relaxers ( baclofen suppository) , digital trigger release work and core breathing exercises took me from total dysfunction spasms, unable to do my sport. Two months on, I just set new state record for my class.
It might be controversial, but my sports chiropractor changed my life by fixing my hips. I was late 30’s and had days when it was so painful to even get up stairs, let alone get on a horse! I was so worried, my horses are down hill from my house and it was painful to get to them. I went to a chiro who works on riders in my area and he had me comfortable and up and down stairs in less than six months. Before then I thought i was headed for new hips.
Might not be a solution for everyone, but very worth a try! With a few catch up appts a year ( i don’t go monthly - but would if i needed!) i’m up and down hills and horses 
I went to a great clinic by a sports PT last year. He basically said that hip/lower back/pelvic pain is misdiagnosed so often that it’s not realistic to try to dx yourself, or even have a GP try to do it. He goes through a battery of specific range of motion exercises to pinpoint the problem because pointing at the place it hurts is never going to work. Usually he is able to identify the problem by the inability to perform certain things, even (and very often) without pain.
So, my point is that no one can really give you advice on whether you should continue riding or not. An MRI would probably help but an appointment with a good PT might be better.
I will say that the solution for many of the issues that he identified is core/pelvic and hip strengthening exercises. E.g. clamshells. Just did a quick google and this is a good sample of some similar exercise. Maybe try these - if you have any specific pains while doing them they might be very helpful to a PT or MD to diagnose your exact issue.
https://uhs.princeton.edu/sites/uhs/files/documents/Pelvic-Stabilization-Hip-Strengthening.pdf
What S1969 said. I had hip pain that made getting in and out of a chair and my car very painful. I had to lift my right leg over my horse to get on and off. It turned out that stretches and strengthening exercises did the trick. Sometimes it flares because I neglect the exercises when I don’t hurt. Google ileopsoas, hip flexors, and hip abductors. There are great exercises.
It could be uneven muscles. Strengthening and stretching hip abductors, ileopsoas, and hip flexors may help. There are some great exercises. My doctor sent me to physical therapy and I learned more from a horse/people massage friend. There are a lot of exercises online. Good luck.
I think a lot of us with hip pain have been down long and not terribly straightforward diagnostic paths, and not always with stellar outcomes, so keep your chin up and be prepared for the kind of complexity that something as central to the body as a hip can involve.
FWIW I have moderate OA in one hip that wasn’t identified on imaging, but was obvious once they got a scope in there. Only treatment option I’ve been given is the usual NSAIDs, so I’m not sure how valuable it is to me to know for sure that the cartilage in there is jacked up. I certainly wouldn’t pay lots of money for that knowledge.
It’s possible that something is going on in your hip that didn’t show up on your rads. If bursitis is your primary problem and there’s some OA as well, though, it might make sense to have your doctor check for/treat the bursitis before moving on to imaging. Trochanteric bursitis can usually be diagnosed with a bit of palpation and manipulation, and is often treated with steroid injections and PT. Potentially an easier thing to find and fix than arthritis.
Wishing you all the best!
This fall, I couldn’t stay in the saddle for longer than 20 minutes even after doubling up on Aleve. I finally bit the bullet and got the x-rays I had been avoiding because I was convinced it would be OA (my mother had hip replaced at 50 and was not active, I’m 32 and active). Instead, the soft tissue appears to be intact, but I have femoroacetabular impingement (FAI) in both joints, right predominant, where I have ‘pincer-cam’ form FAI and now extra fun boney ossifications from constant grinding.
FAI is morphological but aggravated by sports like gymnastics, dancing and riding… so likely disproportionately common in riders but under-diagnosed. Doctors weren’t paying attention to FAI back when I got my first x-ray 12 years ago, was re-assessed 8 years ago, re-assessed 5 years ago… none of the doctors and physiotherapists I saw considered it.
Since then I’ve been getting cortisone injections while waiting to hear from the “young athletic hip surgeon” and the relief has been unbelievable. The first time I got on after I cried realizing how much pain I had been in. I rode for an hour today! AN HOUR!
My point is, IMO… get the imaging done, and then create a plan from there. If I had been more vocal and pro-active I could have saved years of blaming myself for not doing enough stretches, stability training, chiro, physio, whatever. Personally, if I need it, I’d rather have surgery now and be able to ride while I’m still healthy otherwise.
GOOD LUCK to all of us with bum hips who love horses, lol, we need it!!
I had been having pain off & on over the past 5 years? i originally self-diagnosed as sciatica, did recommended exercises for same, and recovered. Then a hard sit on an icy driveway while carrying a bucket of water brought back the pain. Again, exercises, recovery, but I farmed out stall cleaning to younger backs. More recently the pain became chronic and sometimes unbearable, all down my leg, but seemingly emanating from the hip. I gave up, saw my GP who did x-rays & other diagnostics, diagnosed bursitis, prescribed physical therapy which has helped, but has not solved the problem entirely. I had not ridden since before the winter holidays, due to the pain as well as the cold. Have ridden briefly a couple of times recently, and I am improved, can actually post (!)…Now the extreme heat will prevent riding again to continue to test improvement for a week or so. My unsolicited advice to the young is to strengthen and protect your core…vital to so many joints above and below…
Bummer, still no better options? 
Gawd, I can rattle off a good half dozen things from steroid to HA to PRP to stem cell to pills like gabapentin or patches like Butrans. So many options that have the potential to make you feel better. I’m sorry you’re still stuck with “take a couple Advil” :no: :no:
Are you at all familiar with subtle body work in yoga? Your feet are made up of a large network of individual bones. Something as small as putting more weight on one part of the foot than the others can effect the rest of the leg and the whole body. (I myself have a tendancy to put too much weight into the ball of my little toe, for example) You may be doing something with your feet that is causing the hip to rotate out of anatomical neutral.
I work at a hospital in administration. My mom just underwent right hip replacement for OA; also many friends. Once arthritis sets in, you can do the injections and take NSAIDS, but there really isn’t much to offer but replacement. And since instrumentation will need to be taken out and be replaced at some point (if you’re relatively young and live to a good old age), most people are encouraged to wait until they just can’t stand it any more before undergoing replacement. At 53 with just bursitis, I’m not quite there.
And as an aside, our orthopedics QI and research review committees have looked at the efficacy of stem cells for orthopedic issues and unfortunately, there just is no persuasive proof that it actually works. We do not do it here. Maybe the science will improve, it’s not there yet. And none of the docs do PRP, period. Only people with horses waste money on that. FYI/YMMV
I’ve had beautiful results with PRP. There is very little consistency in the research–cell mix, number of cells, cell separators, etc, etc–and it’s no wonder that the results are not consistent. Does it work for everyone? Nope. But when you’re in chronic, long standing pain, and the only answer, maybe, someday, is total hip, tossing a grand at PRP to see if it will help, using the best regenerative medicine specialist you can find, is not an unreasonable thing to try. It carries little risk. My labral reconstruction, using the best hip preservationist I could, with a second opinion from THE labral reconstruction clinic in the US, if not the world, was far less successful, far more painful, and far more expensive than the PRP I’ve done.
Cause and effect.
Are you sure, very sure, it was what was used that helped, or part of the process going in there that helped, would have no matter what was injected?
That is the question we had when our vet insisted on trying that on a horse kicked on a hock.
Eventually surgery helped him, but surgery would have been more effective up front, before other and time had damaged the joint further.
Hindsight is somewhat helpful, some times nothing helps, is more of a guess what may be going on there.
My story is with MSM, how much it helps so many, but still no real proof.
I was told to try it for arthritis in my hands, could hardly button a shirt.
Asked my Dr, that said let me check.
A few weeks later, Dr called and said, can’t find anything definitive, but it seems harmless, try if you want to.
By then, what do you know, my hands had self repaired to an extent on their own, were functional again, other than now they have some interesting bumps here and there in the joints, without trying anything like MSM.
Had I tried it up front, I too would say " MSM sure seemed to help".
My point, while we can’t say never, we also have to be careful to insist something did work, or didn’t, as we think it did.
Yes, I’m sure. Repeatable results. No other changes. Multiple other things have been injected into both hips. This isn’t a one time deal, bluey.
Also not the placebo effect, if you’d like to suggest that next :rolleyes: I’d love if it would work in the surgical hip that’s such a pile of flaming garbage, even if it WAS a placebo effect. But alas, despite really, really hoping for results (twice) it does nothing there. Perhaps because the labrum is no longer live tissue but an 8cm graft with multiple anchors holding it in.
But thanks for telling me I’m wrong about what manages my pain, despite knowing very little about my history! That’s nice of you :encouragement:
(You know what? My various doctors even have OTHER patients with great results with PRP! Crazy, huh? Many of them have even used PRP on themselves–they say they’ve seen first hand the poor surgical outcomes, and better results with PRP. I’m hearing more and more of joint preservationists using it in conjunction with surgery, too. The top hospitals in the country use it. It’s FAR from something “only crazy horse people throw money away on.”)
As you say, I don’t know your history and if I did, I still would not be able or willing to comment on it directly, not being a doctor.
My point was, we really can’t be that sure with those processes to insist, when others had different results, that it will work.
Medicine doesn’t work like that sometimes, that’s all.
Glad is working so well for you, something to consider for those with similar problems and wondering if they may want to go there.
Given the history you’ve shared in other threads, I’d be amazed if you’ve got some spontaneous improvement happening that just happens to coincide with injection timing. Bluey’s alternative causal reasoning would require one hell of a coincidence in your situation, from what you’ve shared!
From the research standpoint, nearly all of the available treatments in medicine moved at some point in their histories from being hypotheses, to being deemed plausible through in vitro studies or animal model experimentation, to being experimented with in vivo, before being accepted as reliable. PRP for hip pain might not be at that last stage, but just in the last 2 years research is starting to appear in press that shows significant positive results in controlled, double-blind studies. Until we have enough of that kind of evidence to flesh out our understanding of the treatment, the experiences of people like Simkie – including self-reported pain relief – are important for individual decisions about whether treatments considered to be experimental are worth trying. Hospitals and insurers, of course, will be more concerned about the aggregate, but some individuals have motivations to explore all avenues with potential for a good outcome.
This is not unlike veterinary medicine, in that when all well-researched options fail, some are willing to try more experimental treatments based on small-n studies or anecdotal information. But IMO it is unlike crazy horse people throwing their money away on dubious interventions in that Simkie can simply tell me about the pain relief she got from PRP and the case history behind her situation, and I’m not forced to have a vet student jog her across a parking lot on her known-to-be-impaired joints while one or two people squint at her and make subjective judgments about the degree to which her gait has improved, and then filter that information through one or two other people, before using it to inform a perspective on the treatment.
I’d be delighted to be in a position to try PRP, given that the more widely accepted alternative is to cope with a lot of pain and watch my life contract as activities I enjoy become difficult or impossible for a few decades between now and when I’d be eligible for THR.
