Medically reviewed by: Radhakrishnan Ramaraj, MD, FSCAI, Board-Certified Interventional Cardiologist & Endovascular Specialist, Champion Health System. Fellowship-trained at Cedars-Sinai/UCLA and Yale, with vascular interpretation training at Brigham and Women’s Hospital, Harvard University. Fellow of the Society for Cardiovascular Angiography and Interventions (FSCAI).
Every runner knows the difference between the good kind of sore and the kind that doesn’t go away. If you’ve been nursing a nagging ache on the outside of your hip for weeks or months, cutting back mileage, stretching, icing, and it’s still there when you lace up, you’re dealing with more than a passing overuse issue.
At Champion Health System, we treat active patients throughout Raleigh, Oxford, Henderson, and Dunn who have pushed through hip pain and other sports injuries for far longer than they should have. The good news is that most chronic hip pain in athletes can be treated without surgery, and without the months on the sidelines that surgery usually requires.
Common Causes of Hip Pain in Active People
Not all hip pain is the same, and the location often tells you a lot about the cause:
- Greater trochanteric pain syndrome (GTPS): pain on the outer hip, often from irritated tendons and the bursa near the top of the thigh bone
- Gluteal tendinopathy: degeneration of the tendons connecting the glute muscles to the hip, common in runners and cyclists
- Hip labral irritation: pain deeper in the joint, sometimes with a catching or locking sensation
- Overuse and repetitive strain: from training volume that’s increased faster than your body can adapt
Many runners and athletes deal with a combination of these, which is part of why generic treatment plans don’t always work.
When Rest, Ice, and Physical Therapy Aren’t Enough
Conservative treatment, rest, activity modification, physical therapy, and anti-inflammatory medication, resolves most cases of hip pain within a few months. But when pain persists beyond that window despite doing everything right, it’s usually a sign that the tendon tissue itself has changed. Similar to chronic tendon pain elsewhere in the body, long-standing hip tendon pain often involves abnormal new blood vessel growth that keeps feeding pain signals to the area, which is why stretching and rest alone stop being effective.
Non-Surgical Options Beyond Physical Therapy
Before jumping to hip surgery, it’s worth exploring options that address the pain at its source:
- Targeted physical therapy focused on hip and glute strength, not just stretching
- Diagnostic imaging (ultrasound or MRI) to pinpoint the exact structures involved
- Guided injections to help confirm the pain source and provide short-term relief
- Musculoskeletal embolization for chronic, imaging-confirmed tendon degeneration that hasn’t responded to standard care
What Is Musculoskeletal Embolization for the Hip?
Musculoskeletal embolization (MSK embolization) is an image-guided, outpatient procedure performed by an interventional radiologist. A thin catheter is guided through a small access point, usually in the wrist or groin, directly to the abnormal blood vessels supplying the damaged hip tendon tissue. By reducing that excess blood flow, the procedure calms the nerve activity that’s been driving your pain, without cutting through muscle or joint structures the way surgery does. You can read more on our Musculoskeletal Embolization treatment page.
The procedure generally takes about an hour, is done under local anesthesia with sedation, and most patients are back home the same day.
How Dr. Ramaraj Evaluates Hip Pain Patients
Before recommending embolization for hip pain, Dr. Ramaraj and the Champion Health System team review ultrasound or other imaging to confirm which structure is involved (gluteal tendon, bursa, or labrum) and to look specifically for the abnormal vessel growth (neovascularity) associated with chronic tendinopathy, rather than treating hip pain as one generic diagnosis. Dr. Ramaraj has pursued additional international training specific to musculoskeletal embolization, including a hands-on visit to Dr. Yuji Okuno’s clinic in Japan, one of the pioneering centers for this technique, and regularly participates in embolization-focused sessions at the Global Embolization Symposium and Technologies (GEST) conference. This distinction matters for active patients, since the right diagnosis determines whether embolization, physical therapy, or a guided injection is the more appropriate next step.
Patient Selection Criteria: Am I a Good Candidate?
Hip embolization tends to be a good fit for active patients who have:
- Hip pain lasting longer than three to six months
- A confirmed diagnosis such as gluteal tendinopathy or GTPS on ultrasound or other imaging modalities, with imaging evidence of abnormal vessel growth (neovascularity) in the affected tendon
- Limited or short-lived relief from physical therapy or injections
- No labral tear or structural joint damage requiring surgical repair
- A goal of returning to training or competition without a lengthy surgical recovery
Getting Back to Training
Because there’s no incision to heal or joint to reconstruct, recovery timelines are typically much shorter than with surgical options. Many patients notice gradual improvement over the following weeks as the abnormal vessels recede, and our team works with you on a return-to-activity plan tailored to your sport and training goals.
Why Choose Champion Health System
Our team, led by Dr. Radhakrishnan Ramaraj, has deep experience treating chronic joint and tendon pain in athletes and active adults throughout North Carolina. We focus on finding the actual source of your pain and matching you with the least invasive treatment that will get you back to doing what you love.
Don’t Let Hip Pain Keep You on the Sidelines
If hip pain has been holding back your training for months with no real improvement, it may be time to look at options beyond rest and physical therapy. Our team can help you find out if musculoskeletal embolization is right for you.
Request an appointment online, or call the Champion Health System location nearest you:
- Raleigh Clinic: (919) 651-4345, 7901 ACC Blvd #102, Raleigh, NC 27617
- Oxford Clinic: (919) 339-4077, 1614 Williamsboro Street, Oxford, NC 27565
- Henderson for Wound & Limb Preservation Center: (252) 573-4223, 511 Ruin Creek Road, Suite 106
Henderson, NC 27536
- Henderson for Internal Medicine & Geriatrics: (252) 492-6127, 511 Ruin Creek Road, Suite 101, Henderson, NC 27536
- Dunn Clinic: (910) 304-1212, 710 Erwin Road, Dunn, NC 28334
Learn more at championhealthsystem.com
