GLUTEAL TENDINOPATHY - WHAT DO I DO?

 

Gluteal tendinopathy is one of the most common conditions I see my clinics at Lifecare Ashburton Sports Medicine and Advance Healthcare Boronia.  It's also known as 'Trochanteric Pain Syndrome', 'Gluteus medius tendinitis' or 'Gluteal Bursitis'.

The condition is caused when there is an increased load through the gluteal tendons. This can cause compression of the tendon and the bursa, which results in characteristic pain on the outside of the hip

This condition affects females more than males and is especially common in females over the age of about 50.

How do you know if you have gluteal tendinopathy?


trochanteric pain location

You will likely have pain on the outside of your hip - as seen in this photo. For all of these photos - assume the sore hip is the RIGHT hip.


If you can stand on the affected leg for 30 seconds WITHOUT any pain, it's likely you DO NOT have this condition. Pain in this region can also be referred from the back or hip joint - although this is less common.


don't lie on the sore side!

Pain is often worse with stairs, or with lying on the sore side at night time


So what can you do to relive the symptoms of gluteal tendinopathy?

Firstly - avoid lying on the sore side in bed. This causes compression of the tendon and can aggravate the tendon problem.  Lying on your back or on your opposite side with a pillow between the knees can help in reducing the tendon compression.


gluteal tendinopathy posture

Standing with a good posture can help.  'Hanging' on the sore leg can make things worse


gluteal tendinopathy sitting posture

Sitting on a low chair can also cause more compression of the hip tendon and should be avoided where possible.


hip tendon sitting posture
 
hip tendon towel sitting

Sitting in a higher chair so that the hip is ABOVE the knee is preferred. If you don't have a high chair (e.g. in the car) you can use a foam wedge or towel to lift up the hip.


crossing legs gluteal tendon

Crossing your legs unfortunately also compressed the tendon and should be limited.


Walking up stairs can be tricky with gluteal tendinopathy.  It's best to place your feet slightly wider on the steps to make things easier.

So how do you 'fix' this problem? Unfortunately the evidence suggests that cortisone injections or blood injections don't provide long term relief.  Appropriate strength and control exercises from your physiotherapist, as well as avoiding compression of the tendon as mentioned above, can be helpful to reduce the pain from the tendon


We will look at typical rehabilitation exercises for this problem in an upcoming blog article.  

Aidan originally published this article for Lifecare Ashburton Sports Medicine - you can find the original here.  Aidan works at Advance Healthcare Boronia and Lifecare Ashburton Sports Medicine as an APA Sports Physiotherapist.  You can find him on LinkedIn and Google+