Gluteal Tendinopathy

Gluteal tendinopathy is one of the most common causes of lateral hip pain, most commonly affecting women up to four times more often than men.  Gluteal tendinopathy is characterized by having lateral hip pain (or pain on the outside of the hip). Individuals often report difficulty with lying on the affected side, walking, standing, climbing stairs, and sometimes sitting.  Previously, this diagnosis has been referred to as trochanteric bursitis, but gluteal tendinopathy is now the most prevalent name for this condition involving pain over the greater trochanter.hip

Common risk factors for developing gluteal tendinopathy include being over the age of 40, being female, having a history of low back pain, and possibly having a higher BMI (body mass index).  While these factors are not required to be diagnosed with gluteal tendinopathy, these are common characteristics of those diagnosed with this condition.  Your physician and physical therapist will do a thorough examination to determine the primary cause of your hip pain.  Additionally, your physician may order imaging such as a radiograph, MRI, or ultrasound to confirm the diagnosis.

At this time, exercise, shockwave therapy, corticosteroid injection, and surgery are the most researched interventions.  Exercise and corticosteroid injection appear to be most effective, although corticosteroid injection therapy seems to not have effects lasting greater than 12 months.  As a result, if electing to receive a corticosteroid injection for pain management, it is important to also have a developed exercise program by your physical therapist to ensure improved strength and flexibility.  Surgery tends to be reserved for more severe cases of tearing and compression and will be recommended by your physician when appropriate.

Your physical therapist will direct your home program to minimize compression (i.e. standing on one leg, sitting with knees crossed, incorrect sleeping postures such as laying on the affected side, etc), avoid high loads (reducing certain activities), and educate you on the appropriate actions to take in recovery.  As a result of the mechanics of the hip joint, it is important to avoid these aggravating positions.  These positions increase the amount of compression on the gluteus medius tendon (affected muscle), therefore increasing stress and pain.  Additionally, weakness along these muscles may increase compression and therefore cause hip pain.  Your physical therapist will develop an exercise program to help decrease those stresses that cause pain.  Additionally, your therapist may perform manual therapy techniques to help aid with the healing process.