Sarah Roseingrave, BSc MISCP, CORU
Below, Sarah discusses what causes Gluteal Tendinopathy and how to go about getting relief from your pain.
Gluteal tendinopathy is a common and painful condition. It affects 1 in 4 women over 50 and has similar effects on quality of life as severe hip arthritis. It results in pain over the outer hip, sometimes running down the outer thigh. Pain is often felt during walking and running and sometimes when lying on the affected side.
It is sometimes known as ‘trochanteric bursitis’, however, research shows the tendinopathy of the gluteus medius and/or gluteal minimis are more commonly the origin of pain (though the bursa may become inflamed). The gluteus medius muscle arises from the back of the pelvis. It inserts into the greater trochanter - a bony prominence on the outer hip, which often becomes tender to palpation.
When walking or running, the gluteus medius muscle stabilises and the pelvis. Tendinopathy can occur when tendons have been under very high or repetitive loads. Micro-tears can occur within the tendon in response to this loading, and whilst they generally heal quickly, sometimes they occur at a rate faster than the tendon repairs itself. When the muscles around the affected tendon are weak, the tendon comes under even more load, causing further pain and progressive weakness.
The LEAP trial  In 2018 was the first high quality trial to show education and exercise can be effective in managing gluteal tendinopathy and reducing pain. It found that education and exercise performed better than both steroid injection and a ‘wait and see’ approach. Physiotherapy management will involve assessing the individual’s strength (particularly glute strength) and exercise levels. Rehab will involve progressing the client through an individualized rehab program, rather than one specific exercise approach.
Our approach at AON Physiotherapy is to always find the root cause of the problem. As mentioned above it may be due to weaker muscles around the hip. But we will always take a comprehensive history of previous injuries, what the range of motion in that area and other joints may be and what the pain and discomfort is restricting you from doing. Examples may be, struggling to do the gardening or lifting children or grandchildren, going for a walk, or walking up a flight of stairs.
Once we can figure out all these things in an assessment, we can go about creating a specific treatment individualised to you.
At AON physiotherapy we understand just how much of an impact pain can have on your life. If you are struggling with such pain or know and friend or family member that is, please do not hesitate to forward this to them or get in contact with AON Physiotherapy on 089 615 0347.
MOVE WELL - FEEL WELL