What is gluteal tendinopathy?
Gluteal tendinopathy has many names. It is also called trochanteric bursitis and greater trochanteric pain syndrome.
The gluteal muscles help move the hip and are important for pelvic stability. Their tendons insert onto the outside of the hip bone.
Gluteal tendon pathology can be classified into three categories:
Tendonitis is acute inflammation of the tendon. This occurs after an injury or trauma.
Tendon tears can occur after severe injuries.
Tendinopathy is chronic overuse or overload of the tendon. This usually occurs after prolonged repetitive and overuse activities. Read more about tendinopathy here.
How does gluteal tendinopathy occur?
Gluteal tendonitis can occur after high impact activities that cause inflammation of the tendon. People with tendonitis can usually pinpoint a specific activity or injury that triggered the symptoms.
Gluteal tendinopathy results from repeated stress of the gluteal tendons. Pain usually gets worse over the course of days to weeks. Women tend to have a wider pelvis and have higher rates of gluteal tendinopathy. Pain in other areas such as the feet, knee, or back can cause gait abnormalities. This leads to a compensatory effect which overloads the gluteal muscles.
Gluteal tendinopathy symptoms
Gluteal tendinopathy causes pain at the outside of the hip. Symptoms are typically worse with walking, climbing stairs, running, and cycling.
Diagnosis of gluteal tendinopathy
Gluteal tendinopathy can be diagnosed with a thorough physical exam. Swelling may be present over the affected area. There can be tenderness at the outside hip bone. Moving the hip or strength testing may provoke pain.
X-rays may be necessary in the setting of injury or trauma to rule out fracture.
Ultrasound can look for inflammation and assess the integrity of the tendon.
Gluteal tendinopathy treatment
Initial treatment involves resting and protecting the hip. Avoid or modify activities that exacerbate pain. Once pain improves, gradually increase physical activity.
Acute pain
Icing the area can help reduce pain and swelling. Apply ice 15-20 minutes at a time. Do this every 4 hours for the first two to three days or until pain improves.
Oral or topical anti-inflammatory medications can help decrease inflammation and control pain.
Persistent symptoms
Patients with persistent symptoms may need injections. Many studies have shown that platelet rich plasma injections can significantly help improve gluteal tendinopathy symptoms.
Gluteal tendinopathy rehabilitation
The goal of rehabilitation is to return to activity as quickly and as safely as possible. Returning too soon can exacerbate symptoms. It can also weaken the tendon and lead to tendon tears.
A home exercise program will help improve range of motion, stability, and strength. Some people choose to participate in physical therapy. Physical therapists assess, guide, and teach you exercises and stretches. They also individualize a training program for you and your body.
Here is a link to a great example of a home exercise program for gluteal tendinopathy:
Try to do your home exercise program twice a day. When pain is severe, focus on stretching and range of motion. Include strengthening exercises as pain improves.
Recovery for gluteal tendinopathy
Recovery is determined by the duration and severity of the injury. The longer you have symptoms, the longer it will take to get better. Use symptoms as a guide for progression. Avoid using time in days or weeks as a marker for recovery.
Decrease the frequency of your home exercise program as your symptoms improve. For example, if doing the exercises twice a day, decrease to once a day. Do this for about one week.
Many people choose to incorporate these exercises into their weekly workout routine. This can help prevent reinjury as well as maintain strength, mobility, and range of motion.
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Some pictures were taken without permission from the Sports Medicine Patient Advisor. They are intended for educational purposes only.
