Gluteus Medius Tendinopathy
What is a gluteus medius tendinopathy?
Gluteal tendinopathy is one of the main causes why individuals have pain on the outside of the hip and is usually associated with females above 50 years of age or in competitive elite athletes. The pain is located at the outside upper portion of the hip and can radiate down the thigh.
How do I know if I have gluteal tendinopathy?
Signs and symptoms of a gluteal tendinopathy may include:
- Pain/ tenderness on the side of hip
- Pain when lying on affected side
- Pain/ stiffness in the morning after waking up
- Pain radiating down the outside of the thigh
- Pain when standing on one leg
- Pain when performing weight-bearing exercises (e.g. running)
- Pain when sitting with legs crossed
- Loss of strength in hip and buttock
How is gluteal tendinopathy diagnosed and managed?
It is usually diagnosed through a physical examination carried out by a Doctor or Physiotherapist. It is quite common for specialists to do a bedside ultrasound scan or for patients to be sent for an MRI to determine the nature of the injury. Gluteal tendinopathies are rarely surgically treated and usually would improve with conservative therapies such as medication and Physiotherapy.
How can Physiotherapy help?
The Physiotherapist will carry out an assessment of lower back region as well as your lower limbs. This would include an assessment of the range of movements in your lower back and a neurological examination of your lower limbs to rule out any nerve involvement. The role of the Physiotherapist is to identify problem areas in the lower back so that treatment can be targeted and effective.
Treatment may include but is not limited to:
- Advise and education pertaining to your condition
- Soft tissue therapy
- Movement with mobilisation
- Heat therapy
- Dry needling
- Shockwave therapy
- Taping to offload the gluteal tendon
- Movement training
- Returning to sport training
- Personalised home exercise program
Is walking good for gluteal tendinopathy?
This would be dependent on the nature and severity of your symptoms. With a gluteal tendinopathy, the considerations that should be made when deciding what activities are appropriate is to look out for pain symptoms at the following time points:
- During the activity itself
- 24-48 hours after carrying out the activity
- Increase in baseline pain and stiffness after waking up in the morning
If pain has increased at any of the above time points, it would be wise to consider reducing the amount of activity or changing the activity itself to allow the tendon to recover.
What can I do at home to avoid worsening the condition?
In the case of having a tendon related problem, it is advised not to cause too much stretching or compressive type loading onto the injured area. Specific movements which should be avoided at home would be:
- Not lie on the affected side
- No massage directly over the painful area
- Crossing your legs
- Running/ jumping/ high impact activities