What is it Gluteal tendinopathy?Gluteal tendinopathy is a common cause of pain on the outside of the hip. If the gluteal tendon has a reduction in its health from overuse, weakness and/or degeneration then you can develop pain. Some people can have other hip pathologies simultaneously such as bursitis.
Signs and symptomsThe physiotherapist will have a good idea of your diagnosis from taking your history. It is unnecessary for you to have any scan to confirm the diagnosis as many people without pain can have tendon changes on a scan. Most people can be diagnosed with clinical tests and simply touching the gluteal muscles in irritable cases will cause pain.
- Pain centered over the outside of the hip that may extend down the outside of the knee
- Pain after rest periods e.g. sitting for long periods of time or driving
- Morning stiffness
- Aggravated with walking and performing stairs
- Night pain when sleeping on the painful side
Causes of Gluteal TendinopathyGluteal tendinopathy is believed to be caused by an overload in the tissues capacity. For example increasing training and exercise too quickly or simply through repetitive missuse and progressive weakness. However, what the research does show is that this condition is more common in women and in 1 in 4 women over the age of 50 will suffer from gluteal tendinopathy. Therefore there is a relationship between the female hip musculature, walking pattern and ageing. Other causes can be biomechanical imbalances including weakness or restrictions.
From these findings, a treatment plan is developed specifically to you. Some aspects of the treatment plan may include:
- Activity modification: An initial change to your exercise regime or daily activities is needed to offload the tendon. Educating individuals of everyday postures that can cause more stress on the hip is important such as standing on one leg and sitting with your legs crossed.
- Strengthening/Isometric loading. Research shows that the right type of exercise or loading has the best long term outcomes for your tendon. It is important that strength is addressed for this condition so that the affected area can tolerate more load. This is done initially with isometric loading then progressed. Stretching is not recommended in this condition.
- Hands on techniques. There are some manual therapy techniques that can provide some short term pain relief and help address biomechanical causes.