Lateral Hip Pain: Gluteal Tendinopathy

What is it?

  • A tendon disorder generalized to the hip that can be caused by increased tension to the gluteal musculature or compression of the tendon.

Factors that can influence the likelihood of developing gluteal tendinopathy

  • Pelvic structure

    • Femoral neck angle less than 40 increases the likelihood

  • Female Gluteus Medius muscles are smaller at the point where the muscle and bone attach which creates less force dissipation and a shorter lever arm.

  • Weakness of lateral stabilizers of the pelvis can create irritation to the gluteal tendons

Presentation of injury

  • Age: >40 y.o.

  • Females more than males

  • If there is difficulty with the following functional tasks;

    • Laying on your side

    • Walking causes pain

    • Stairs or sitting cause pain

How to manage pain?

  • Load management!!

    • Reduce compressive activities (whether that’s running, sport, something at work)

    • Control high tension loads or anything that can pull too much on that tendon such as crossing legs

    • Do not overstretch a tendon injury!

What can Physical Therapy do?

  • Stage a rehab protocol to manage pain in the early weeks of injury

  • Progressively strengthen specific musculature to improve the tendon's capacity to tolerate load and strengthen surrounding musculature to offload the affected tendon

  • Implement higher force demands on the tendon and plyometrics of necessary to create an environment for the injury that can tolerate all demands of life

  • And finally, making rehab functional to the person's lifestyle, sport, or vocation to create a comprehensive rehab where you feel confident to return to what you love.

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