Gluteal tendinopathies are becoming one of the most common reasons for lateral (outside) hip pain in individuals. Your hip/buttock is made up of three main muscles; gluteus maximus, gluteus medius and glutes minimis. These muscles attach onto your sacrum and across onto the hip bone (greater trochanter), where they attach at the hip bone is a tendinous junction, this is where majority of tendinopathies occur.
A gluteus tendinopathy is the inflammation of one or more of these tendons.
- Gradual worsening pain over the hip bone and surrounding area
- Pain on sleeping/lying on affected side
- Pain on walking
- Pain on walking up/down stairs or hills
- Crossing of legs
- Weight shifting onto affected leg in static standing
- Discomfort getting up/down from chair or getting in/out of car
- Develops more in the female population, especially over the age of 50.
- Develops more commonly in runners and in people who are less active.
- Excessive loading or overuse of the muscles.
- Specific loading exercises prescribed by your Physiotherapist – research has shown that loading the muscles/tendons at the correct dosage results in better and faster outcomes.
- Education/Advice – specific solutions to avoid aggravating movements.
- Taping Techniques – to offload tendon/muscles
- Massage – reduce tension and spasm in associated muscles to promote better movement.
- Dry Needling/Acupuncture – is a safe way to release tight muscles and decrease pain levels.
- Heat/Ice – can be effective treatment modality that can be used to ease discomfort at home or at work.
What about cortisone injections?
Research has found that cortisone injections into the tendon can be effective for short term pain relief, however it has shown no benefit long term. Cortisone injections affect individuals in different ways, some get no relief while others see the benefit. Usually individuals will present back with the pain weeks or months down the track.
How to reduce aggravating factors?
|Lying on painful side||Add extra padding on top of the mattress|
|Lying on non-painful side||Place a pillow in between your knees.|
|Sitting with legs crossed||Don’t cross your legs, keep them in line with your hips.|
|Sitting in low chairs||Try to sit in a higher chair whereby your knees are lower than your hips.|
|Getting changed/Putting shoes on||Sit down to put clothes/shoes on to prevent loading of hip.|
|Walking||Keep to low flat level surfaces|
|Climbing Stairs||Use one step at a time, leading with your unaffected leg|