Symptoms Of Gluteal Tendinopathy
Gluteal tendinopathy is a common cause of lateral hip pain and presents with a number of symptoms which may include:
- Pain or a feeling of tightness at the side of the hip that may run down the outside of the thigh to the knee.
- Pain sleeping, when lying on the affected side there is direct compression of the gluteal tendons. And with lying on the non affected side then sore leg is upper most and can fall into a stretched position for the gluteal tendons. Either of these positions may therefore cause lateral hip pain and stiffness during the night or when rising in the morning.
- Pain sitting for extended periods of time or sitting with legs crossed.
- Pain running, the pain is often felt during the impact phase of running when the foot strikes the ground and body weight moves over top of the foot.
- Pain when hopping or even with single leg balance control on the sore side if pelvic control is poor.
- Pain walking up or down hills or stairs.
Diagnosis Of Lateral Hip Pain
The hip is a complex area and other conditions causing lateral hip pain may present similar to gluteal tendinopathy. Conditions such as osteoarthritis of the hip and bursitis. Gluteal tendinopathy diagnosis is frequently missed, often incorrectly diagnosed as hip bursitis. The management of lateral hip pain as a result of brusitis verses gluteal tendinopathy is different, bursitis is often treated with cortisone injections however the same injections may cause further degeneration of the tendon when gluteal tendinopathy is the cause of lateral hip pain. Although cortisone injections may offer some temporary relief in symptoms with gluteal tendinopathy as a rule cortisone injections are not the preferred course of management for tendinopathies.
Most of the time a physiotherapist will accurately diagnose gluteal tendinopathy in the clinic without the need for investigations, but if the symptoms are severe or there is failure to improve investigations such as an ultrasound scan or MRI may be requested.
Treatment For Lateral Hip Pain
Management Of Lateral Hip Pain In The Acute Situation when the tissue is first aggravated or when there has been a re-aggravation of a chronic situation the most important factor is the reduction of load on the gluteal tendons and working on improving hip and pelvic control.
This will often involve avoiding running or like activities, avoiding activities which put stretching load on the tendons (mainly movements where the hip is adducted across the body, such as crossing your legs). Stretching motions are generally avoided with gluteal tendinopathy as stretching the gluteal muscles or the ITB can increase the compression on the tendons.
Tip: If it feels like the gluteal muscles or ITB are tight or there are some trigger points that need to be relieved then getting a massage or the use of a foam roller on the these areas can be beneficial. However it is best to avoid directly massaging or rolling on the gluteal tendons as not to cause more compression and swelling to the tendon.
Management Of Lateral Hip Pain In The Subacute / Chronic Stages is similar to in the acute and reactive stages where the load to the tendon still needs to be managed via avoiding stretching of the area and graduating your return to activity. However at this stage of degeneration your physiotherapist can progress the home exercises using isometric and eccentric exercises to the tendon and progress the exercises introduced in the reactive stage focused on working to achieve good pelvic control (stability). Sometimes the application of shockwave therapy or dry needling in this degenerative phase can be beneficial in pain management and helping return to pre-injury activity levels.
Disclaimer: Sydney Physio Clinic provides this information as an educational service and is not intended to serve as medical advice. Anyone seeking specific advice or assistance on Lateral Hip Pain Diagnosis And Management should consult his or her general practitioner, sports medicine specialist, orthopedic surgeon, physiotherapist or otherwise appropriately skilled practitioner.