Gluteal Tendinopathy Is A Common Cause Of Lateral Hip Pain
Gluteal tendinopathy is a common hip tendon injury, the gluteal tendons are the tendons that attach the gluteal muscles to the hip bone on an area known as the greater trochanter. Injury to these tendons as with all tendons may occur suddenly or gradually over time, the usual course of events with gluteal tendinopathy as it is with most tendons is the more gradual onset, with the pathology related to progressive overload leading to many tiny tears to the tendon, tears that have occurred in the tendon over a period of time.
Tendon injuries generally occur in three areas of the tendon, including:
- The insertion of the tendon into the bone, for the gluteal tendons it is where the tendons insert into the greater trochanter of the femur. With regard to gluteal tendinopathy it is this type of tendon complaint that is most common site of pain.
- The mid-tendon, this is the point of the tendon that lies between the insertion point to the bone and the actual muscle. Depending on the area of the body, mid-tendon complaints are very common an example of this is the Achilles tendon where a mid tendon complaint is the most common form of tendinopathy.
- The muscle-tendon junction, this is the point where the tendon joins the muscle and generally is less common than either insertional or mid tendon complaints.
As mentioned gluteal tendinopathy is frequently an insertional tendon injury and is often associated with an enlarged bursa overlying the greater trochanter and tendons. The specific tendons involved with gluteal tendinopathy are the Gluteus Medius and/or Gluteus Minimus (see figure below).
On palpation the pain location presents as pain over the bony lump at the side of your hip, known as the greater trochanter. The pain felt from gluteal tendinopathy may also spread down to the outside of the thigh and knee.
Causes Of Gluteal Tendinopathy
Gluteal Tendinopathy is most prevalent in physically active women over the age of 50 yrs old. Anatomical variations of the anatomy of the female hips and pelvis compared to males, coupled with the hormones influencing the female body around this stage of life are suggested to contribute to the risk of injury for this population and its relatively high prevalence.
Suggested causes of of gluteal tendinopathy in the general population are due to poor hip and gluteal muscle control. This poor control and relative hip-pelvis instability leads to over load of the gluteal tendons. It is thought that the gluteal tendons may get compressed by the overlying ITB (Iliotibial Band) when the hip is adducted across the body (adduction of the hip is when the leg moves inwards towards the other leg as would happen if you crossed your leg across the other). This compression by the ITB in hip adduction can be increased if combined with flexion of the hip upwards, or external rotation of the hip where the hip rotates outwards. These compressive motions can occur when the hip is under load during running and as a result of hip-pelvis instability when the pelvis drops on the non weight bearing side causing relative adduction of the weight bearing hip and compression under load of the gluteal tendons by the ITB (see figure below, right hand side image being the image indicating poor pelvic stability, verses the left side image being the normal).
Repetitive Actions Are A Common Trigger For Gluteal Tendionpathy
Anyone can develop a tendon injury, most result from gradual wear and tear to the tendon associated with overuse, or ageing. Individuals who make repetitive motions over and over again in their occupation, sports, hobbies or general daily activities are at more risk of overloading their tendons in this way contributing to this “wear and tear” on the soft tissues. Your tendons are designed to withstand high tensile forces, compressive forces and repetitive loading. However small micro tears can develop when a tendon is stressed, if this stress and load to the tendon continues then these micro tears and the rate of damage can exceed your bodies rate of recovery and the damage may worsen to the point it become symptomatic causing pain and possible functional impairment.
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 What is Gluteal Tendinopathy? should consult his or her general practitioner, sports medicine specialist, orthopedic surgeon, physiotherapist or otherwise appropriately skilled practitioner.