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A gluteal tendinopathy is a common injury that occurs on the outside of the hip or buttock. It is a condition that results from compression forces applied to the gluteal tendons leading to its frequent compression. If the force changes this can lead to changes in the tendon making it less able to tolerate the same load. The gluteal tendons are a tough band of tissue that connects the deep buttock muscles to the hip bone at a site, known as the greater trochanter. The condition is therefore sometimes referred to as Greater Trochanteric Pain Syndrome (GTPS).
A gluteal tendinopathy affects 10% to 25% of the population and is three times more common in women than men. This is due to women’s hips generally being wider, increasing the force on the gluteal tendon. Patients tend to be aged between 30 and 40. Younger patients who are active or who participate in aerobics classes and who have weak lateral hip muscles can contribute to lateral hip pain or gluteal tendinopathy. Postural positions in less active patients can lead to the structures around the hip becoming tight. A sudden increase in activity levels can then cause compression of hip tendons resulting in lateral hip pain.
Symptoms
- The outside of the hip joint is tender to touch. (Lateral Hip Pain)
- Pain when in a side lying position on the affected side.
- Night pain in the affected side
- Morning stiffness in the tendon structure – especially after prolonged side lying position.
- Referred pain into the outside of the thigh or the knee.
- Pain during weight-bearing activities such as walking, running, climbing stairs, or performing a single-leg stance.
- The relief when the buttock muscles are being stretched.
- Lateral thigh pain when sitting for too long.
- Buttock weakness
- Pain with legs crossed and knees crossed.
Management
- Ice: a cold pack (ice pack or frozen peas wrapped in a damp towel) can provide short-term pain relief. Apply this to the sore area for up to 15 minutes, every three hours and up to four times a day, ensuring the ice is never in direct contact with the skin.
- Relative rest: reduce activities that are making your symptoms worse, for example, the amount of time you spend on your feet.
- Exercise: you should complete specific exercises that aim to increase the strength of your hip; this will help you return to activities.
Treatment
Currently, the best evidence for treatment of gluteal tendinopathy is through a multidisciplinary approach with the aim to decrease pain and increase function. If your pain is long-standing (chronic) it is recommended a course of shockwave therapy. For short-lived (acute) conditions, it may react well to ‘hands-on’ treatments like massage and manipulation, used in conjunction with other modalities such as ultrasound and acupuncture.
