Can an intrasubstance tear of the gluteus minimus muscle cause hip pain?

From the Guidelines

Yes, an intrasubstance tear of the gluteus minimus muscle can definitely cause hip pain. This type of injury involves a partial tear within the muscle tissue itself and commonly produces pain on the lateral (outside) aspect of the hip. Patients typically experience sharp pain with certain movements, particularly when walking, climbing stairs, or lying on the affected side. The pain may radiate down the lateral thigh and can be accompanied by weakness, especially when attempting to abduct the hip (move the leg away from the midline). According to the American College of Radiology Appropriateness Criteria 1, MRI is highly sensitive and specific for detecting many abnormalities involving the surrounding soft tissues, including intrasubstance tears of the gluteus minimus muscle. Treatment usually involves rest from aggravating activities for 2-4 weeks, ice application for 15-20 minutes several times daily during the acute phase, and anti-inflammatory medications like ibuprofen (400-600mg three times daily with food) or naproxen (220-440mg twice daily with food) for pain relief, as suggested by various studies 1. Physical therapy is crucial for recovery and typically includes gentle stretching, progressive strengthening exercises, and modalities to reduce inflammation. The gluteus minimus is an important hip abductor and internal rotator, so when torn, it affects these movements and can alter normal hip biomechanics, potentially leading to compensatory movement patterns that cause additional problems if not properly addressed. Some key points to consider in the diagnosis and treatment of intrasubstance tears of the gluteus minimus muscle include:

• The use of MRI for diagnosis, due to its high sensitivity and specificity for detecting soft tissue abnormalities 1
• The importance of rest, ice, and anti-inflammatory medications in the acute phase of treatment 1
• The role of physical therapy in promoting recovery and preventing long-term complications 1
• The potential for altered hip biomechanics and compensatory movement patterns to cause additional problems if not properly addressed 1

From the Research

Intrasubstance Tear of the Gluteus Minimus Muscle and Hip Pain

• An intrasubstance tear of the gluteus minimus muscle can cause hip pain, as evidenced by studies on gluteus medius and minimus tears 2, 3, 4, 5, 6.
• The gluteus minimus tendon insertion is located anterior to the anterior facet of the greater trochanter of the femur, and pathology in this area can manifest as chronic lateral hip pain 3.
• Tears in the gluteus medius and minimus tendons are a recognized cause of chronic greater trochanteric pain syndrome, which may be accompanied by hip abductor dysfunction 2, 4.
• Treatment options for gluteus medius and minimus tears include conservative management with physical therapy and anti-inflammatory measures, as well as surgical management for more severe cases or those that fail conservative management 2, 3, 4.
• Platelet-rich plasma injections have been shown to be effective in treating gluteal tendinopathy, with significant improvement in pain and function at 12 weeks compared to corticosteroid injections 5.
• Magnetic resonance imaging is a useful diagnostic tool for identifying gluteal tears, including intrasubstance tears of the gluteus minimus muscle 6.