What is gluteus medius tendinopathy?

From the Guidelines

Gluteus medius tendinopathy is a condition where the tendon connecting the gluteus medius muscle to the hip bone becomes irritated, inflamed, or damaged, typically causing pain on the outer part of the hip that worsens with activity and improves with rest. In simple terms, it's an overuse injury affecting the tendon on the side of your hip. This condition occurs because the gluteus medius muscle plays an important role in hip stability and walking mechanics; when overworked or subjected to repetitive stress, the tendon can develop small tears and inflammation 1.

Key Points to Understand

• The pain often worsens with activity and improves with rest, and is usually described as “sharp” or “stabbing” 1.
• Treatment usually involves rest from aggravating activities, ice application for 15-20 minutes several times daily to reduce inflammation, and over-the-counter pain medications like ibuprofen (400-600mg three times daily with food) or naproxen (220-440mg twice daily with food) for 1-2 weeks 1.
• Physical therapy exercises focusing on hip strengthening and stretching are crucial for recovery, including clamshells, side-lying leg raises, and gentle hip stretches performed daily 1.
• Most cases improve within 6-12 weeks with proper management, and proper footwear, avoiding excessive hill running, and maintaining appropriate exercise progression can help prevent recurrence 1.

Diagnostic Considerations

• Ultrasonography can be used to identify tendinopathy, partial tear, and complete tears/avulsion of the gluteus medius tendon in nonsurgical and postsurgical patients 1.
• Plain radiography, and magnetic resonance imaging can also be helpful if the diagnosis remains unclear 1.

Treatment Approach

• Relative rest and reduced activity are recommended to prevent further damage and promote healing and pain relief 1.
• Eccentric strengthening is an effective treatment of tendinopathy and may reverse degenerative changes 1.
• NSAIDs are recommended for short-term pain relief but have no effect on long-term outcomes 1.
• Locally injected corticosteroids may be more effective than oral NSAIDs in acute-phase pain relief but do not alter long-term outcomes 1.

From the Research

Explanation of Gluteus Medias Tendinopathy

Gluteus medias tendinopathy is a condition that affects the gluteus medius tendon, causing lateral hip pain and discomfort. According to 2, this condition is a primary source of lateral hip pain and can interfere with sleep and common weight-bearing tasks.

Causes and Risk Factors

The exact causes of gluteus medias tendinopathy are not fully understood, but research suggests that mechanical loading, joint position, and muscle and bone elements play a role in its development 2. Females are more likely to be affected than males, and the condition often occurs in mid-life, both in athletes and non-athletes.

Symptoms and Diagnosis

Symptoms of gluteus medias tendinopathy include lateral hip pain, which can be exacerbated by activities such as walking, running, or climbing stairs. Diagnosis is typically made through a combination of clinical examination and imaging tests, such as ultrasound or MRI.

Treatment Options

Treatment options for gluteus medias tendinopathy include:

• Platelet-rich plasma (PRP) injections, which have been shown to be effective in reducing pain and improving function in patients with chronic gluteal tendinopathy 3, 4, 5
• Corticosteroid injections, which can provide short-term relief but may not be as effective in the long term 3, 5
• Exercise and physical therapy, which can help to improve strength and flexibility in the affected area
• Shockwave therapy, which has been shown to be effective in some cases 6
• Surgical procedures, such as bursectomy or tendon repair, which may be necessary in severe cases 6

Key Points to Consider

• Gluteus medias tendinopathy is a common cause of lateral hip pain and can be debilitating if left untreated.
• Treatment options should be tailored to the individual patient and may involve a combination of conservative and surgical approaches.
• PRP injections have been shown to be a effective treatment option for chronic gluteal tendinopathy, with sustained improvements in pain and function at 2 years 5.