Lateral hip pain can be extremely painful and debilitating. You may have heard the term ‘bursitis’ used for it before or have previously been diagnosed with ‘bursitis’ of the lateral hip. More recent research suggests that the primary problem is tendinopathy of the gluteus medius or gluteus minimus tendons. Gluteal tendinopathy is a common cause of ‘Greater Trochanteric Pain Syndrome.’ This condition has been found to be more common in females and individuals over the age of 40. Let’s start by defining tendinopathy. Tendinopathy = a broad term encompassing painful conditions that occur in and around tendons in response to long-term overuse; a non-inflammatory degenerative condition Now, let’s take a look at some of the anatomy. Here you can see the tendons of all of the gluteal muscles and specifically gluteus medius and minimus and their attachments onto the greater trochanter of the hip. So, their tendons attach the gluteal muscles to the hip. What happens over time due to overuse, tiny microtears can develop in the tendons leading to pain. Tendons are designed to withstand high, repetitive loading however when the load applied to the tendon is too great for it to withstand, the tendon is stressed and over time this leads to those microtears. If this is not managed appropriately in the acute phase, it can lead to progressive pain and dysfunction. There are different phases in tendinopathy that can greatly affect your response and likelihood to improve with functional rehabilitation/physical therapy. What causes gluteal tendinopathy?? The most common reason for onset of gluteal tendinopathy is due to poor hip and gluteal muscle control, which then leads to overstressing the gluteal tendons. This can lead to increased pain and instability of the hip/pelvis region. If you continue to perform repetitive activities such as prolonged walking, running, etc. with this poor control of the hip/pelvis, it can lead to increased stress on the gluteal tendons and eventually pain and dysfunction. What are the symptoms of gluteal tendinopathy??
What do I do about my lateral hip pain?? In the acute phase shortly after you have noticed your lateral hip pain, you can manage it with relative rest and icing the lateral hip. Relative rest means try to stay somewhat active, however try to avoid the activities that really increase your pain/symptoms in order to avoid aggravating the hip pain. Apply ice 20 minutes at a time for the first 72 hours to help with pain and any inflammation that may be occurring in the early stages. Be Assessed by A Physical Therapist!!! Tendon injuries vary by the individual and respond to specific loads placed on them. Tendon injuries often need a progressive rehab plan guided by a physical therapist with knowledge in this area. People with gluteal tendinopathy often present with weakness in the hip abductor muscles (those lateral glute muscles), poor control during walking, and poor control of the hip with other single leg activities. A physical therapist can help determine muscular imbalances, dysfunctional movement patterns, weakness in various areas, etc. to ensure you are performing the proper exercises to help your injury heal! This program will often include exercises targeting the core and hip musculature based on findings from their evaluation. Some of the research suggests that the gluteal tendons can be compressed at the hip/greater trochanter, possibly by the iliotibial band. Thus, I often educate people to avoid positions of compression of the gluteal tendons, which includes the following:
If you have persistent pain that has not resolved, please contact a physical therapist to have a full assessment so your plan can be individualized to you! Your body will thank you, it is time to start living pain-free!! How can you schedule an appointment with me??
At your first appointment, we will determine a plan that works for you and a recommendation for number of visits needed for your condition! My goal is to get you better, faster in the least amount of visits necessary! I would LOVE to help you :)
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AuthorKaitlin Hartley, PT, DPT Archives
January 2020
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