As with hip (Trochanteric) bursitis, gluteal tendinopathy presents with pain over the lateral hip (bony) area, but unlike bursitis, tendinopathy is not an inflammatory condition. The two conditions can co-exist, this is called Greater Trochantric Pain Syndrome (see below).
Gluteal tendinopathy is caused by the degeneration of the collagen fibres within the tendon due to repetitive overloading, in particular the fibres of gluteal medius and minimus. This repetitive loading then causes swelling in the tendons which leads to additional compression and pain. Continued repetitive loading at this stage leads to a breaking down, or degeneration of the tendon fibres.
Tendon injuries tend to occur from repetitive use and as such are more common as we age. Repetative movements from our sport (running, jumping, throwing); work (manual labour, packing, lifting) and day to day activities (gardening, twisting etc) can all lead to the degeneration to the tendon fibres.
- Localised pain around the greater trochanter (sometimes lower back pain as well). This pain can travel down the outside of the thigh to the knee
- Pain can be worse when using the tendon – running, walking, jumping, stair climbing
- Pain worse when lying on the affected side, lying on the opposite side can also be problematic as the hip is the positioned in adduction which can aggravate the tendon.
- Pain on crossing legs, sitting in low chairs and ‘hip hanging’
- Pain is often worse at night and when you first rise in the morning
How can Myo help?
Once Gluteal Tendinopathy has been identified, your myotherapist will discuss your treatment options. Initially, this will be reducing your pain and discomfort:
- Activity modification – we will discuss activities to avoid that may aggravate the pain including sleeping position, sitting position and day to day movements.
- NSAID’S – anti-inflammatory medication (speak with your doctor first about taking medication). Although tendinopathy is not an inflammation disease, NSAID’s have been shown to be effective in the reactive stage to help reduce swelling within the tendon.
- Soft Tissue Therapy & Dry Needling – if muscles are tight they may be aggravating the situation. Soft tissue massage and dry needling can help reduce the tension in the attached muscles.
Once the pain has receded it is important to begin strengthening and gain flexibility in the surrounding muscles. Your myotherapist can discuss suitable exercises for this stage.