Gluteal tendinopathy is one of the most common causes of pain at the side of the hip in women. This condition is still often referred to as trochanteric bursitis, however researchers have now determined that the primary problem is a reduction in health and load tolerance of the gluteus medius (an important muscle in controlling the hips) and minimus tendons. Gluteal tendinopathy is more common in women than men, about 1 in 4 women over the age of 50 suffer from lateral hip pain.
Pain is felt at the side of the hip and can extend down the outer thigh towards the knee. Pain may be felt when walking, particularly at speed, uphill or upstairs and when standing on one leg to dress. It is common to experience pain and a feeling of stiffness when rising from a chair after prolonged sitting. Night time is often worse, particularly when lying on your side.
Physiotherapy can help gluteal tendinopathy in multiple ways. Your physiotherapist can advise you about controlling aggravating tendon loads—everyday postures, movement habits, walking pattern and activities that might be provoking your pain.
Research has found that exercise provides the best long-term outcomes for tendon pain. A specific exercise program that aims to improve your movement patterns, gradually strengthen the muscles involved and improve the health of your hip tendons is essential. Massage, self-trigger point releases, acupuncture, dry needling, laser therapy and heat may assist with short term symptomatic pain relief. However, a specific exercise program and being taught how to control loads across your tendons are key strategies in managing this condition for the longer term.
Stretching of the gluteals or Iliotibial band (ITB), while a common strategy, will usually only aggravate the tendons. Corticosteroid injections have previously been recommended, but these have been found to have only short term benefits. It is important to remember that complete rest does not heal tendon problems and the more inactive you become, the weaker you become. Visiting your physiotherapist as soon as possible will help you to get on track with a tailored education and exercise program.
With specific advice and a tailored exercise program, most people will notice some reduction in pain within 2-4 weeks. However, it will usually take a commitment to an exercise program over a number of months to regain adequate improvements in strength and movement patterns to consistently control symptoms and regain normal activity levels. The timeframe can vary significantly depending on the severity of the tendon problem, duration of the problem, previous interventions, level of muscle weakness or physical conditioning, other coexisting health problems and adherence with advice and exercise prescription.
If you would like any further information or to book an appointment please call Whittlesea Physiotherapy & Clinical Pilates on 03 9716 2250 or email [email protected]