By Andy McGree
Are you experiencing pain on the side of your hip? If so, its quite likely you have gluteal tendinopathy which may or may not be accompanied by an irritable and inflamed bursa. The good news is that you are not alone, with as many as 1 in 4 women over the age of 50 being the most prevalent demographic with this condition, but also regularly occurring in younger populations as well. The even better news is that it is easily treated with physiotherapy and a specifically guided exercise program.
What is it?
Gluteal tendinopathy is when the tendon fibres that attach the gluteus medius and gluteus minimus muscles to the bony prominence on the side of your hip (greater trochanter), degenerate due to repetitive overload and potentially develop a tear as well. In association with this condition, the trochanteric bursa, which is a sac of fluid located near that bony prominence, may also become painful and inflamed.
What causes it?
There can be many contributing factors, which will be different for each individual. Here are some regularly recurring contributing factors found:
- Weakness of the gluteal muscles;
- Incorrect gait pattern, most notably a hip drop or waddling gait pattern;
- Prolonged inactivity and deconditioning;
- A sharp increase in exercise or activity your body is not prepared for;
- Structure of your feet and/or inappropriate footwear;
- Leg length discrepancy.
What are the symptoms?
The primary symptom for this condition is pain and weakness to the side of your hip. Activities that will commonly provoke this painful condition, particularly when the activities are over a prolonged period can include:
- Sitting, particularly in a deep chair/couch and worse with legs crossed;
- Sidelying, even on the unaffected side;
- Single leg stance;
- Carrying your baby/child on one hip.
How can I fix it?
It is important to be assessed by your Physiohealth physiotherapist for a complete examination to ensure all of your individual contributing factors are found and addressed as a part of your treatment plan. Common modalities that may be incorporated to ease your symptoms include:
- Manual therapy;
- Dry needling;
- Ice or heat;
- Analgesic and/or anti-inflammatory medication;
- Avoiding aggravating activities, potentially even a period of rest may be required;
Ultimately, for complete rehabilitation, the most important element of your treatment program is to undertake a progressive exercise program. The program will be focused on improving your gluteal muscle strength, it will begin at a level that is tolerable as dictated by your condition, then will be continually progressed to higher levels until you are able to complete higher level functional tasks with correct technique. This exercise program may also incorporate other global muscles that are contributing to the initial poor movement patterns as well.
An important note with rehabilitation, is that it is essential not to stop the exercise program at which point you are pain free, but to continue until you have completely rehabilitated the gluteal tendons to normal function, until the gluteal muscles reach their required strength and until your movement patterns normalise, to ensure you don’t experience a recurrence of this painful and debilitating condition.
For more information or an assessment please contact your nearest Physiohealth clinic.