Gluteus Medius Tendinopathy is a painful condition of the hip that can be can limit one’s ability to stand, walk, use stairs or run. It usually comes through wear and tear of the structure of the tendon through overuse, but there can be traumatic tears of the tendon.
A lot of things can contribute to Gluteus Medius Tendinopathy. Like any tendon in your body, it joins a muscle to a bone and has a lot of force going through a narrow area. Just like muscles, tendons get stronger with exercise and weaker with disuse. If there is excessive force going through a tendon, and it doesn’t get the chance to recover and heal, and over time the structure of the tendon begins to break down.
If someone is performing a new activity like hiking or running, that can overload the tendon and cause some of the breakdown. Often the tendinopathy (sometimes called tendinitis) comes seemingly "out of the blue", and can be related to gaining weight, being less active, or if something else has affected the quality of movement (e.g. where knee pain causes limping, or back pain inhibits the gluteal muscles from working properly).
Tendon problems are more common in those who are middle-aged or older, and poor general health, poor nutrition, and some medications may increase the chance of getting Gluteus Medius Tendinopathy.
Someone suffering from Gluteal Tendinopathy will usually feel pain slightly behind the outside edge of the hip, especially when putting load through the hip like standing or sitting, going up/ down steps, or slopes. The pain may radiate down the back or the side of the leg.
The diagnosis of Gluteus Medius Tendinopathy typically comes from a Physician after they have conducted a thorough background check on a patient's medical history and identification of their symptoms and severity. Additional steps might be taken to confirm Gluteus Medius Tendinopathy including the use of X-Rays or MRIs.
The key to a tendon healing is appropriate loading. Firstly, adapting the load going through the tendon by adjusting the activity, while addressing the biomechanics and joint control of the hip and adjacent regions. An exercise program that gradually and incrementally stresses the tendon is essential — too little and the tendon won’t heal, too much and the tendon will further break down. Massage and manual therapy can help support and simplify the rehab, and interventions such as trigger point dry needling, strapping & taping, instrument-assisted soft tissue work, and orthotics may also be supportive.
This process can take some time, depending on the stage of the condition and many other variables. Tendons heal at a rate about double the time of muscle tissue but often they can begin to improve quite quickly. Rarely the tendon could rupture and require surgical repair.
Good habits that can help prevent tendinopathy are the same habits that benefit general health- regular exercise including resistance training, good nutrition, sleep quality, maintaining a healthy weight, and avoiding sudden and dramatic changes in activity.
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