Gluteal Tendinopathy: Understanding Hip Pain on the Outside
Pain on the outside of your hip can be debilitating, making activities like walking, climbing stairs, or even sleeping on your side a challenge. While often mislabelled as "bursitis," one of the most common causes of this type of pain is gluteal tendinopathy.
This condition involves the tendons of your gluteal muscles, particularly the gluteus medius and minimus, which are vital for hip stability. Osteopathy offers a comprehensive approach to managing gluteal tendinopathy by addressing not just the painful tendons, but the underlying biomechanical factors that led to the problem.
Key Facts About Gluteal Tendinopathy
A Common Culprit: Gluteal tendinopathy is the most prevalent disorder causing lateral hip pain, especially in women over 40.
A Tendon Issue: It is a condition of the tendon itself, involving degeneration and failed healing, rather than simple inflammation (which is why the older term "tendinitis" is less accurate).
Impact on Function: It can significantly impair walking, standing on one leg, and other weight-bearing activities due to the role these muscles play in pelvic stability.
Common Causes and Risk Factors
Gluteal tendinopathy is typically an overuse injury caused by compression and overload of the tendons. Key factors include:
Tendon Compression: This is a primary mechanism. The gluteal tendons pass over the bony prominence of the greater trochanter on the hip. Positions or activities that compress this area can irritate the tendon. This includes:
Sleeping on your side.
Sitting with your legs crossed.
Standing with your weight shifted onto one hip (hip-hitching).
Sudden Increase in Load: A rapid uptick in walking, running, or climbing activities without adequate conditioning can overload the tendons.
Biomechanical Weakness: Weakness in the gluteus medius and minimus muscles means they cannot effectively control pelvic movement during walking, leading to excessive strain on their tendons.
Altered Gait: Issues elsewhere in the body, such as in the lower back, opposite hip, knee, or foot, can change your walking pattern and increase stress on the hip.
Other Factors: Age-related changes in tendon health, being overweight, and a history of low back pain can also contribute.
Common Signs and Symptoms
Pain Location: Pain is localised to the outside of the hip (the upper thigh bone) and can sometimes radiate down the outside of the thigh.
Pain with Pressure: Tenderness when pressing on the bony point on the side of your hip.
Pain with Specific Activities: Pain that is worse with:
Walking, climbing stairs, or running.
Standing on the affected leg.
Lying on the affected side.
Stiffness: Stiffness in the hip, particularly after periods of rest.
How Can Osteopathy Help with Gluteal Tendinopathy?
Osteopathic management focuses on reducing pain, modifying load, and correcting the biomechanical faults that are overstressing the tendons.
During your initial consultation, we will:
Take a detailed history of your pain, activities, sleep habits, and daily postures.
Perform a physical examination to assess your hip's range of motion, muscle strength, and identify the specific tender points.
Conduct a functional and biomechanical assessment of your posture, gait, and the mobility of your lower back, pelvis, knees, and feet.
This whole-body assessment is crucial to identify the root cause of the tendon overload.
What Does Osteopathic Treatment Involve?
Using a range of gentle, hands-on techniques, we aim to:
Reduce Pain and Muscle Tension: Soft tissue massage and myofascial release techniques are used to relax tight muscles in the hip, thigh, and lower back that may be contributing to the problem.
Improve Joint Mobility: Gentle mobilisation of the hip, sacroiliac joints, and lower back can restore normal mechanics, ensuring the hip moves efficiently and reduces strain on the tendons.
Address Compensatory Patterns: We identify and treat issues in other parts of the body that are altering your movement and placing extra load on the hip.
Provide Personalised Education and Load Management Advice: This is a critical component. We will provide specific guidance on:
Activity Modification: How to temporarily adjust your activities to reduce tendon irritation.
Avoiding Compression: Practical advice on sleeping positions (e.g., avoiding lying on the painful side) and sitting postures.
Tailored Exercise Rehabilitation: A progressive exercise program is essential. We will guide you through specific, pain-free exercises to gradually strengthen your gluteal muscles and improve their capacity to handle load, which is key to long-term recovery.
When to Seek Further Medical Help
It is important to get a correct diagnosis for your hip pain. Please consult your GP for a referral if you experience:
Severe, unremitting pain that prevents weight-bearing.
Hip pain following a significant fall or trauma.
Night pain that is severe and unrelated to position.
Signs of infection, such as fever, redness, or warmth in the hip.
Numbness, tingling, or weakness that travels down your leg.
Your GP can help rule out other conditions like true bursitis, arthritis, or referred pain from the lower back.
Take the Next Step Towards a Pain-Free Hip
Gluteal tendinopathy can be a stubborn condition, but with the right approach, recovery is very achievable. Osteopathy provides a safe, effective, and drug-free pathway to not only alleviate your pain but also to address the root causes and empower you with the knowledge to prevent its return.
Click here to schedule an appointment with one of our experienced osteopaths. Let us help you get back to moving with confidence and comfort.
References
*Fearon, A. M., Cook, J. L., Scarvell, J. M., Neeman, T., Cormick, W., & Smith, P. N. (2015). Greater trochanteric pain syndrome: defining the clinical syndrome. British Journal of Sports Medicine, 49(12), 792-793. [Link: https://bjsm.bmj.com/content/49/12/792]*
Mellor, R., Bennell, K., Grimaldi, A., Nicolson, P., Kasza, J., Hodges, P., ... & Vicenzino, B. (2018). Education plus exercise versus corticosteroid injection use versus a wait and see approach on global outcome and pain from gluteal tendinopathy: prospective, single blinded, randomised clinical trial. BMJ, 361, k1662. [Link: https://www.bmj.com/content/361/bmj.k1662]
Australian Institute of Health and Welfare (AIHW). (2020). Musculoskeletal conditions. [Link: https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/musculoskeletal-conditions]
Disclaimer: This blog post provides general information only and is not intended as a substitute for professional health advice, diagnosis, or treatment. Always consult a registered health practitioner, such as your General Practitioner (GP) or osteopath, for diagnosis and treatment of health conditions. The information provided is based on the best available evidence at the time of publication but should not be relied upon as a sole source of information. Individual results from osteopathic treatment may vary based on the individual’s specific condition and response to care. The exercise rehabilitation component is crucial for managing this condition, and adherence to a tailored program is recommended for optimal outcomes.