Gluteal (Tendinopathy)

Pathophysiology

Gluteus Medius is a muscle of the buttock which attaches to a bony prominence on the outside of the hip. There are also two bursa (fluid-filled sacs) which lie in this area to prevent friction, able to expand and swell to do so. Irritation of the Gluteus Medius tendon (attaching muscle to bone) can lead to tendinopathy and cause you the following symptoms to the outside of your hip.

Symptoms

• Pain on the outside of the hip which may radiate towards the knee

• Pain when lying on either side in bed

• Pain with crossing legs, getting out of a car or climbing stairs

• Pain with pressure onto the outside of the hip

Management

• Activity modification and offloading e.g avoiding sitting cross-legged and using a pillow between knees to sleep at night

• Ice or heat

• Pain relief

• Physiotherapy including range of movement exercises and a graded strengthening programme

• Orthopaedic options- If pain and function is limited in severe cases steroid injection may benefit

Investigations

Not generally indicated