Gluteal Tendinopathy

Does this sound like you?

Most people have several of these, not all of them.

• Pain on the bony point at the outside of the hip
• Marked pain lying on that side, which is usually the worst part
• Pain on standing up after sitting, easing after a few steps
• Discomfort climbing stairs or hills
• Referral down the outside of the thigh, rarely past the knee

Why it happens

• Compression from sitting cross-legged or standing on one hip
• A rapid increase in walking, hill work or running
• Weakness through the deep hip muscles
• Most common in women in their forties to sixties
• Lying on the affected side, which both causes and worsens it

What we would do about it

Roughly in this order — each step waits for the one before it.

1. Removing the compressive positions, which is the fastest single change
2. Progressive loading of the gluteal tendons
3. Pillow between the knees at night, and off the affected side
4. Deep hip and pelvic strengthening built up in stages
5. Walking and hill load managed rather than stopped
6. Referral for injection only where pain blocks all loading