Gluteal Tendinopathy

Gluteal tendinopathy, also known as greater trochanteric pain syndrome (GTPS), is a common condition that affects the tendons of the gluteal muscles around the hip. This condition is characterised by pain and inflammation in the tendons of the gluteus medius and gluteus minimus muscles, which play an essential role in stabilising the hip and pelvis during movement. People with gluteal tendinopathy often experience pain on the outer side of the hip, which can worsen with activities like walking, climbing stairs, or standing on one leg.

The mechanics behind gluteal tendinopathy usually involve repetitive stress or overload or underload on the gluteal tendons. This can occur due to factors such as muscle weakness, poor biomechanics, overuse, or improper loading during physical activities. For example, prolonged standing, running, or repetitive movements can cause excessive strain on the tendons, leading to microtears and inflammation. Other contributing factors include hip tightness in surrounding muscles, or imbalances in strength between the hip muscles.

Physiotherapy plays a crucial role in managing and treating gluteal tendinopathy by addressing the root causes and helping reduce pain while improving function. Here’s how physiotherapy can help:

·       Pain management: Techniques like soft tissue mobilisation, deep tissue massage, and ice or heat therapy can help reduce inflammation and alleviate pain in the affected tendons.

·       Manual therapy: Joint mobilisations and specific manual techniques can improve hip joint mobility and reduce stiffness, allowing for better movement and less discomfort.

·       Strengthening exercises: A key part of rehabilitation is strengthening the gluteal muscles (gluteus medius and minimus) along with the surrounding muscles, such as the core and hip stabilisers. Stronger muscles help support the hip joint and reduce strain on the tendons.

·       Stretching and flexibility: Stretching exercises for the hip flexors, hamstrings, and surrounding muscles can relieve tightness and improve flexibility, which can reduce the load on the gluteal tendons.

·       Biomechanical assessment and correction: Physiotherapists assess posture, gait, and movement patterns to identify any contributing factors such as muscle imbalances or poor alignment. By correcting these issues, we can prevent excessive strain on the tendons.

·       Activity modification: Education on modifying activities that exacerbate the pain (e.g., climbing stairs, prolonged standing) helps prevent further irritation of the tendons during the healing process.

·       Progressive loading: Gradual and controlled loading of the tendons through specific exercises allows the tissues to heal and adapt, avoiding overloading or re-injury.

By implementing these strategies, physiotherapy helps accelerate recovery, reduce pain, and prevent future episodes of gluteal tendinopathy.