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Guide to Hip impingement

What is Gluteal tendinopathy?

Gluteal tendinopathy is irritation of the gluteal tendons. It presents itself as pain and tenderness along the side of the hip which can also refer down the outside of the leg. It is usually described as a constant ache or bruise on the side of the affected hip with pain being worse in the mornings.

What are the symptoms of Gluteal tendinopathy?

Gluteal tendinopathy is 3x more likely to occur in females than men between the ages of 40 and 60.

Some of the signs and symptoms associated with gluteal tendinopathy are:

  • Pain that gets worse when crossing the legs
  • Pain that intensifies when laying on the affected side and occasionally on the other side
  • Pain that is aggravated by going up and downstairs
  • Pain that is located on the outside of the hip may refer pain to the outside of the thigh and knee

What causes Gluteal tendinopathy?

Gluteal tendinopathy tends to develop from a combination of excessive tension and compression of the tendons leading to irritation and micro-tears.

Certain risk factors increase the likelihood of developing gluteal tendinopathy such as:

  • Repetitive, high-force gluteal contractions.
  • Leg length inequalities creating more pressure on one side
  • Obesity
  • A sudden increase in load

How is Gluteal tendinopathy diagnosed?

The diagnosis of gluteal tendinopathy is made using a combination of clinical tests and diagnostic imaging such as MRI or ultrasound. Clinical tests involve things such as testing the strength of the muscle, range of motion of the hip, assessing your walking and asking you questions that reveal more information about the condition.

Your practitioner may refer you to get some diagnostic imaging done which are very effective at diagnosing the true pathology that may be causing your pain.

How is Gluteal tendinopathy treated?

The treatment goals for gluteal tendinopathy will be physical therapy that includes:

Reducing modifiable risk factors and poor movement mechanics that create excessive tension or compressive forces on the gluteal tendon.

This is done by observing your posture and seeing how it can be modified through rehabilitation which includes specific stretching and strengthening programme designed for you.

Some advice that you can start implementing immediately would-be things such as:

  • Avoiding standing on one hip
  • Avoiding sitting with knees crossed
  • Avoid prolonged periods of sitting
  • Place a pillow between the knees while sleeping on your side
  • Avoid any type of long-distance running or hill climbing

If you find that physical therapy is unsuccessful then a different approach may be taken such as Ultrasound-guided injection which will help settle down any inflammation. But this should be done with a strengthening programme as the aim of the injection is to reduce the amount of pain you’re in to allow you to strengthen the muscle.

References

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