Gluteal Tendinopathy

What is gluteal tendinopathy?

Gluteal tendinopathy is a type of tendon disorder in your hips and buttocks area (gluteal region). The disorder causes the tendon tissue to break down or deteriorate. Gluteal tendinopathy is a common cause of hip pain, especially in older women. Physical therapy exercises can help, although some people need other interventions.

What are tendons?

Your tendons are strong, flexible tissues that connect your muscles to your bones. These parts of your musculoskeletal system work together to help you move, run, walk, sit and stand. When something irritates, inflames or injures your tendons, you experience musculoskeletal pain.

What parts of your body does gluteal tendinopathy affect?

Gluteal tendinopathy affects the tendons that connect to your buttocks muscles. These include the gluteus maximus, medius and minimus. These muscles run from your hipbone (pelvis) to your greater trochanter. The greater trochanter is the ridge at the top of your thighbone (femur).

Who gets gluteal tendinopathy?

People assigned female at birth who are over 40, especially those who have completed menopause, are more prone to hip pain and gluteal tendinopathy. The condition also affects younger people who run, ski and dance. As many as 1 in 3 people with lower back pain also develop hip pain from gluteal tendinopathy.

What’s the difference between gluteal tendinopathy, gluteal tendinitis and trochanteric bursitis?

Several conditions can affect the tendons in your hips and glutes, causing pain. But their underlying causes and treatments are different.

• Gluteal tendinitis: Repetitive movements cause small micro-tears in your tendons, leading to inflammation and tendinitis. You may have deep pain in your hip area that improves with rest, ice, compression and elevation (RICE).
• Gluteal tendinopathy: This hip pain is the result of a tendon injury that causes tissue to break down or deteriorate. Rest doesn’t typically help, but physical therapy exercises can ease symptoms. It takes longer to recover from tendinopathy than tendinitis.
• Trochanteric bursitis: Trochanteric bursitis is inflammation in one of the bursa sac (bursitis) in your hip. These fluid-filled sacs cushion the space between bones, muscles and tendons. Some people with trochanteric bursitis develop greater trochanter pain syndrome (GTPS). Treatments may include nonsteroidal anti-inflammatory drugs (NSAIDs), cortisone shots, splinting and surgery as a last resort.

What causes gluteal tendinopathy?

Gluteal tendinopathy can occur from tendon overuse or underuse. Potential causes include:

• Putting too much force on your tendons during physical activities (overuse).
• Tendon compression due to a fall or another type of accident.
• Excess pressure on the tendons from weight gain or obesity.
• Inactivity or a sedentary lifestyle (underuse).
• Wide pelvis or hip instability.

What are the symptoms of gluteal tendinopathy?

The most notable sign of gluteal tendinopathy is moderate to severe hip pain. This pain extends down the outside of your leg to your knee or lower leg. You may also experience lower back pain, groin pain or gluteal pain. The pain often starts at the greater trochanter at the top of your thighbone. This area may feel tender to touch.

The pain may feel worse when you:

• Climb stairs or walk up a hill.
• Get out of bed in the morning.
• Lie on your side.
• Sit for a prolonged time or sit cross-legged.
• Stand on one leg — like when you pull on a pair of pants.

How is gluteal tendinopathy diagnosed?

Your healthcare provider will evaluate your symptoms and perform a physical examination. You may get an MRI or ultrasound to look for tendon injuries or inflammation. Many conditions can cause hip pain. A correct diagnosis is critical to proper treatment and a faster recovery.

How is gluteal tendinopathy treated?

About half of people with gluteal tendinopathy will get better without treatment — but symptom relief may take up to a year. That’s a long time to live with hip pain, especially when 7 out of 10 people with the condition see significant improvements with eight weeks of physical therapy exercises. Other people may need surgery to mend a torn tendon.

You may also benefit from:

• Applying heat to the painful area.
• Avoiding low chairs.
• Minimizing stair climbing.
• Not crossing your legs.
• Sleeping with a pillow between your knees.
• Walking on flatter surfaces, when possible.

Can you prevent gluteal tendinopathy?

These tips may lower your risk of developing hip pain and gluteal tendinopathy:

• Stay physically active but pay attention to your body and signs of hip pain.
• Modify or take a break from activities like running that irritate your hips.
• Avoid repetitive activities that put a lot of pressure on your hips.
• Lose weight, if needed.
• Lift weights to strengthen your gluteal muscles.
• Practice yoga or stretching exercises to keep your hip muscles flexible.
• Treat lower back pain and practice good posture.

What is the outlook for people with gluteal tendinopathy?

Severe, chronic pain from gluteal tendinopathy can affect your quality of life. It can interfere with your ability to work, exercise and socialize. You may experience fatigue and irritability if the pain affects your sleep. Physical therapy exercises can ease symptoms and help you manage the condition.

When should I call the doctor?

Call your healthcare provider if you experience:

• Severe hip pain that interferes with daily activities or sleep.
• Inability to walk up a flight of stairs without pain.
• Pain in your lower back and hip.

What should I ask my provider?

You may want to ask your healthcare provider:

• What caused the gluteal tendinopathy?
• Could I have a different condition like tendinitis or trochanteric bursitis?
• What is the best treatment for me?
• Should I look for signs of complications?

A note from Cleveland Clinic

If you have severe hip pain that affects your ability to exercise, sleep or comfortably move, you should see your healthcare provider. Many conditions, including gluteal tendinopathy, can cause hip pain. But the pain is usually more severe and chronic with gluteal tendinopathy. You may need imaging tests to pinpoint the precise cause of your hip pain. This tendon problem rarely gets better without treatment. Rest also doesn’t help. Your provider can start you on physical therapy exercises to improve your mobility and ease symptoms.