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Top tips for runners with Gluteal Tendinopathy

Gluteal tendinopathy causes pain predominantly over the side of your hip, but it can also refer down the side of your leg. You can check out the video below for a full explanation of what causes it, how to test for it and what treatments and exercises can help for it. In this article I’m only going to focus on some practical advice that I’ve found can decrease my patients’ pain within a few days.


In this video I explain the causes and treatment of gluteal tendinopathy in detail:



1. Stop crossing your legs when you sit


It is usually the glute med and glute min tendons that are injured when you have a gluteal tendinopathy. When you cross your legs, you stretch those tendons and compress them over the hip bone. These tendons do not appreciate being compressed when they are injured and it can be one of the reasons why your pain is continuing.


2. Stand on both legs!


This may sound like a strange command but think about it – how often do you stand mainly on one leg and just drop your other hip so that you’re hanging off the supporting one? That position also caused A LOT of compression of the glute med and min tendons and can aggravate your pain further.



3. Avoid sitting in very soft, deep chairs


Once again compression is the problem. Part of the gluteal tendons are stretched and compressed when you sit with your hips in a lot of flexion e.g. when you sink into a deep chair. Try to stick to firm chairs that aren’t too low.


4. Sleep on your back or with 2 pillows between your legs


It makes sense that when you sleep on your injured side it compresses the injured tendons, causing pain. But my patients can often not understand why sleeping on the uninjured side also hurts their injured leg, despite it now being on top.


When you sleep with your injured side on top, the leg usually ends up dropping down slightly. This, once again, causes the tendons of the glute med and min to stretch and compress. If your tendon is very sensitive, it may cause pain immediately, but if your tendon is less aggravated it may take a few hours before the position becomes painful. In my experience using 1 pillow between your knees is often not enough. My patients tend to find that they have to use 2 pillows to get totally comfortable.


In case you find it too tricky to balance this tower of pillows while sleeping, sleeping on your back will of course eliminate the need for any pillows.


Let me know if you have any questions, but check out the video above for a full explanation of available treatments. You’re also welcome to consult me online via video call if you would like an assessment of your injury and a tailored treatment plan.

Best wishes

Maryke


About the Author

Maryke Louw is a chartered physiotherapist with more than 15 years' experience and a Masters Degree in Sports Injury Management. Follow her on LinkedIn, ResearchGate, Facebook, Twitter or Instagram.




References:

  1. Ali, M., Oderuth, E., Atchia, I., Malviya, A., The use of platelet-rich plasma in the treatment of greater trochanteric pain syndrome: a systematic literature review, Journal of Hip Preservation Surgery, Volume 5, Issue 3, August 2018, Pages 209–219,

  2. Ebert, J. R., et al. (2017). "A Systematic Review of Rehabilitation Exercises to Progressively Load the Gluteus Medius." Journal of sport rehabilitation 26(5): 418-436.

  3. Fitzpatrick, J., et al. (2019). "Leucocyte-Rich Platelet-Rich Plasma Treatment of Gluteus Medius and Minimus Tendinopathy: A Double-Blind Randomized Controlled Trial With 2-Year Follow-up." The American Journal of Sports Medicine 47(5): 1130-1137.

  4. Grimaldi, A. and A. Fearon (2015). "Gluteal tendinopathy: integrating pathomechanics and clinical features in its management." Journal of Orthopaedic & Sports Physical Therapy 45(11): 910-922.

  5. Grimaldi, A., et al. (2015). "Gluteal tendinopathy: a review of mechanisms, assessment and management." Sports Medicine 45(8): 1107-1119.

  6. Grimaldi, A., et al. (2017). "Utility of clinical tests to diagnose MRI-confirmed gluteal tendinopathy in patients presenting with lateral hip pain." British Journal of Sports Medicine 51(6): 519-524.

  7. Mellor, R., et al. (2018). "Education plus exercise versus corticosteroid injection use versus a wait and see approach on global outcome and pain from gluteal tendinopathy: prospective, single blinded, randomised clinical trial." British Journal of Sports Medicine 52(22): 1464-1472.

  8. Plinsinga, M. L., et al. (2019). "Physical findings differ between individuals with greater trochanteric pain syndrome and healthy controls: A systematic review with meta-analysis." Musculoskeletal Science and Practice.

  9. Stastny, P., et al. (2016). "Strengthening the gluteus medius using various bodyweight and resistance exercises." Strength and conditioning journal 38(3): 91.

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