Gluteus medius tendinopathy
Understanding this condition
The gluteus medius is a muscle located on the side of the hip. Its tendon attaches to a bony prominence called the greater trochanter, easily felt beneath the skin above the thigh. This muscle stabilises the pelvis with every step: without it, we would fall to the side of the advancing leg.
Gluteus medius tendinopathy is a painful condition of this tendon: inflammation, degeneration, or partial tear. It is the hip equivalent of a shoulder tendinopathy. It is very common, particularly in women over 50.
Symptoms
Pain on the lateral aspect of the hip, directly over the bony prominence of the greater trochanter. It is typically triggered at night when lying on the affected side, and appears when climbing stairs, rising from a low chair, or walking for extended periods.
Simply pressing the greater trochanter with a finger is painful. A limp may develop when the tendon is significantly weakened.
How can it progress?
Chronic inflammation can lead to degeneration and then a partial or complete tendon tear. An established tear causes a permanent limp and loss of strength that impacts independence.
The earlier treatment is initiated, the better the results of non-surgical management.
Treatment options
Physiotherapy is the gold-standard treatment: eccentric strengthening exercises, stretching, postural work. It yields excellent results in the majority of cases, but requires commitment over several weeks.
Ultrasound-guided injections can complement treatment. In the case of a confirmed tear on MRI, or failure of well-conducted medical treatment, surgical tendon repair (open or endoscopic) is possible. A consultation guides the most appropriate strategy.