Gluteal Tendonopathy Explained by Lindsay Young
The Gluteal Muscles Explained
The gluteal muscles are a set of three muscles, gluteus medius, gluteus minimis and gluteus maximus located in the backside. They play an integral role in supporting the hip, knee, pelvis and lower back and cause movement at the hip joint. Tendons are what attach muscles to bones. They are made up collagen (connective tissue found throughout the body) and cells called tenocytes which have a parallel arrangement. Gluteal tendinopathy involves changes to the matrix of the tendon cells.
Signs and symptoms of gluteal tendinopathy:
- Pain located over the buttock, especially towards the hip
- Stiffness, especially of the lower back and gluteal muscles
- Night pain and evening pain
- Morning pain and stiffness
- Tenderness over the gluteal tendo
Gluteal tendinopathy’s tend to often be associated with hip bursitis and lumbar spine referred pain. A bursae is a small fluid filled sac prone to inflammation that acts to cushion the tendon where it inserts into the bone. The gluteal muscles are also often a site of referred pain form the lumbar spine. Treatment, stretching and strengthening of the lower back is often required to see full recovery in gluteal tendinopathys.
If the gluteal tendon pain is acute (less than one month) management needs to include an immediate period of rest to offload the tendon before commencing localised strengthening. If the pain has been there for longer than 3 months and the tendon cells have started to degenerate the management approach is different. Strengthening in this case tends to commence immediately. Tendon rehab is difficult as tendons don’t like being offloaded or having too much load.
In all cases of tendinopathy the contributing factors towards the tendon pain need to be addressed. These factors include
- Load (including training or everyday life)
- Muscle strength
- Flexability and length
- Joint stiffness
- Body weight
Time frames for recovery vary depending on how long the tendon has been sore for. In cases of chronic pain tendons can take up to 6-12 months to fully recover as the tendon needs time to replace its cells and for the matrix of the cells to be re-aligned.