Physiotherapy for Gluteal Tendinopathy: Causes, Symptoms, and Exercises

What Occurs in the Gluteal Tendons, and What Steps Can Individuals Take To Address It?

• The tendons are the strong elastic tissues that connect the muscles to the bones. Gluteal tendons connect the gluteal muscles to the femur bone.

• Gluteal tendinopathy is a tendon disorder of the gluteal region (hips and buttocks). Gluteal tendinopathy causes the tendons to deteriorate. It is the most common cause of hip pain in older women.

• It is common in females who are over 50 years of age, especially in women who attained menopause. These women are more prone to gluteal tendinopathy and hip pain.

• Gluteal tendinopathy also affects people involved in running, dancing, and skiing.

• Gluteal tendinopathy affects the butt muscles tendons, including the gluteus maximus, gluteus medius, and gluteus minimus. These gluteus muscles run from the pelvis (hip bone) to the greater trochanter (ridge present at the top of the thigh bone). This disorder can be treated through physical therapy; some need additional interventions.

What Are the Causes of Gluteal Tendinopathy?

The most common cause of gluteal tendinopathy is the underuse or overuse of tendons of the gluteal region. The other causes include:

• Providing too much force to the tendons while performing physical activities.

• Being inactive without involving in any physical activities.

• Compression of the tendon due to fall or accident.

• Hip instability.

• Wide pelvis.

• Obesity causes excessive pressure on the tendon.

What Are the Symptoms of Gluteal Tendinopathy?

The most common symptom of gluteal tendinopathy is mild to severe hip pain. The hip pain can radiate to the lower leg and the knees. People may also experience gluteal or groin pain and lower back pain. The pain usually starts from the greater trochanter, the top surface of the thigh bone. There may also be tenderness to the touch. The pain may be aggravated on:

• Climbing the stairs.

• Walking on the hill.

• Getting out of bed.

• Lying on the side.

• Sitting for a prolonged time.

• Standing on one leg.

How Is Gluteal Tendinopathy Treated?

In most cases, gluteal tendinopathy may get better without treating it. Conservative treatments and physical therapy may ease this tendon disorder. The conservative measures include:

• Application of heat to the affected area.

• Avoid low chairs.

• Avoiding crossing the legs.

• Sleeping by placing a pillow between the knees.

• Reduce climbing stairs.

• Walking on flat surfaces as much as possible.

Doctors usually refer patients with gluteal tendinopathy to a physical therapist who suggests several exercises that prevent in worsening of the condition and improve mobility. These exercises also help to improve strength by stimulating the tendon to heal. The exercises for gluteal tendinopathy include

1. Bridge - This exercise works on the glute, core, and hamstrings.

• The person should lie back on the floor and rest the neck on a pillow.

• Then the person should place the soles of their feet firmly against the floor.

• Then the person should raise their hip towards the ceiling by locking the legs to a comfortable height until the person feels some tension.

• Then the person should hold the position for 30 seconds and get down to the starting position.

• The exercise should be repeated 10 times.

2. Static Abduction - This exercise works on the buttocks, hips, and upper leg. The instructions are:

• The person should stand straight on the floor with the feet apart and wider than the hips.

• Then the person should start sliding the legs apart gradually until they feel the tension in the buttocks and hip area.

• Then the person should relax from the sliding and return to the starting position.

• The exercise should be repeated three times.

3. Step-Ups - This exercise works on gluteal muscles and leg muscles. The instructions are:

• The person should place their right foot firmly on the first step of the staircase.

• Then the person should raise their left foot onto the step by locking the buttocks and straightening the neck to align both in line.

• Then the person should lower their foot back to the floor one by one and repeat the exercise for 30 to 60 for three times a day.

4. Single-Leg Standing Stretch - This exercise works on the gluteal muscles on the sides of the hip. The instructions are:

• The person should stand and shift the body's weight onto the right foot. The person can hold on to a chair or a table for support.

• Then the person should gently raise the left foot from the floor and hold it for a few seconds.

• The person should align the pelvis in a straight line and balance the body.

• The exercises should be repeated at least once a day for five to fifteen seconds.

5. Single Leg Squat - The instructions are:

• The person should stand straight on the floor and shift the body's weight to the right foot. Then the person should raise the left foot from the floor.

• Then the person should bend the knee of the raised left leg so that the pelvis will shift backward and the torso forward and align the ears and neck with the hips and shoulders.

• Then the person should straighten the right foot and complete the squat.

• The person should hold both the down and up positions for three to four seconds.

• The exercise can be repeated three times.

What Exercises Should Be Avoided for Gluteal Tendinopathy?

• Any exercises or stretches that involve the knees bending across the body, like the piriformis, lower back rotation stretches, etc.

• Any exercises that push the hip outward.

• Hip exercises that rotate the leg far backward.

How Is Gluteal Tendinopathy Prevented?

Gluteal tendinopathy can be prevented by:

• Staying physically active.

• Doing warm-up exercises before starting the workouts.

• Avoiding activities that overuse the hip muscles.

• Stopping activities like running irritate the hip muscles.

• Lifting weights to improve the strength of the gluteal muscles.

• Practicing stretching exercises to improve the mobility of the hip muscles.

• Reducing weight in obese persons.

Conclusion:

Chronic and severe pain caused by gluteal tendinopathy can affect the quality of life of a person. It always interferes with daily activities and prevents the person from socializing. Gluteal tendinopathy also causes fatigue and sleep disturbances. Physical therapy can reduce the symptoms and heals the effects of gluteal tendinopathy. Reaching out to the physical therapist may be beneficial.