Lateral Hip Pain - Gluteal Tendinopathy

Lateral Hip Pain – Gluteal Tendinopathy

Lateral hip pain refers to pain and tenderness at the side of the hip that may radiate down the thigh. While this condition has traditionally been referred to as trochanteric bursitis or greater trochanteric pain syndrome (GTPS), gluteal tendinopathy is now accepted as the primary cause of lateral hip pain1–4. This is because ultrasound studies have found that only 10-20% of those with pain over the greater trochanter had bursal involvement with the majority being tendon related2,5. Therefore, for the purposes of this protocol, lateral hip pain +/- associated bursal pathology, will be referred to as gluteal tendinopathy.

What is Gluteal Tendinopathy?

Gluteal Tendinopathy is the most prevalent of all lower extremity tendinopathies6 . It is diagnosed when symptoms are reproduced during the following clinical tests: pressure over the greater trochanter, stretching of the gluts, resisted hip abduction and/or single leg balance7 . Although it is common in both male and female athletes and non-athletes, it is most prevalent in women, affecting one in four over 50 years of age8 . The pain is typically aggravated while side lying and during activities like walking, running, or climbing stairs. It often interferes with a person’s sleep, activity level, and overall quality of life9 . Current management of gluteal tendinopathy centers around activity modification and progressive exercise-based programs10.

What is the cause?

The cause of tendinopathies can be multifactorial. However, the primary driver is thought to be caused by a load related issue. The condition occurs when tendons are either over-loaded11 or chronically under-loaded12,13 and adaptive changes occur within their architecture14–16. These changes can alter the ability of the tendon to manage stress and can reduce their load-bearing capacity12. Essentially, individuals only have so much tolerance for load and when the demand of an activity exceeds the tendons capacity, pain and dysfunction can develop. In more severe cases, there can even be tears in the deep portions of the tendon.

A - Lateral Hip Protocol - Gluteal Tendinopathy.pdf

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