Gluteal tendinopathy is one of those most common pathologies in people who have lateral hip pain as it affects 10-25% of the general population. Gluteal tendinopathy is the degeneration of the gluteal tendon as a result of excessive loading and poor biomechanics producing compressive forces on this tendon. Typically, those who have gluteal tendinopathy report lateral hip, buttock or thigh pain and can struggle when sitting to standing, climbing stairs or sitting when legs are crossed. For those who currently experience lateral hip pain, here are some tips on how you can manage this;
Avoid provocative positions: A common contributor to lateral hip pain can be poor biomechanics and posture when sitting or standing which can increase compression of the gluteal tendon. Simply adjusting your positions each day is important to reducing compressive loads and can make a positive change to pain levels and symptoms. Simple strategies can include;
- Sitting with feet and knees apart, instead of sitting with legs crossed.
- Standing up straight with legs shoulder width apart and ensure that you are distributing your weight between both feet so that a neutral pelvic position is maintained.
- Sleeping – when lying on your side, it is useful to sleep with a pillow in between in the knees, as this will reduce compression of the hip from crossing the legs over.
Exercise! Physical therapy is a critical part for treatment of gluteal tendinopathy, regardless of the stage of our condition. It is important that at any stage of this pathology, exercises that mechanically load the tendon itself are needed. Tendon’s respond well to mechanical stimulation and can induce tissue repair/ remodelling and can combat deconditioning of the tendon itself. An exercise program should include these things;
- Isometric exercises: no matter what stage of treatment, these types of exercises have shown to reduce pain for roughly 45 minutes after a bout of exercise. An example of this can be isometric clam or a bridge hold.
- Strengthening and activation: Lateral hip pain is the accumulation of excessive hip adduction (when hips move towards the midline of your body) and hip internal rotation so it is important to complete exercises that encourage the hips to move away from the midline of your body. Therefore, gluteus maximus and medius exercises should be completed, as this will reduce compression and improve physical performance. Such exercise can include crab walks, standing hip abductions and seated clams.