Running with Gluteal Tendinopathy: Causes, Symptoms, and Treatment

 

Gluteus Medius Tendinopathy runningGluteal tendinopathy is a prevalent condition frequently observed among runners, often giving rise to lateral (outer) hip pain. This injury typically results from heightened compressive loads exerted on the gluteal tendons, specifically at the greater trochanter situated on the outer side of the hip.

Excessive pelvic drop or hip adduction during running frequently leads to the heightened compressive loads. When the gluteal tendons are repeatedly stressed, they can become inflamed and damaged, resulting in tendinopathy. This condition is often characterized by pain and tenderness in the buttocks region, particularly during activities such as running uphill, lying on the affected side, climbing stairs, and engaging in single-leg movements.

 

Symptoms of gluteal tendinopathy

Gluteal tendinopathy is often associated with specific symptoms that can vary in severity. The most common symptom is pain and tenderness in the buttocks, which may worsen during activities that stress the gluteal tendons, such as running or climbing stairs. This pain is typically localized to the outer hip region, specifically around the greater trochanter.  Full list of of symptoms include:

  • Discomfort concentrated on the outer side of the hip, potentially radiating down the thigh but not extending below the knee.
  • Pain is experienced during the contraction of the gluteus medius muscle, touching the gluteus medius tendon, and stretching the gluteus medius muscle.
  • Standing on one leg
  • Navigating stairs
  • Lying on the affected side
  • Engaging in prolonged activities such as walking or running also trigger pain.

 

Causes of gluteal tendinopathy

numb feet when runningGluteal tendinopathy can have various causes, but it often stems from overuse or repetitive stress on the gluteal tendon. Runners who increase their mileage too quickly or engage in activities that involve frequent hip and buttock movements are particularly susceptible to developing this condition.

Other contributing factors include poor running mechanics, such as excessive pelvic drop or hip adduction, as well as muscle imbalances, inadequate warm-up or cool-down routines, and insufficient recovery between training sessions. It is important to identify and address these underlying causes to effectively manage and prevent gluteal tendinopathy.

 

Treatment for gluteal tendinopathy

Treating gluteal tendinopathy involves a multifaceted approach that aims to alleviate pain, promote healing, and restore function.

  • Seek out medical advice – Learn from a medicial provider about the injury, how to manage it and get a presonalized recovery plan.
  • Rest the injured area but remain active – Avoid activities that strain, stretch, or compress your tendon.
  • Physical therapy and strength training program – One of the primary treatment modalities for gluteal tendinopathy is physical therapy to restore your gluteal tendons’ load tolerance. A qualified physical therapist can design a personalized exercise program that focuses on strengthening the gluteal muscles, improving running mechanics, and addressing any muscle imbalances or weaknesses.
  • Platelet-rich plasma – This study found good evidence for using platelet-rich plasma in grades 1 and 2 tendinopathy. Shockwave therapy, exercise, and corticosteroids showed good outcomes, but the effect of corticosteroids was short term.
  • Non-steroidal anti-inflammatory drugs (NSAIDs) to reduce pain and inflammation, corticosteroid injections to provide short-term relief, and shockwave therapy to stimulate healing. It is essential to consult with a healthcare professional to determine the most suitable treatment approach based on individual needs and circumstances.

 

How long does it take for gluteal tendinopathy to heal?

Pain that has recently emerged, without an extended history will have a recovery period extending from 4 to 10 weeks (for mild cases).  However, complete rest is not the recommended solution during this time. Sustaining a certain level of activity within the tendon’s load tolerance allows for a quicker return to the chosen activity.

For those experiencing pain over an extended period, spanning months or years, it may be in the degenerative stage and 12 – 16 months (for more severe cases).

 

Treatment exercises for gluteal tendinopathy

 

Lateral hip pain sleeping tips

 

When to see a doctor for gluteal tendinopathy

If you suspect you may have gluteal tendinopathy or are experiencing persistent hip pain while running or engaging in daily activities, it is advisable to consult with a healthcare professional. A doctor or physical therapist can evaluate your symptoms, conduct a physical examination, and recommend appropriate diagnostic tests, if necessary, to confirm the diagnosis.

Seek medical attention if the pain is severe, worsens over time, or significantly impacts your ability to perform daily activities. Additionally, if conservative treatments and self-care measures do not provide relief within a reasonable timeframe, it is essential to consult with a healthcare professional for further evaluation and potential alternative treatment options.

 

Can Telemedicine Help?

Telemedicine is gaining popularity because it can help bring you and the doctor together quicker and more efficiently. It is particularly well suited for sports injuries  and facilitating the diagnosis of the severity of the injury and a treatment plan.  Learn more via SportsMD’s Telemedicine Service.

 

References

Barton, C. J., et al. (2016). “Running retraining to treat lower limb injuries: a mixed-methods study of current evidence synthesised with expert opinion.” British Journal of Sports Medicine 50(9): 513-526.

2021 Jul; 9, Treatment of Gluteal Tendinopathy: A Systematic Review and Stage-Adjusted Treatment Recommendation