Pain on the outside of your hip? Bursitis? Gluteal Tendinopathy?

Pain over the outside of the hip is something that Physiologix has become specialised in treating.  Our clinic in The Gap has long had a special interest in hip and pelvic pain.   Pain over the outside of the hip is fast becoming one of the most common hip problems we see.

Pain over the outside of the hip can be due to many different things and all of these other   possible diagnoses need to be considered. Treatment varies considerably so a successful outcome relies and good diagnostics

What is gluteal tendinopathy or hip bursitis?

Here we will look at what was previously known as hip bursitis and is now referred to as “gluteal tendinopathy”.

There are two gluteal (buttock) muscles based more to the back and outside of the hip.  These are called the “gluteus minimus” and “gluteus medius” muscles.  They help to lift our leg out to the side, and to keep you standing tall on one leg,  preventing your hip from falling to the outside.  These muscles run from your pelvis bone down to attach to the bone that sticks out at the top of the outside of your leg, known as your “greater trochanter”.   The muscles attach to this bone via a tendon.  These tendons can compress between this bone as well as the ITB, a thick band of fascia that runs down the outside of the leg.  

The compression eventually results in pain, known as gluteal tendinopathy. There are also several small fluid filled sacks in the area known as “Bursa”. Usually the bursa don’t contain much fluid, but they will fill up in response the irritation to the tendons and can result in pain, known as trochanteric bursitis.  

Why does gluteal tendinopathy occur

There are a few key reasons we see gluteal tendinopathy occurring.  

The most common group to experience pain are peri to post menopausal women.  Eighteen percent of the population aged over 50 suffers with lateral hip pain and women are 3 times more likely to develop greater trochanteric pain syndrome.  This may be due to:

• Changes in the health of the tendons due to lack of exercise or to too much activity
• A return to activity after a break
• Changes in the tendon health secondary to systemic hormonal changes
• Pregnancy and gluteal tendinopathy or hip bursitis

Pregnancy or after child birth is a time we also see many women with gluteal tendinopathy. 

In pregnancy: this may be in reponse to the changes in flexibility around the pelvis and the way people move as they become more heavily pregnant.

After pregnancy: this may occur as the pelvis and hips are regaining normal strength and stability, but also to the increased compression that can occur when mums stick their hip out excessively to carry their baby on.

What is the treatment for gluteal tendinopathy

Key to the success in the treatment for gluteal tendinopathy is to target many things, not just focus on one thing.

Education from your physio helps you understand what the problem is, and why is may have occurred for you

Advice from your physio will help you understand the many ways to can rest and move in different ways that prevent further irritation to your tendons.  This includes looking at how you sleep, sit, stand and move.  This includes advice and not stretching the leg across the body, a key area so many of our patients have gone wrong.

Exercise is essential, rest is not advised.  Your physio will start you on a program that addresses your gluteal muscles in particular the gluteus medius but using safe and specifc exercises.  At Physiologix we do not use the “clam” exercise – we will help you understand why not and what to do instead.

Loading correctly is learning to understand how much you can do that is helpful and when you may also be under, or overdoing things. Your physio will help you understand how to control and progress what you do so that your tendons benefit.

This is a complex issue to correct but with care and good guidance you can do extremely well with your recovery from this condition.  Call us to book an appointment with one of our hip knowledgeable physios by clicking here or book an appointment from the "book here" tab at the top right of this page.