The gluteus medius is a muscle located on the outer side of the hip, extending from the pelvic bone to the upper part of the thigh bone (femur). Its primary roles include stabilizing the pelvis and enabling the leg to move outwards, a motion known as hip abduction. Tears in this muscle are a common cause of hip pain and weakness.
What a Gluteus Medius Tear Is
A gluteus medius tear involves damage to the muscle or its tendon, which connects it to the greater trochanter on the outer femur. These tears can arise from acute injuries, such as a fall or sports-related trauma, or from repetitive stress and age-related degeneration. Degenerative tears are particularly common in individuals over 50, with women being more frequently affected.
Partial-thickness tears involve damage to a portion of the muscle or tendon, while full-thickness tears are a complete rupture. Tendinopathy or tendinosis refers to chronic inflammation and degeneration of the tendon.
Common symptoms include pain on the side of the hip and buttocks, which may worsen with activities like walking, climbing stairs, or lying on the affected side. Weakness, limping, and difficulty maintaining balance are also reported. Diagnosis typically involves a physical examination, including specific hip tests, and is often confirmed with imaging such as an MRI.
Non-Surgical Healing Approaches
Many gluteus medius tears, particularly partial ones, can heal successfully without surgery. This approach, known as conservative management, is often the first line of treatment. The goal is to reduce pain, inflammation, and restore function.
Rest and activity modification are initial steps, involving avoiding movements that aggravate the hip. Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen are often prescribed to manage pain and reduce inflammation. Physical therapy is a central component of non-surgical treatment, focusing on strengthening the gluteal muscles and improving hip flexibility and stability. Therapists guide patients through specific exercises to restore normal movement patterns and reduce strain on the injured tendon.
Corticosteroid injections can be administered into the affected area to alleviate pain and inflammation, providing temporary relief that can facilitate participation in physical therapy. Platelet-rich plasma (PRP) injections, derived from the patient’s own blood, are another option for pain relief. Pain relief can be achieved in up to 90% of patients with conservative treatment.
Surgical Options
Surgery for a gluteus medius tear is typically considered when non-surgical treatments have not provided sufficient relief, or when the tear is severe, such as a complete rupture. The main objectives of surgical intervention are to alleviate pain, repair the damaged tendon, and restore the hip’s strength and stability.
Common surgical techniques include open repair and arthroscopic repair. Open repair involves a larger incision to directly access and mend the torn tendon, often using sutures or anchors to reattach it to the bone. Arthroscopic repair is a minimally invasive procedure where small incisions are made, and a camera and specialized instruments are used to visualize and repair the tear. Both methods aim to secure the tendon back to its anatomical attachment site on the greater trochanter. While surgery can be highly effective, it is generally reserved for cases where conservative methods are insufficient, especially for larger or chronic tears.
Navigating Recovery
Recovery following treatment for a gluteus medius tear, whether surgical or non-surgical, requires a structured rehabilitation program. Physical therapy plays a central role in regaining strength, flexibility, and function. The rehabilitation process is tailored to the individual and the extent of their injury.
For surgical recovery, patients typically use crutches and may wear a hip brace for several weeks to protect the repaired area and limit weight-bearing. Physical therapy usually begins a few weeks post-surgery, focusing on controlled movements and gradual strengthening exercises. Full recovery after surgery can range from three months to a year or more, depending on the tear’s severity and individual factors. Non-surgical recovery timelines vary but often involve several months of consistent physical therapy and activity modification.
Patience and strict adherence to professional guidance are important throughout recovery. Challenges can include managing pain, maintaining activity restrictions, and the gradual progression of exercises. Long-term management often involves continued exercises to maintain hip strength and flexibility, helping to minimize the risk of recurrence and promote lasting hip health.