Gluteal tendinopathy is a common and often painful condition affecting the hip region. It develops due to various factors, including underlying biomechanical issues, daily activities, and individual predispositions.
What is Gluteal Tendinopathy?
Gluteal tendinopathy refers to irritation or degeneration of the gluteus medius and gluteus minimus tendons. These tendons attach to the greater trochanter, a bony prominence on the outer side of the hip. The gluteus medius and minimus muscles stabilize the hip, especially during single-leg stance, and abduct the leg (move it away from the body).
This condition commonly causes pain on the side of the hip, also known as greater trochanteric pain syndrome. Symptoms include discomfort that worsens with physical activity, prolonged standing, walking, or lying on the affected side. It is a prevalent issue, particularly among middle-aged women, and can affect daily function and quality of life.
The Core Problem: Tendon Overload
The main cause of gluteal tendinopathy is chronic overload or compression of the affected tendons. Unlike acute inflammation (tendinitis), tendinopathy results from repetitive strain, leading to microscopic changes within the tendon structure over time. This condition involves degeneration and failed healing responses rather than sudden inflammation.
Excessive tensile forces, which occur when a tendon is stretched repeatedly beyond its capacity, can contribute to this microscopic damage. Similarly, direct compression, such as when the iliotibial band (ITB) presses against the gluteal tendons as they pass over the greater trochanter, can also impair the tendon’s health. This cumulative effect of repeated mechanical stress gradually weakens the tendon’s structural integrity, making it susceptible to pain and dysfunction. The tendon’s ability to repair itself may not keep pace with ongoing micro-trauma, leading to structural breakdown.
Everyday Activities and Habits
Daily activities and habits can contribute to the chronic overload experienced by the gluteal tendons. Prolonged postures that place the hip in a position of adduction (leg moving towards the midline) or internal rotation can increase compressive forces on the gluteal tendons. For example, sitting with crossed legs, standing with weight shifted predominantly to one hip, or even prolonged periods of sitting without changing position can contribute to tendon compression.
Repetitive movements, particularly those involving hip abduction or single-leg stance, can also exacerbate tendon stress. Activities such as running, walking long distances, climbing stairs, or participating in certain exercises like squats or lunges with improper form can repeatedly strain the gluteal tendons. A sudden increase in the intensity or duration of physical activity without adequate conditioning can overwhelm the tendons’ capacity to adapt, leading to overload injuries.
Regularly sleeping on the affected side can apply direct compressive pressure to the greater trochanter and the underlying tendons, potentially aggravating the condition or hindering recovery.
Personal Risk Factors
Several intrinsic characteristics and conditions can increase an individual’s susceptibility to gluteal tendinopathy:
Age and Gender: The condition is more common in middle-aged and older adults due to age-related tendon changes. Women are disproportionately affected, possibly due to differences in hip biomechanics and hormonal factors.
Muscle Imbalances: Weakness in gluteal or core muscles can alter movement patterns and stress tendons.
Tightness: Tightness in the iliotibial band or hip flexors can increase compressive forces.
Gait Abnormalities: Abnormal walking patterns can lead to altered hip mechanics and uneven tendon loading.
Increased Body Weight: Obesity places greater mechanical load on the hip joint and its surrounding tendons.
Previous Injuries: A history of hip or lower back injuries can alter biomechanics and muscle function.
Systemic Medical Conditions: Conditions like diabetes or rheumatoid arthritis can affect overall tendon health.