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Gluteus Medius and Minimus Tendon Tears

Description

If you’ve ever done an exercise like a bridge, deadlift, or squat, you’ve likely heard the emphasis placed on building up your glutes. The “glutes” are actually a set of muscles that work together, largely to support your hip and low back.

The largest of the gluteal muscles is your gluteus maximus, which helps to extend your hips. Underneath the gluteus maximus lies your gluteus medius, and under that, your gluteus minimus.

Between the three gluteal muscles, they function together to help support your hip, spine, and pelvis as you move through the world.

Specifically, your gluteus medius and gluteus minimus help you move your hip into abduction, which is the movement you would make if you were standing and moving your straight leg out to the side. They also work to help stabilize your hip, which is important for activities like walking, climbing stairs, hiking, and many other tasks you may do on a daily basis.

A tendon is a part of a muscle that helps to connect the muscle to a bone. For example, in the case of the gluteus medius, the tendon attaches the muscle to its insertion, which is a bony portion of your femur (thigh bone) called the greater trochanter. When these muscles become stressed over time, it can lead to tears along the tendon.

Causes & Triggers

The cause of a gluteal tendon tear typically happens after a trauma, like a fall, or it can happen over time as a result of a tendinopathy or tendonitis. Repeated stresses along the tendon can result in inflammation, which, if left unchecked, can worsen over time, potentially leading to a tear.

Tendon tears can be classified as partial-thickness or full-thickness. A partial-thickness tear refers to a tear that goes part of the way through a muscle or tendon, while a full-thickness tear means that the tear has gone through the muscle or tendon. Identifying the type of tear can help identify the right treatment options and path to recovery.

Signs & Symptoms

Injuries to the tendon along the gluteus medius or minimus can cause several symptoms. Depending on whether the injury was acute (happened very recently) or chronic (happened overtime), your symptoms will vary. If the injury has taken place over time, common symptoms can include:

● Pain and/or tenderness along the side of the hip
● Dull, achy sensation around the hip
● Reduced strength (often in abduction)

You may also find that you have difficulty lying on your side due to pain or discomfort, or you may feel that your walking pattern has changed. In the case of an acute injury, like a fall, it’s more likely that the pain will come on suddenly around the side of the hip.

If you’re experiencing these types of symptoms, it’s important to see a healthcare provider, like a physician or physical therapist, who can help you determine the possible cause of your pain and the extent of the injury. They will also work to help you find the best treatment options for your specific situation.

Tips & Treatment

Often, a physician or physical therapist will see you to assess and diagnose the source of your pain. They may order imaging to help them with the diagnostic process, but they will also take into consideration how your pain came about, how long you’ve had pain, where it’s located, and the activities that make pain worse or better. Once they have an understanding of your current condition and past medical history, they may perform additional tests to assess strength, range of motion, or special tests that are specific to certain diagnoses. Following a diagnosis, and depending on the severity of the tear, some of the treatment options you may discuss with your healthcare provider include:

● Physical therapy
● Medications
● Injections
● Surgical repair

With conservative care, a physical therapist will work with you, often to improve strength, range of motion, and/or decrease your pain through exercises, movements, and other recommendations. As you progress, the physical therapist may begin to work with you on specific tasks or activities that you’re looking to get back to or improve upon. A physician may also prescribe medications or injections as a part of a treatment plan.

In other cases, you may be referred to a specialist, like an orthopedic surgeon, to discuss surgical options. If conservative treatment does not improve your condition, or if your injury is more severe, a physician may recommend surgery, such as a gluteal tendon repair, as a treatment option.

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