Gluteal Tendinopathy

What is Gluteal Tendinopathy?

Gluteal tendinopathy is irritation or degeneration of the gluteus medius or minimus tendons, which stabilize the hip and pelvis. It’s one of the most common causes of lateral hip pain, especially in runners, walkers, and active adults.

Common Symptoms

• Pain on the outside of the hip, especially when lying on it

• Pain with walking, climbing stairs, or running

• Tenderness over the greater trochanter (bony side of the hip)

• Stiffness or weakness in hip stabilizers

Physical Therapist Diagnosis

A PT assesses the lateral hip for tenderness and tests hip abduction strength. Special tests like resisted external rotation and single-leg stance can reproduce symptoms. Observation of gait and pelvic control helps identify contributing factors.

Why it Happens

Repetitive loading, poor pelvic control, or weak gluteal muscles lead to excess strain on the tendons. Runners and athletes with training errors or biomechanical issues are at greater risk.

Why it Doesn’t Always Heal on Its Own

Rest may relieve symptoms temporarily, but tendons require progressive loading to heal properly. Without rehab, pain often recurs with activity.

Ideal Physical Therapy Treatment

Treatment focuses on tendon loading, improving pelvic control, addressing muscular imbalances, and a progressive return to activity. Dry needling can reduce secondary muscle tension in the glutes and lateral hip muscles.

Key components include:

• Manual therapy to improve hip and pelvic mobility

• Dry needling for pain relief and improved healing

• Progressive strengthening of glutes and core

• Load management to avoid aggravating activities early on

• Movement retraining to improve running and sport mechanics

Expected Outcomes

With progressive rehab, most athletes return to pain-free running and sport. Improvements typically occur within weeks, with full tendon remodeling taking longer, usually within 3-4 months.