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Gluteal Tendinopathy Cheat Sheet (DRAFT) by

Presentation, management etc

This is a draft cheat sheet. It is a work in progress and is not finished yet.


- Glut med originates on the iliac crest
- Minimus originates on the centre of the iliac surface
- Both attach to the greater trochanter
- Both act as hip abductors and internal rotators, posterior fibres act as external rotators
- When torn, ischemia, failed healing, matric degrad­ation, diminished load-b­earing capacitiy

Risk Factors

- Excessive tension and compre­ssion
- Repeti­tive, ballistic, high-force , eccentric gluteal contra­ctions
- Inequal leg length
- Alteration in femoral neck
- Obesity
- Usually presents in 2nd half of life
- Females
- Lower extrem­ity/lx dysfun­ction


- >40 year old
- Insidious, persistent lateral hip pain
- Radiates into buttock and lateral thigh
- Walking, climbing stairs, hills, standing on one leg and prolonged sitting
- Night time pain common
- Usually no leg numbes­s/pain beyond knee
- TTP over greater trochanter (posterior aspect = glut med involv­ement, anterior = glut minimus)
- Hypert­oni­citiy of hip adductors, psoas, TFL, gluteal and lumbar muscles
- Glut max and ITB should be palpated (compr­esses gluteal tendons)
- Limited hip ROM - pain upon passive adduction or external rotation
- RROM painful in abduction
- +ve Obers
- +ve Treled­enberg, single leg squat
- Lateral trunk flexion over stance leg
- Knee adduction, hyperp­ron­ation, contra­lateral arm abduction


- OA
- RA
- Lx radicu­lopathy
- Mechanical LBP
- SI Dysfun­ction
- Meralgia parest­hetica
- Piriformis syndrome
- iliopsoas tendin­iti­s/t­end­ino­pathy
- Labral tear/i­njury
- Fibrom­yalgia
- Stress f#
- Primar­y/s­eco­ndary bone tumour
- Soft tissue neoplasm
- Visceral somatic referral - GI/GU
- Children: SCFE, LCP, infection, primary neoplasms


- Usually not indicated, unless:
- Unrepo­nsive to treatment
- Severe pain
- Inability to bear weight
- Limited passive mobility
- MRI for labral tears, soft tissue abnorm­alities
- US gold standard


- Avoid "­hanging on one hip" and sittin­g/s­tanding with legs crossed
- Avoid prolonged sitting, spread knees out when getting up of a chair
- Avoid side lying postures
- Place pillow between knees
- Athletes should tempor­arily avoid long distan­ce/fast paced running, hill climbing and plyome­trics, consider cycling and water based exercise
- Avoid running on banked, wet, icy surfaces
- Pts with Narrow based gait should widen their legs
- Weight reduction if overweight
- TFL/ITB in hip adduction
- Clam exercises
- Change in nighttime pain as a guide for advanc­ing­/re­tre­ating exercise intensitiy
- High tensile load exercises should not be performed >3 x a week
- Single leg stance, single leg squats, glut squeezes, bridging, side planks, lunges, band walk, side steps, clam exercises
- Start with frontal plane exercises - sitting to standing
- Hip hinging, squatting to limit hip internal rotation
- Orthotics
- SMT/Mo­bil­isation of LS + lower mechanical chain
- Myofascial release of Glut med/min
- Consider surgery if no improv­ement