GLUTEAL TENDINOPATHY VS TROCHANTERIC BURSITIS
We at Body and Mind Physio have been seeing more and more patients with a pain around the outside of the hip area. Hip pain can have many different diagnosis (Hip bursitis, Gluteal Tendinopathy, Trochanteric pain, Osteoarthritis and so many more). It can be confusing for patients with so much information on the internet.
The reasons documented in the research for an increase in pain around the hip is either a change in load (increase running, walking or activity), a change in routine (sitting more due to working from home) or poor biomechanics (change in footwear, increase weight).
Our Physio clinic in Petersfield is based so close to beautiful countryside, that taking our allotted daily exercise has become a pleasure not a chore. As people discover the physical and mental health benefits of getting away from their TV and computer screens, so we increase our mileage.
WHAT IS GOING ON?
Tendon research would indicate that before you develop a painful hip because of gluteal tendinopathy, you will already have pathology within the tendon. The gluteal muscles around the hip generate high tensile loads during walking and running activities. These muscles also wrap around the greater trochanter and cause a compression point, this is compressed further by the iliotibial band (ITB).
WHAT WE DO FOR HIP PAIN?
We will do a differential diagnosis to rule out all the other conditions that can give similar symptoms. We will assess thoroughly your hip and back for this condition, testing the movement, power and function. With Gluteal Tendinopathy it is all about managing the load around the tendons and muscles supporting the hip. It doesn’t matter who rubs you, sticks needles in you or covers you with coloured tape. If you don’t manage your loads and increase your ability to handle loads, things won’t improve long term.
At the point we’re both happy with our diagnosis, we can start to plan a sensible loading routine. Guided exercises to load the hip appropriately are very important, it is also important not to stretch a painful tendon (something our patients find difficult to understand) as this causes more compression and therefore more pain.
In the acute painful phase, we’re more likely to be trying to reduce load and ease pain. Exercise plays a big role in the recovery but hands on treatment will also benefit you and we will include this as part of the programme.
See our youtube video for some ideas and some beneficial exercises, remember that these exercises may be too much load and therefore we recommend seeking our advice before embarking on exercises if you have pain.