Anatomically the Gluteus Medius is a broad fan shaped muscle originating from the rim of the pelvis (Iliac crest) and inserting with a tendon to the greater trochanter. Usually referred to as a tendonopathy or tendonosis, it is characterized as a chronic degeneration or tear of the tendon.
Usually overuse in nature, Gluteus Medius and Minimus tendon dysfunction are often associated with:
- Weakness of the gluteus medius
- General lower body and core weakness
- Pain and dysfunction related to other injuries in the lumbar, pelvic, and hip area
- Nerves that innervate the gluteal muscles (L4/5/S1) originate from the lower lumber segments and can be compromised due to dysfunction in the spine. A muscle with compromised neural function generally becomes weak, tight and susceptible to injury.
Dull, achy lateral hip pain, which is frequently aggravated by weightbearing and resisted abduction. It is often confused with trochanteric buritis.
Procedural options for chronic tendon dysfunction include regenerative-type injections (such as platelet-rich plasma [PRP] that can theoretically provide long lasting pain relief and improved function by stimulating the body’s own natural healing response. There is some evidence that needling the tendon alone can stimulate bloodflow and healing. A procedure called “Tenex” can be used as well which is a nonsurgical procedure involving debridement of the tendon under ultrasound.