What Is Gluteus Medius Tendinopathy?
If you’ve been dealing with persistent pain on the side of your hip, especially when walking, climbing stairs, or lying on your side, you may have a condition called gluteal medius tendinopathy. This can be a frustrating and painful issue, and it often gets worse if left untreated.
As a physical therapist, I work with many people who struggle with this type of hip pain. It is extremely common for someone to set up an appointment because their hip is constantly causing them issues, so if your hip is bothering you, read on!
What is Gluteal Medius Tendinopathy?
To understand this condition, we first need to talk about the gluteus medius muscle. This is one of the three major muscles in your buttocks. It sits on the side of your hip and plays an important role in keeping your pelvis stable when you walk, run, or stand on one leg.
Like all muscles, the gluteus medius is connected to bones by tendons. Tendons are strong, rope-like tissues that help muscles pull on bones to create movement. But sometimes, tendons can become irritated and damaged. When this happens in the gluteus medius tendon, it leads to a condition called gluteus medius tendinopathy.
Tendinopathy is a term that describes damage, weakness, or degeneration of a tendon. It usually develops slowly over time due to repeated stress or overuse. Unlike an acute injury (like a sudden tear or sprain), tendinopathy happens gradually, and the pain may come and go before it becomes a constant issue.
For those with hip bursitis, your issue is the same: your gluteusl medius tendon is irritating the bursa leading to your lateral hip bursitis.
What Causes Gluteus Medius Tendinopathy?
There isn’t just one reason why this condition happens. It’s usually caused by a combination of factors that place excessive strain on the gluteus medius tendon. It is also something that normally happens over a period of time. Here are some of the most common causes:
1. Overuse or Repetitive Movements
Activities that involve repetitive use of the hip muscles can lead to overloading of the gluteal medius tendon. These activities might include:
- Running or long-distance walking
- Hiking, especially on uneven terrain
- Climbing stairs frequently
- Prolonged standing or walking for work
- Intense lower body workouts (such as lunges, squats, or side leg lifts)
If your body doesn’t get enough time to rest and recover, the tendon can become irritated and start to break down. This is especially true if you are in a workplace setting that requires you to do the same movements over and over again on a daily basis. If you go for a hike, for example, and notice that you are sore after, then you should let your body rest. However, this can be tricky for people who must hike daily as part of their job.
2. Weakness or Imbalance in the Hip Muscles
The gluteus medius is responsible for stabilizing the pelvis, especially when standing on one leg or walking. If the gluteal muscles are weak or imbalanced, other muscles have to work harder to compensate, which can overload the tendon and lead to tendinopathy.
Some common causes of muscle weakness or imbalance include:
- Sedentary lifestyle (too much sitting leads to weak gluteal muscles)
- Muscle compensations (if other hip or leg muscles aren’t doing their job, the gluteus medius works harder)
- Previous injuries (such as ankle, knee, or back injuries that change the way you move)
Most people live very sedentary lives currently which is an easy way to develop this issue. All that sitting at a desk all day for work or being at home sitting on a digital device adds up.
3. Poor Hip and Pelvic Alignment
If your hip joint or pelvis isn’t aligned properly, your gluteal medius tendon can be put under excessive stress. Some factors that affect alignment include:
- Leg length differences (one leg being slightly shorter than the other)
- Tight hip flexors (which can pull the pelvis forward and change how forces are distributed)
- Poor posture or movement habits
Again, in our digital age poor posture is a big problem. You have most likely heard of “tech neck” which is where people are holding their necks at an angle to view their cell phones in their hands. This poor posture starts by affecting the neck and causing pain, but as the posture worsens it can lead to more issues.
4. Sudden Increases in Activity
A sudden jump in activity level can overload the gluteal medius tendon, especially if your muscles and tendons aren’t used to that level of work. This commonly happens when:
- Runners quickly increase mileage without enough buildup
- People return to exercise after a long break and do too much too soon
- Someone starts a new workout routine with high-impact exercises
Tendons need time to adapt to increased loads, and when they’re pushed too hard too fast, they can become irritated and painful.
5. Aging and Degeneration
As we get older, tendons naturally become weaker and less flexible. This makes them more prone to microtears and degeneration over time. While tendinopathy can affect younger athletes, it is more common in people over 40 due to age-related changes in tendon structure.
Don’t let your age get you down, though. Even as we get older, there are ways to manage hip pain to overcome it and live your life the way you want to, as an Austin physical therapist can share.
6. Being Female
Women, especially those going through or past menopause, are more likely to develop gluteus medius tendinopathy. This is due to:
- Hormonal changes that affect tendon health
- Differences in hip structure (wider hips can create more strain on the gluteal tendons)
- Increased likelihood of osteoporosis or muscle weakness
7. Poor Footwear or Biomechanics
Shoes that lack proper support can change the way forces move through your legs and hips. High heels, worn-out sneakers, or unsupportive sandals can all contribute to improper movement patterns that overload the gluteal medius tendon.
In addition, issues with foot posture (such as flat feet or high arches) can also affect how weight is distributed through the legs and hips, leading to increased stress on the gluteal tendons.
Even if you are someone who does not necessarily walk a lot, footwear plays an important role in your overall health. Be sure your feet are fully supported to prevent pain down the road.
8. Lying or Sleeping on One Side Too Often
If you sleep on one side for long periods (especially without a supportive mattress or pillow), the gluteal medius tendon can get compressed. Over time, this repeated pressure can lead to irritation and pain. Many people notice hip pain when they try to lie on the affected side.
Signs and Symptoms of Gluteal Medius Tendinopathy
People with gluteal medius tendinopathy often describe their symptoms as dull, aching pain on the outside of the hip. The pain can range from mild discomfort to more intense pain that makes daily activities difficult.
Common symptoms include:
- Pain on the side of the hip (especially when pressing on the area)
- Pain that gets worse with activity (such as walking, running, or climbing stairs)
- Discomfort when lying on the affected side (which may wake you up at night)
- Stiffness in the hip area, especially in the morning or after sitting for a long time
- Weakness in the hip and leg, leading to difficulty balancing or standing on one leg
The pain may start gradually and come and go, but over time, it can become more persistent if the tendon continues to be overloaded. Unfortunately, this is not something that will go away on its own. We often have patients that say they noticed a little pain and then did their best to ignore it. Because, they figured it would fix itself and go away. If you notice any sort of pain at all, you should reach out for help immediately to address the issue sooner rather than later.
How Can Physical Therapy Help?
If you have ongoing hip pain, you don’t have to live with it! Many people try to push through the pain, hoping it will go away on its own, but that often leads to more damage.
The good news is that physical therapy can help. A physical therapist can:
- Identify the root cause of your pain (whether it’s muscle weakness, poor movement patterns, or another factor)
- Teach you proper movement techniques to avoid further irritation
- Help strengthen the hip muscles so the tendon isn’t overloaded
- Provide hands-on techniques to improve mobility and reduce pain
The earlier you address the issue, the easier it is to manage. If you’re struggling with hip pain, reach out to a physical therapist to discuss your options!
Gluteus medius tendinopathy is a common but treatable condition. If you’re experiencing hip pain, don’t ignore it. Getting the right care now can prevent it from becoming a bigger problem down the road. A physical therapist can help you understand what’s happening and create a personalized plan to get you back to pain-free movement.
Contact us today at Move Empower Concierge Physical Therapy to schedule a FREE discovery session. One of our specially trained physical therapists will evaluate what is causing your pain and create a customized treatment plan just for you.