Lecture on Gluteal Tendinopathy

Introduction

• Presenter: Dr. Zach Greenwade
• Condition: Gluteal Tendinopathy (also known as gluteal tendinitis or greater chronic pain syndrome)
• Common Symptoms:
  • Pain on outside of the hip
  • Worsened by activities such as stairs, walking, or laying on the painful side

Anatomy Overview

• Model:
  • Spine, pelvis, hip joint (ball and socket joint)
  • Greater trochanter (part of the bone)
  • Gluteal tendon and bursae
• Pain Structures: Gluteal tendon over the greater trochanter, bursae under the tendon

Prevalence and Demographics

• Occurs in 10-20% of individuals with hip pain
• Commonly presents as pain radiating outside the hip, possibly into the thigh, groin, or buttocks
• Most common in postmenopausal women aged 40-60
• Risk factors include wider pelvises and smoking

Aggravating Activities

• Prolonged sitting
• Climbing stairs
• Laying on the affected side
• Single leg loading exercises (running, jumping, lifting)

Diagnosis and Misdiagnosis

• Often confused with gluteal bursitis
• Important to address underlying mechanical issues, not just symptoms

Treatment Recommendations

• Avoid Stretching:
  • Avoid hip stretches as they increase tension and compression on the tendon
• Modify Positions:
  • Sleep on back with knees slightly bent and pillow support
  • Avoid leaning on the painful hip while standing
  • Avoid prolonged sitting, especially with crossed legs
  • Keep feet shoulder-width apart while walking
  • Maintain pelvis level on stairs

Exercises

• Level 1 Exercises:
  • Seated positions: Feet wider than hips, press knees into hands
  • Resistance bands for added challenge
  • Standing exercises with glute engagement
• Level 2 Exercises:
  • Glute bridge, single-leg bridge
  • Squats and step-ups
  • Wall slides
• General Guidelines:
  • Gradually increase intensity weekly
  • Exercises should focus on strengthening the tendon over time

Clinical Tests and Expectations

• Tests: FADER and FADDIR to check for pain reproduction
• Pain should be mild (<4/10 on pain scale)
• Pain should subside within 2 hours post-exercise
• No increased pain the following morning

Additional Resources

• Podcast by Alison Gardi on gluteal tendinopathy
• Encouragement to listen for more insights

Conclusion

• Emphasis on addressing mechanical issues and strengthening over time
• Encouragement to like the video and explore additional resources and channels for more information