Anatomy of the gluteus
The gluteus medius is a muscle on the outside of the hip that attaches the pelvis to the upper end of the hip bone and functions to help move the leg to the side (abduction). A healthy gluteus medius muscle is important for walking pain free, and walking without a limp.
The gluteus medius muscle has a large strong attachment on the pelvis, but attaches to the hip bone at a point called the “greater trochanter” via a narrow tendon. Tendons are how all muscles attach to bone.
The narrow tendon attachment, called an insertion, is susceptible to injuries.
Gluteus medius sprains and tears
Gluteus medius sprains and tears involve injury to the tendon attachement site to the hip bone.
While the gluteus medius and its tendon is very strong, it is in constant use, and therefore prone to injury. Injuries can be due to inflammation. In this case repetative use has overworked the tendon and caused tendonitis. This causes pain but may not be associated with a tear. Partial of complete tears are also possible. This is injury can cause pain and is sometimes referred to as the “rotator cuff tear of the hip.”
What are the symptoms of a gluteus medius tear?
Acute sharp pain in the upper lateral thigh, with pain similar to trochanteric bursitis.
Other symptoms include:
- weakness in hip motion
- pain with hip motion
How is a gluteus medius tear diagnosed?
A gluteus medius tear is diagnosed through physical examination and imaging.
A physical examination can help delineate the area of pain and identify any subtle weakness in the hip. It is also helpful to differentiate a gluteus medius tear from trochanteric bursitis, which can present with similar pain. It will afford Dr. Cooper the ability to understand how the injury occurred, your level of pain, and your desired outcome.
Through imaging, including X-rays and magnetic resonance imaging (MRI), Dr. Cooper will have a full understanding of the injury and its severity.
How is a gluteus medius tear treated?
Treatment is determined by the severity of your injury, your needs and goals.
Non-surgical treatment consists of rest, ice, modalities, non-steroidal anti-inflammatory drugs (NSAIDs), gentle stretching, therapeutic exercise, and gradual return to athletic activity, over approximately 4 to 6 weeks. Dr. Cooper at DOCS Spine+Orthopedics guides a tailored physical therapy and rehabilitation program to help patients recover as quickly as possible from proximal hamstring injuries.
If pain persists after non-surgical treatment, the gluteus medius tendon may need to be repaired surgically. Surgical repair can be done arthroscopically with small anchors to help re-attach the injured tendon to bone. In certain settings, a collagen patch may be used to help strengthen the repair and promote robust healing.
After surgical repair of a gluteus medius tear
After surgery, your activity will be restricted for several weeks to allow the area to heal. You will use crutches and wear a hip brace to prevent strain on the muscle during the early stages of healing. Dr. Cooper may recommend treatment with platelet-rich plasma injections to accelerate healing. Rehabilitation will begin almost immediately to restore range of motion, strength and flexibility and take at least 6 months. A majority of patients recover full function after rehabilitation.
Dr. Joe Cooper is a preeminent orthopedic surgeon at the prestigious DOCS Spine+Orthopedics in Los Angeles California whose focus is on helping you get back to play and help you to prevent reinjury. Contact him to schedule a consultation. He welcomes national and international patients.