Lateral hip pain is called many things including; bursitis, tendonitis, and/or greater trochanteric pain syndrome. In particular women seem to be more inclined to develop this issue due to our child bearing hips and the changes our bodies go through during pregnancy. Imaging and treatment of hip pain has truly evolved over the years since I was a new PT. More commonly it was diagnosed under the umbrella term of bursitis and treated with an injection and relative rest. Now treatment of hip pain has evolved into a more specific management plan depending on location, causation, and irritability level. Gluteal tendinopathy, is a more specific lateral hip pain that tends to be the real root of lateral hip pain.
Gluteal Tendinopathy aka lateral hip pain is most often seen in women, who live an active lifestyle mostly consisting of running especially those who love to run hills or stairs. Other things we look at besides the obvious are: Do you have stiff ankles? Can you activate your gluteals? Did you do post-natal and or core exercises? It’s typically a cumulative effect that lands you in the clinic.
First things first, depending on your irritability level, reduce tendon compression. Avoid positions of compression, which include crossing your legs, standing hanging on one side, and sitting in a low chair. In an acute stage, where the pain is constant, you should avoid the famous figure 4 stretch. You should also be aware of how you are sleeping at night. The best position is on your "good" side with a firm pillow between your legs to decrease the load on your hips or on your back.
Strengthening is the next step. Remember motion is the lotion. Remove all forms of incline and stair walking and or running. You will need to commence a strengthening program that targets muscles around the hip and improves pelvic stability. Non weightbearing/ open weightbearing exercises such as clams will be progressed to weightbearing closed kinetic chain exercises like band walks.
Stretching is encouraged but initially you want to avoid stretches that compress the hip tendons such as figure 4 stretches. Foam rollers and trigger balls can help release tight spots. Gentle stretching surrounding the hip joint is encouraged as long as it’s pain free and does not aggravate the hip further.
Return to regular exercise is always the goal but can be slow with a tendonitis problem. Be aware of pain during activity and 24 hours later as these tend to be indicators that you have overdone it. Tendinopathy can be a stubborn injury but if you take a comprehensive approach from addressing your lifestyle habits (crossing your legs) to your strengthening exercises (slow progression of loading the tendon) you will be on the road to recovery in no time.