Gluteal Tear

A gluteal tear is a condition where there is a tear in the tendons of the gluteal muscles. This can cause pain on the outside of the hip, making it difficult to walk, sit, or lie on the affected hip.

The pain usually starts on the side of your upper leg but can also radiate to the knee, or upwards to the buttock and lower back. You may also feel stiffness after prolonged sitting, or a collapsing sensation when bearing weight on your leg.

Overload can be divided into three phases:

• Reactive tendon: the tendon reacts to sudden loading, becomes thicker and painful. Temporarily reducing the provocative load can help here.
• Altered tendon structure: the tendon changes due to sustained loading, remains thick. Temporarily reducing the provocative load in combination with appropriate exercise therapy can help here.
• Chronically overloaded tendon: severe damage due to prolonged overload, with scar tissue and an increased risk of tears. Treatment ranges from exercises to potentially injections or surgery.

How do tears in the gluteal tendons occur?

A gluteal tear can occur acutely or gradually. An acute injury can result from, for example, a fall on the affected hip.

It can also develop gradually. This is a typical consequence of an imbalance between load and the tendon's capacity. When the load exceeds the tendon's capacity, the risk of overload and injury increases. Sometimes, we also see this after surgery.

Repeated loading of the gluteal tendons causes pressure to accumulate. The tendon attempts to adapt, but this only succeeds if the tissue is sufficiently strong and has enough time to recover. If one of these conditions is lacking, the body reacts with an inflammatory response in the tendon. This reaction is a warning that the tendon is overloaded.

This approach allows the tendon to recover and significantly reduces the chance of recurrent complaints. It is important to take the body's signals seriously and support the recovery process step by step.

Loading is not the only factor that can cause tendon overload. The following should also be considered:

• Age: as we age, the quality of tendon tissue decreases.
• Gender: women more often suffer from overload of the tendons at the level of the lateral gluteal muscles.
• Hormonal: tendons have receptor cells for sex hormones. A change in hormonal balance can influence tendon tissue.
• Weight: extra weight can put more strain on the tendons.
• Emotions and stress: chronic stress can lead to increased muscle tension, which can increase the load on the tendons.
• Gait pattern and postures: certain postures and characteristics of your gait pattern can increase the load on the tendons. This can contribute to the persistence of the overload injury.

The pain usually starts on the side of your upper leg but can also radiate to the knee, or upwards to the buttock and lower back. You may also feel stiffness after prolonged sitting, or a collapsing sensation when bearing weight on your leg.

Treatment for a gluteal tear may include the following elements:

• Adjusting load and lifestyle
• Specific exercise therapy
• Injection
• If necessary, this tear can be surgically treated with a gluteus medius repair.

We will discuss with you which treatment option is most suitable based on your specific situation and needs.