A common cause of lateral hip pain, ranging from tendon degeneration through to partial or full-thickness tears. Treatment depends on severity and includes physiotherapy, injection and in some cases surgical repair.
(03) 9573 9659
Gluteus medius tendinopathy is a common cause of lateral hip pain, particularly in women over 40. It ranges from tendon degeneration without a structural tear through to partial and complete tears of the tendon. The treatment approach depends on where on that spectrum the patient sits. It is frequently misdiagnosed as trochanteric bursitis, but current understanding recognises that the primary pathology in most cases is the tendon itself, not the bursa.
The gluteus medius is one of the main muscles responsible for stabilising the pelvis during walking and single-leg activities. Its tendon attaches to the greater trochanter, the bony prominence on the outer side of the hip. When this tendon degenerates or tears, it causes pain and weakness on the outer side of the hip that can significantly affect walking and daily activities.
Gluteus medius tendinopathy most commonly affects women over the age of 40. It is associated with hormonal changes, altered lower limb biomechanics and repetitive loading. It may also occur following a fall, a period of prolonged inactivity or as a complication of hip surgery.
The primary symptom is pain on the outer side of the hip and upper thigh, which is typically worse with walking, climbing stairs, lying on the affected side and prolonged sitting with the legs crossed. There may be localised tenderness directly over the greater trochanter. Weakness in the hip abductors can cause a Trendelenburg gait, where the pelvis drops to the opposite side during walking.
MRI is used to confirm the diagnosis and distinguish between tendinopathy, partial tear and full-thickness tear. This distinction is important because it directly guides the treatment approach.
For tendinopathy and partial tears, treatment begins with physiotherapy focused on progressive gluteal loading, correction of biomechanical factors that increase tendon stress, and activity modification. Cortisone injection can reduce pain in the short term but does not address the underlying tendon degeneration and is used judiciously. Platelet-rich plasma (PRP) injection is an option for patients who have not responded adequately to physiotherapy.
Full-thickness tears causing significant functional impairment and weakness may require surgical repair. Mr Balakumar discusses the full range of options with each patient based on the MRI findings and the degree of functional limitation.
(03) 9573 9659
Mr Balakumar is one of a small number of surgeons in Australia with formal training in both paediatric and adult hip surgery. His fellowship at Harvard’s Children’s Hospital in Boston, under some of the world’s leading specialists in hip preservation, gives him a depth of expertise that is difficult to find in a single practice.
His approach is the same whether the patient is 6 months or 65 years old – thorough assessment, honest options, and no pressure toward surgery until the clinical picture clearly supports it.
(03) 9573 9659
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Melbourne Orthopaedic Group is home to a team of experienced orthopaedic surgeons, providing comprehensive care for sports injuries and orthopaedic conditions. Whether it’s joint replacement or sports injuries, our specialists provide comprehensive orthopaedic care.
