Gluteal tendinopathy is an injury that affects all or one of the gluteal or buttock tendons. The condition is characterised by either mild or chronic pain in the gluteal muscles, making it hard to participate in normal running exercises. If you’ve been diagnosed with gluteal tendinopathy, here’s all you need to know about the recovery time.
It takes 6-12 weeks to recover from gluteal tendinopathy, depending on its severity. Recovery may take longer if you have a history of the injury. Consult a physio to determine the extent of your injury and pursue treatment, like load management, tendon rehabilitation, and corticosteroid injections.
Looking to learn more about gluteal tendinopathy and how long it’ll keep you sidelined?
If so, then you couldn’t be in a better place. Read on as we shed more light on gluteal tendinopathy, discussing its treatment and how best to handle your recovery and get back to running.
How Long To Rest From Running With Gluteal Tendinopathy
The amount of time you rest from running when you have gluteal tendinopathy greatly depends on the extent of injury and pain levels. This is because gluteal tendinopathy usually has two main stages: the reactive (early disrepair) and the degenerative (late disrepair) stage.
The reactive stage is often an acute response to excess load. It could be that you modified your training by running longer distances or included challenging hills and speed work in your training regimen.
These changes can lead to a combination of tensile and compressive loads on the gluteal tendons, ultimately leading to a reactive response.
The good thing about the reactive stage is it shouldn’t keep you from training for too long. As a rule of thumb, your pain levels during the reactive stage of gluteal tendinopathy should determine the length of your rest.
If the pain is manageable, then you can take up lighter training routines to avoid aggravating the injury. Continue with light runs if you don’t experience any reaction for at least 24 hours.
However, if the pain levels are high or you develop a reaction several hours after training, then you’ll need to take rest from running for anything from a couple of days, to a week or more, depending on your physio’s advice.
If you’ve had recurrent lateral hip pain that has progressively worsened and you’re well into your thirties or forties, chances are the gluteal tendinopathy is in its degenerative stage.
At this stage, it’s difficult to determine the extent of tendon damage or injury without a thorough examination.
During the degenerative stage, tendon structures usually start to change, increasing the risk of long-term injury layoffs. Although it’s still possible to train while at this point, your overall pain rating should act as a guide. However, you should avoid running or heavy loading exercises (compressive loads) if you’re in too much pain.
How To Return to Running After Gluteal Tendinopathy
Again, your return to running when dealing with gluteal tendinopathy greatly depends on your rehabilitation. The more you avoid aggravating your gluteal tendons, the higher your chances of recovery and thus return to running.
The first step in your successful rehabilitation is to get the right diagnosis. Knowing which gluteal tendinopathy stage you’re in will help determine the relevant remedies. However, offloading from compressive positions is a sure way to help rehabilitate the injured tendon.
You can minimise the compression of the gluteal tendons by avoiding movements that involve hip adduction (i.e. movements where the affected leg crosses the midline of the body).
You should also limit other aggravating factors until gluteal tendinopathy symptoms are under control. This means avoiding walking on steep surfaces or running until you no longer get painful responses from the affected glutes.
Once the pain recedes after a few days (for mild gluteal tendinopathy symptoms), you can start loading the muscle and tendon in strategic, non-compressed positions (without allowing the thigh to cross the midline).
This is where a physio will come in handy. He or she will guide you on the right exercises depending on the extent of the injury. Later in this article, I will share some gluteal tendinopathy rehab exercises for you to try.
When your physio gives you the go-ahead to reintroduce running into your training, be sure to follow a structured return to running plan which gradually increases your training load over a series of weeks. Click here for a free return to running plan you can use.
What Is Gluteal Tendinopathy?
Gluteal tendinopathy — also referred to as greater trochanteric bursitis, lateral hip pain or greater trochanteric pain syndrome (GTPS) — affects one or all the gluteal tendons in isolation.
The injury is often characterised by pain in the gluteal muscles and is often described as a persistent ‘bruised’ feeling or ache on the side of a hip that can extend to the lateral leg.
Gluteal Tendinopathy Causes
The main cause of gluteal tendinopathy is reduced gluteal and hip muscle strength (and control). The resulting functional instability and weakness more often than not lead to excessive load on gluteal tendons, which results in pain and increased muscle weakness.
The gluteal muscles consist of three main muscles that make the buttocks: the gluteus minimus, gluteus medius and gluteus maximus.
These muscles originate from the sacrum and ilium, inserting across the femur to allow for hip movement while also supporting your body to bear weight while running or walking.
Although common in postmenopausal women, gluteal tendinopathy also affects active individuals. The injury is mostly associated with physical activities like running, dancing and skiing, due to the load placed on the gluteal tendons.
Gluteal Tendinopathy Symptoms
The main symptoms of gluteal tendinopathy are listed below:
- Muscular stiffness and reduced strength in the affected area.
- Increased pain when using the tendon (i.e., when running, ascending stairs or hopping).
- Severe pain when lying on the affected hip.
- Severe pain even when lying on the painful side, which occurs when the affected hip falls into adduction.
- Pain may refer to the knee or lateral thigh.
- The lateral hip might be swollen, tender, warm or pinkish-red.
Gluteal Tendinopathy Diagnosis
In most cases, gluteal tendinopathy doesn’t require diagnostic imaging. Your signs and symptoms, pain response to tests (loading) and clinical history should be enough for your psychotherapist to give a diagnosis. MRI or ultrasound might be needed to determine the exact area the pain is generating from.
Best Treatment for Gluteal Tendinopathy
Remember, gluteal tendinopathies are more often than not degenerative, meaning they’ll require ongoing loads to manage. So you’ll need to stay active by taking up exercises that don’t aggravate the injured tendon.
This is because degenerative tendons tend to worsen with rest, which is exactly why the wait-and-see approach rarely works in managing gluteal tendinopathy.
Limit long-distance running, hill running, and plyometric training temporarily until the injured tendon’s load-bearing ability improves.
Some of the most popular ways to manage gluteal tendinopathy are as discussed below.
This step is important, as you’ll get to learn the correct load positioning and activities that are notorious for increasing compressive load on your gluteal tendons. Monitor your sporting activity, avoiding training routines that combine high compressive and tensile loads.
An example of load management is when you avoid compressing the affected tendon by reducing training in the outer muscle range. You should also load the tendon progressively to assist matrix remodelling.
Gluteal Tendinopathy Exercises
Rehab exercises are an important way for runners to manage gluteal tendinopathy. Based on your physio’s advice, you should include isometric and isotonic loading as part of your early recovery training routine.
Isotonic training should follow isometric loading. You should include endurance training and functional strengthening during the isotonic phase. Aim for high load, slow velocity exercises in positions of little to no hip adduction.
Here are some example exercises for you to try:
Other treatment methods used to manage gluteal tendinopathy include:
- Shockwave therapy
- Corticosteroid injections
- Platelet-rich plasma injection
- Tenocyte injections
Why Do Runners Get Gluteal Tendinopathy?
Runners get gluteal tendinopathy mostly because running requires stretch-shortening cycles in tendons. Therefore, adduction might occur during impact if a runner has poor control.
Gluteal tendinopathy also tends to affect runners who change up their training routine either abruptly or by taking up longer or tougher regimens.
Moreover, people who run with a noticeable cross-over gait are predisposed to gluteal tendinopathy. This is because narrow running exacerbates the angle of hip adduction, leading to both compressive and tensile load.
Here’s a video that will help you if you know your feet cross the midline when you run:
Therefore, while gluteal tendinopathy is commonly known to affect runners, improving running technique and hip stability can help reduce the chances of sustaining the injury.
Although it can take a minimum of 6-12 weeks to recover from gluteal tendinopathy, your recovery greatly depends on the extent of the injury and the rehabilitation’s effectiveness.
With a physio’s guidance, you should alter your training routines, leaning more towards progressive loading.
At the reactive stage, it’s best to limit running. However, through light exercises, aim to gradually increase tensile loads (without increasing the compressive load).
Reducing the compressive load at the early stages of treatment will allow you to rehabilitate the injured tendon through progressive loading successfully.