In this blog, we’ll outline gluteal tendinopathy symptoms and gluteal tendinopathy diagnosis. Gluteal tendinopathy is also often referred to as trochanteric bursitis or greater trochanteric pain syndrome (GTPS). If you're wondering about the differences between gluteal tendinopathy, trochanteric bursitis and GTPS, you can read more about this on another of our blogs.
Essentially, we now understand that the main condition related to pain over the side of the hip is gluteal tendinopathy, with trochanteric bursitis referring to some additional change in the bursa that may accompany the tendon changes. Together, they can be referred to as GTPS, so the symptoms and diagnosis for these conditions is the same.
Recovering from Gluteal Tendinopathy, Trochanteric Bursitis or GTPS
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Do you have hip bursitis or gluteal tendinopathy? Not sure where to start on your road to recovery? Or what your next steps should be?
This FREE resource provides a suggested treatment pathway, based on the available scientific evidence and Dr Alison Grimaldi's 30+ years of clinical practice as a physiotherapist and 20+ years as a researcher and educator in this field.
The main gluteal tendinopathy symptoms (or trochanteric bursitis symptoms) are pain and tenderness over the bony prominence at the side of the hip, called the greater trochanter. If you stand upright with your arms hanging by your side, the greater trochanters are at about the level of your wrists. The greater trochanters are part of the femur (thigh bone) and serve as an anchor point for some of the gluteal (buttock) muscles. Pain may also spread down the outer surface of the thigh towards the knee. The red area on the model below highlights the common area of pain experienced with gluteal tendinopathy and bursitis.
Pain is often worst at night particularly when lying on the side (lying on either side may be painful) and can disturb sleep considerably. The pain can have a significant impact on activity due to discomfort when walking, particularly walking up hills, slopes or stairs. Sitting in low chairs, particularly with the legs crossed can also aggravate the pain. Getting up from a chair after sitting can be quite uncomfortable and there might be a limp for the first few steps.
Gluteal tendinopathy pain is usually experienced when:
Do you have hip bursitis or gluteal tendinopathy? Not sure where to start on your road to recovery? Or what your next steps should be?
This FREE resource provides a suggested treatment pathway, based on the available scientific evidence and Dr Alison Grimaldi's 30+ years of clinical practice as a physiotherapist and 20+ years as a researcher and educator in this field.
Following a thorough interview and establishing that you have these gluteal tendinoapthy symptoms, there are a number of special tests that a health professional can perform in order to make a gluteal tendinopathy diagnosis (+/- trochanteric bursitis, GTPS). A couple of the tests that researchers have found most useful in diagnosing this condition1, you can perform at home yourself.
1. Sustained Single Leg Stance Test (Watch the video below)
Stand side on to a wall, with your sore hip furthest from the wall
Place 1 finger, from the nearside hand, on the wall at about shoulder height – this is just to help with balance
Now lift the nearside foot up behind you, just clearing the foot from the ground
Stand here for up to 30seconds
If you develop pain over the side of the hip within this 30 seconds, you may have gluteal tendinopathy.
(If you experience pain more quickly than 30seconds, don’t keep holding there, the test is positive)
Note: A positive test result significantly improves the chances that you have this problem. Some people will however test negative on this test and still have the problem, so this test is most useful for indicating a diagnosis of gluteal tendinopathy (+/- bursitis, GTPS) when it is positive1.
Wondering if you have Gluteal Tendinopathy or Trochanteric Bursitis?
Watch the video below to take our quick test in the first FREE lesson of our Gluteal Tendinopathy and Trochanteric Bursitis Self Help Course
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2. Palpation over the greater trochanter
If you are tender over the greater trochanter when you press with your fingers, you may have gluteal tendinopathy diagnosis (+/- bursitis, GTPS).
Note: Many people without gluteal tendinopathy are also tender over this bone, so this test cannot be used alone to diagnose the condition. Research has found that if there is no tenderness when pressing on this bony point, it is much less likely that there is a problem with the gluteal tendons1. So, this test is most useful for indicating that a gluteal tendinopathy diagnosis (+/- bursitis, GTPS) is unlikely when there is no tenderness.
There are a number of other useful diagnostic tests that need to be performed by a health professional. Organise to see a Hip Pain Professional as soon as possible – early gluteal tendinopathy diagnosis means early recovery and less chance of long-term problems.
Ultrasound and MRI (Magnetic Resonance Imaging) scans may also be used in the diagnosis of gluteal tendinopathy and trochanteric bursitis. It is important to be aware that changes seen on a scan do not always accurately identify what is causing the problem.
In one large study, 50% of people without pain over the side of their hip had gluteal tendinopathy on their MRI scans2. This is not surprising, similar phenomena have been shown in other tendons all over the body. This means that even if your scan reports changes in the tendons or bursae, this may be a red herring! What this means is that tissue changes on imaging may NOT be related to the pain you are experiencing.
Intervention should never be planned on imaging findings alone. Tests such as those mentioned above must also be positive. A physical assessment by a health professional is required to determine the relevance of any scan results to ensure the planned treatment is appropriate and most likely to have a positive outcome. See a Hip Pain Professional for a thorough assessment, to ensure you don’t waste valuable time and resources treating the wrong condition.
Do you have hip bursitis or gluteal tendinopathy? Not sure where to start on your road to recovery? Or what your next steps should be?
This FREE resource provides a suggested treatment pathway, based on the available scientific evidence and Dr Alison Grimaldi's 30+ years of clinical practice as a physiotherapist and 20+ years as a researcher and educator in this field.
This blog was written by Dr Alison Grimaldi, an expert physiotherapist, educator and researcher with over 30 years working in the field, a special interest in the hip and 20+ years contributing to hip research.
Dr. Alison Grimaldi BPhty, MPhty(Sports), PhD is Practice Principal of PhysioTec Physiotherapy Clinic in Brisbane, an Australian Sports Physiotherapist, an Adjunct Senior Research Fellow at the University of Queensland, and a Fellow of the Australian College of Physiotherapists.
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