Gluteus Medius Tears
What is the gluteus medius / minimus muscle?
The gluteus medius and minimus muscles are buttocks muscles that connect the thigh bone to the pelvis. They attach at the outside of the hip bone and insert on the greater trochanter, the bony prominence of the upper thighbone. These collectively are known as the hip abductor muscles, which provide the ability to pull the thigh out to the side of the body (hip abduction) and to rotate the thigh.
The gluteus medius and minimus muscles provide hip support and are the primary pelvic stabilizers keeping the pelvis straight during walking, standing and single-leg weight bearing. Failure of these muscles can result in abnormalities in walking patterns, sometimes known as a Trendelenburg gait.
A tear of the tendon that attaches the gluteus medius muscle usually occurs where the tendon attaches to the greater trochanter. Tears may be partial, where the muscle is partially attached, or complete, where the muscle is torn off the bone.
Gluteus medius and minimus tears may occur due to trauma from a fall while playing sports, improper lifting or degeneration of the tendons with overuse. Common traumatic injury is found in runners, soccer and basketball players. Sudden bursts of activity can also cause a tear.
These tears are a common source of chronic lateral hip pain (also called greater trochanteric pain syndrome) affecting middle-aged women more than middle-aged men, caused by chronic degeneration of the tendon that eventually tears the tendons. Sometimes these tears are misdiagnosed as muscle strain, but often misdiagnosed as trochanteric bursitis.
- persistent dull lateral-sided hip pain
- difficulty sleeping on the side at night
- low back pain
- buttocks pain
- swelling along the side of the hip
- difficulty with prolonged sitting and standing
- muscle weakness that causes abnormal gait including balance difficulties
- reduced hip range of motion
- hip instability
The expert clinicians at LALL Orthopedics + will conduct a comprehensive orthopedic examination including review of your medical history, injuries, and symptoms, and a physical exam testing muscle strength, range of motion and gait abnormalities. Often times, patients with these tendon tears present with what’s called a Trendelenburg gait, where the hip abductor muscles are weak causing the pelvis to droop on to the opposite side. Because the pain and weakness are also symptoms of bursitis and lumbar spine (low-back) disease, these injuries must be ruled out. X-rays may be ordered to evaluate the bones and an MRI can help to describe the tear. An ultrasound-guided injection can be used to help identify a tear.
First line treatment is conservative in nature involving activity modification, ice, compression, and elevation plus anti-inflammatory drugs, physical therapy, and cutting-edge regenerative medicine options such as platelet-rich plasma (PRP) or Stem-Cell injections. Surgical management is indicted for partial and complete gluteal tendon tears when conservative measures fail to relieve pain.
Minimally-invasive arthroscopic surgery can repair a torn gluteus medius or minimus tendon tear. During surgery the tendon is sewn back to the bone. However, mini-open procedures may be necessary to treat a large tear; and when repair is not possible, tendon reconstruction with a graft may be indicated.
Recovery after surgical repair of the gluteus medius tendon requires 2-6 weeks of restricted weight bearing and the use of a hip brace to protect the hip during healing. Postoperative rehabilitation is vital to restoration of pain free function. Most patients can begin physical therapy immediately following surgery and continue until muscle strength has been reestablished.
Dr. Ajay C. Lall is a former dual sport NCAA collegiate athlete (football and track & field), American board certified and triple fellowship-trained hip surgeon. Dr. Lall and the team at LALL Orthopedics + specializes in diagnosing and treating gluteus medius tears. Schedule a hip consultation today.
At a Glance
Ajay C. Lall, MD, MS, FAAOS
- Board Certified – Orthopedic Surgery
- Triple Fellowship Trained
- Performs over 750 Surgeries Per Year
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