Gluteal tendinopathy

[Poppytime]

Not sure if this is the right place but as it's come from exercise (i think!) it seemed appropriate!

Took up running during last lockdown, fine for a few months then noticed lower bone/one sided hip ache after runs. Pushed through it (why oh why) and eventually has got so bad even walking a few mins starts a horrible burning pain in the top of my hip and glute. Had Mri to rule out and sciatic and lumbar issues, and pelvis and hip scan. Came back with slight bursitis in hip but I feel that was a secondary issue. Had a steroid injection for that which felt in wrong place for the original pain, and hasn't helped :(. Gp throws painkillers at me which don't help. I haven't run since June. I've tried Pilates, cycling etc, I'm finding it so hard to find the balance between what aggravated it and doing nothing, which doesn't help either. I've been seeing a phsyio who is lovely but the exercises don't seem to help and not much hands on atm due to current issues. I feel like I need to massage it constantly which is hard to achieve. Diagnosis seems to be as in title.

Basically has anyone had experience of this? I'm getting very depressed not even being able to walk a few mins without pain, not being able to exercise having previously being very active and also have 2 very active children! Any tips/positive stories are welcome. Feel about 85 and not even 40 yet thank you

It was never bad enough that I was prevented from running but I did rest for a month after it became clear it wasn't going away and running was making it worse. Initially stretching helped a bit but it only went so far. I did go for some sports massages where I was told that leg was really tight - yeah tell me something I don't know. I'd say it's about 70% better but it's been 70% better for about a year now. It's got to the stage I've forgotten what it's like not to have pain after sitting for ages to the extent I keep forgetting to mention it to the last I see for sports massages as it's just a part of every day life now.

Oh yes - I'd also recommend a good sports masseuse. You'll be tight around your hip and lower back and massage release helped me enormously

Are you anywhere near Cambridge? I use a chiropractor there and he is fantastic, has got rid of a problem that plagued me for over a decade and foxed several other professionals.

I’ve had this since breaking my femur three years ago. It’s much better than it was after lots of physio. The only thing to do is strengthen the glutes to support the tendon. The main exercise to do is the clamshell as it’s usually weak glute mede. However I also got piriformis syndrome from running. That was cured with some good physio massage followed by strength training. Are you sure it’s not that. Piriformis syndrome hurts when walking up stairs. Gluteal tendinopathy hurts if you lie on affected side or sit with legs curled up (ie whenever tendon is compressed). You need to ensure you don’t lie on it or compress it and sleep with pillow between your legs etc. Massaging and stretching also don’t help although feel like they will. My physio explained it as a donught. The hole is the damaged tendon and you have to strengthen the muscles around it. It’s caused by really weak glutes. I don’t think mine hurt after walking a few minutes though. Are you sure it’s not the bursitis? Good luck. Try to find a good physio who can accurately diagnose.

I’ve also come to accept mine won’t ever go away but it’s loads better than it was and I can curl up on the sofa for a bit without pain now and it doesn’t bother me running anymore. It depends how degraded the tendon is I think. My physio also made me restart my running with couch to 5k after doing the strength training and it was fine

OP when you start running again (crossing fingers for you) try Yoga with Adriene. She is excellent anyway but does a specific pre and post run session. I injured my back during the early part of last lockdown which I think was down to a perfect storm of upping my distance too quickly in the lead up then not strength training at all which I think led to weak glute and hip flexors but continued running.

After a few weeks rest then just yoga for a while I found that the above sessions have helped massively plus as pp have said, doing strength training at home. I do appreciate however your journey is trickier

pink I often find that too

YY to Yoga with Adrienne.

I would recommend having a look at Tom Morrison and his simplistic mobility method(SMM). My friend who is a remedial masseuse put me on to him and his Facebook page.
Im a regular exerciser working out 4/5 sessions a week (HIIT, running and dance) but was waking up with sore hip, knee and shoulder/neck
I could hardly walk. I spent ages stretching at the end of my workouts, constantly on the foam roller and that little ball.
I signed up for the SMM for my birthday, but he does free 7 day routine and videos on Facebook and his YouTube channel. It has been a complete game changer for me and I no longer use my foam roller or massage ball. No soreness and I feel great after the exercises.
Like most things in life though you have to put the work in and actually do the exercises but it certainly works for me.

My physio gave me needling yesterday; it's helped. Not a lot better but a little better, which is a godsend by now.

nice side effect of strong glutes is a nice behind.
bye mum moon bum

Hi @Poppytime - I am so sorry to hear that you are having such a rough time and can really appreciate how not having a break from the pain or an end in sight can really grind you down!

Speaking as a Rehabilitation Therapist (I am a Graduate Sports Therapist sitting on the same spectrum as Physios, osteos, chiros) I would recommend you find a good rehab therapist with knowledge of returning to function / sport via exercise therapy. Whilst massage, stretching and manual therapy have a place in the rehab process, this is often more about symptom management / modification as opposed to returning to function (caveating to say that this is from my own personal experiences).

Whilst every condition / injury is different having a Therapist who understands S&C (strength & conditioning) protocols goes a long way towards helping recovery!

Thanks for replying! Yes I think finding the right therapist is key - I really like my new physio and think he is definitely helping. It's been up and down but I've managed some small walks last week and some cycling so that's been better. I also went for a sports massage last week which gave some good temporary relief. Tendon issues are really frustrating though and I feel I take one step forward and 2 steps back sometimes. Hope everyone else who is suffering is ok x

Ps has anyone tried acupuncture/dry needling?

@Poppytime - that is good news that you are seeing progress.

Instead of dry needling might I suggest mindfulness? It tackles the sympathetic nervous system (fight or flight adrenalin response) which can contribute to exacerbating your worries about the GT and stress contributes to overall muscle tightness which can contribute to the GT and pain levels. The smiling mind app has been a blessing for me as the short guided sessions (with associated breathing techniques) help activate the parasympathetic nervous system which overrides the sympathetic nervous system helping to ease your stress levels. By the end of one of these I am left feeling serene and relaxed.

It might feel unrelated but muscle tightness caused by stress can aggravate pain and injury.

Good luck!

Joanna

@Poppytime hi op just came across this thread. I've been suffering with glute pain since Sep-2020 - suspected Piriformis. Had MRIs etc to rule out anything sinister. The pain is getting better but it's taking a very long time and I am still in daily pain. Osteopath and physio helping, but I would like this to be over. trying to figure out what is aggravating it. How are you getting on? Hope things have settled down for you.

DH has this. A monthly deep sports massage keeps it at bay.

Oops! Old thread.

Hi Gracie! I still have it I'm afraid but it's not as bad as it was and I think I'm managing it better. I've come to terms with it being a chronic thing I think. What's helped is physio, trigger point massage (also myself at home with a small massage ball), pulling back when I've done too much, not standing around too much (I find ambling and standing around makes it worse, god knows why!). It's almost like everything gets so tights and goes into spasm sometimes. Other times it's more like a deep ache. I'm guessing your mri ruled out anything major? Mine did which was good but also frustrating! I do have some deterioration of my sacroiliac joint which I'm sure is part of the issue. I'm doing lots of Pilates now which I think helps and glute exercises from the physio. What exercise were you doing? Running triggered it for me initially but it got so bad even short walks were hard for a few months last summer.

@Poppytime I could have written the exact same about my situation. I think long walks uphill at the start of the first lockdown triggered mine. Long walks after sitting down for hours working from home without first stretching. I had whole spine mri and a pelvic mri none of them showed anything wrong except mild degeneration, which was apparently normal for my age (36) and according to the surgeon didn’t explain my symptoms.

Saw a neurologist also and he thinks it’s a muscular skeletal problem rather than neurological.

I have found a good osteopath and physio who are helping. I now spend most of my day in between work calls, foam rolling, giving myself trigger point massages with a spiky ball, doing strengthening exercises. I am getting better , the pins and needless down my right leg are 85% gone, I’m just left with a deep ache In my right buttock and some referred low back pain.

I’ve found that doing some of the stretches commonly advised (pigeon stretch etc) makes things worse for me. What has started making things better is doing exercises that strengthen my core and the muscles in my glutes (glute bridges, planks, clams, fire hydrant, squats).

I agree standing for longer than 10 minutes is a nightmare. I’m determined to beat this thing or at least learn how to keep it under control.

@Poppytime ive been referred to a pain doctor next month, who can give me a steroid injection or something similar. To be honest I would like to try and get over this without the injection and I’m hoping to see more improvement between now and May.

@Poppytime one more thing, my physio tried shockwave therapy on me last week. It hurt a lot afterwards but I saw a big improvement. She wants to do 3 more sessions. Maybe that something you can look it into?

Hey! I had a steroid injection in September, the consultant I saw said the mri actually showed a little hip bursitis, which didn't seem quite right as my pain was definitely originating around the si joint and glute, although my hip was getting a little sore latterly - but I thought he must know better so i had it and tbh although it might have helped the hip a bit it did nothing for the original issue. It's also apparently not recommended for tendons as it can degrade them further, but that's just stuff I've read on my own and I'm no doctor! Where did they advise you to have the injection?

Sounds like we have the same thing! Pigeon pose etc feels so tight and I can never tell if it is helping or making it worse. It certainly doesn't really relieve it. It's so hard to know what will make it better or what will make it worse isn't it? I had some darker times with it over the summer and was even prescribed diazepam, am keen not to get back to that again!!

Shockwave yes I've heard but tried. I'll add to the list!! I find massage by my physio so painful but I'm a good way and does give some temporary relief. But sometimes the pain feels deeper than just muscular so I wonder if the muscle tightness is just a secondary thing.

@Poppytime it sounds like you have either piriformis syndrome or some sort of gluteal tendonipathy, or just weak glute muscles. Remember the muscles in the glutes are very deep, and that’s why the pain feels like a very deep ache.

I haven’t been to the pain clinic yet, but an orthopaedic doctor I saw late last year said that the injection would be best given in my piriformis muscle as that’s the muscle that keeps getting tight in my case, and pinching on my sciatic nerve.

I’ve had very dark days with this, the pain has been around everyday since sept 2020, and it’s such a deep indescribable pain, and the neuropathy is the scariest symptom of all. I have good and bad days, but I know that I’ll try my hardest to learn how manage it. My gp threw all the strong painkillers at me but I stopped taking them after 2 months as the opioids made me feel out of it and the nsaids were hurting my stomach.

Definitely give shockwave therapy a go, I’ve only had one session out of 4 so it’s too soon to tell if it will have long term benefits. But I’ve noticed improvements so far.