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Gluteus Medius Tear

The gluteus medius and gluteus minimus are muscles that attach on the outer side of the hip, often referred to as the “abductors.”  They help with movement of the hip and thigh, and help keep the pelvis steady during walking or standing. The muscles become tendons as they near the bone where they attach. These tendons can tear, causing pain, weakness and a limp.

What causes a gluteus medius tear?

Gluteus medius and minimus tears are often degenerative in nature, meaning they occur with typical wear and tear over time.  Though it is possible to injure these tendons by suffering an injury, such as a fall or other trauma, this is less common. Over time, the degenerated tendon can tear from the bone. These tears are often classified as partial thickness or full thickness tears.

What are the symptoms of a gluteus medius tear?

Gluteus medius and gluteus minimus tears most often present with pain on the outer side (lateral aspect) of the hip/thigh. This pain is aggravated by increased activity such as walking, going up and down stairs, or direct pressure applied to the side of the hip such as when lying on the side of the hip. In more severe or chronic cases, a limp may develop.

How is a gluteus medius tear diagnosed?

Gluteus medius and minimus tears are diagnosed using a combination of tests, most importantly a clinical examination by a trained orthopedic specialist. The physician will look for things like tenderness at the outer hip (lateral hip), weakness with abduction (moving the thigh outward from the body) against resistance, and sometimes also identify a particular limp. After X-rays have been reviewed, an MRI is sometimes helpful to assess for a gluteus medius/gluteus minimus tendon tear. It is important to keep in mind that a large percentage of people with no hip pain or problem at all will have gluteus tendon injuries seen on MRI. Because of this, the MRI must be interpreted carefully and in combination with the clinical examination.

How is a gluteus medius tear treated?

Most gluteus medius/gluteus minimus tendon injuries can be treated using non-surgical measures, including activity modification, non-steroidal anti-inflammatories, ice and sometimes physical therapy. In some situations, an injection next to the tendon (in the bursa) may be helpful to relieve symptoms and to also confirm where the pain is coming from. In situations where none of these treatments are able to resolve the pain, and the symptoms are well attributed to the tendon tear, the tendon can be repaired surgical using either open surgery or endoscopic surgery (minimally invasive).

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