Gluteal Tendon Tears

What are Gluteal Tendon Tears?

The gluteal tendons connect the gluteus medius and gluteus minimus muscles to the greater trochanter — the bony prominence on the outer side of the upper femur (thigh bone). These muscles and tendons are essential for stabilising the pelvis when walking and for moving the hip. Gluteal tendon tears, sometimes described as part of “greater trochanteric pain syndrome,” involve damage or degeneration of these tendons and are a common cause of pain on the outer side of the hip, particularly in older adults and more commonly in women.

These tears are sometimes referred to as the “rotator cuff tears of the hip,” because of the similarity to the tendon problems that affect the shoulder.

Causes

Gluteal tendon problems usually develop through:

• Degeneration — gradual age-related wear and weakening of the tendons, the most common cause
• Repetitive load — overuse and repeated strain over time
• Associated tendon irritation and bursitis — inflammation of the nearby bursa often coexists
• Injury — less commonly, an acute injury

Symptoms

• Pain over the outer side of the hip, around the bony prominence
• Pain when lying on the affected side, often disturbing sleep
• Pain with walking, climbing stairs, or standing on one leg
• Weakness of the hip, sometimes with a limp in more significant tears
• Tenderness to pressure over the outer hip

Diagnosis

Diagnosis is based on the history and a clinical examination, including tests that assess strength and reproduce pain over the outer hip. Imaging is used to confirm the diagnosis and assess severity: ultrasound and MRI are both useful for visualising the gluteal tendons, identifying tears and their extent, and assessing any associated bursitis. X-rays may be used to assess the hip joint and exclude other causes of pain.

Treatment Options

Treatment depends on the severity of the tear, the duration and impact of symptoms, and your individual circumstances. Most cases are managed non-surgically.

Non-surgical treatment

• Activity and load modification
• Physiotherapy with a targeted, progressive strengthening programme — a central part of treatment
• Anti-inflammatory and pain-relieving measures
• Injections in selected cases
• Radiofrequency denervation can be used to treat pain associated with trochanteric bursitis

Surgical treatment

Where symptoms are significant and persist despite a dedicated course of non-surgical treatment, surgery may be considered, particularly for larger or full-thickness tears. Surgery aims to repair the torn tendon, where the tear and tissue quality allow. The most appropriate approach depends on individual factors and will be discussed with you at your consultation.

Recovery and Outlook

Many people improve with a sustained, well-structured non-surgical programme, particularly progressive strengthening, though this can take time. Where surgery is undertaken, recovery is protected and gradual to allow the tendon to heal, with a staged rehabilitation programme. Recovery depends on the specific treatment and will be explained according to your circumstances.

Frequently Asked Questions

Why does my outer hip hurt when I lie on it at night?

Pain over the outer hip that is worse when lying on the affected side is a characteristic feature of gluteal tendon problems, due to pressure over the tendons and any associated bursitis. It is a common reason people seek assessment.

Do gluteal tendon tears need surgery?

Most are managed without surgery, particularly with a dedicated, progressive strengthening programme. Surgery is generally reserved for significant or full-thickness tears that have not responded to a sustained course of non-surgical treatment.

Why are these called the “rotator cuff tears of the hip”?

The gluteal tendons stabilise the hip in a way similar to how the rotator cuff stabilises the shoulder, and they are prone to similar degenerative tears. The comparison reflects the parallel between these two tendon problems.

Medical Disclaimer
The information on this page is intended as general patient education and does not constitute medical advice. Every patient is different, and treatment decisions should always be made in consultation with a qualified medical professional based on your individual circumstances, health history, and imaging. Outcomes from treatment vary between patients and cannot be guaranteed. If you have concerns about your hip health, please contact Dr Slattery’s rooms to arrange a consultation.