Gluteal tendinopathy: A concise overview of current evidence

This year we’ve seen a welcome explosion of evidence in Gluteal Tendinopathy (GT). This previously under-researched and mis-understood condition is finally gaining the attention it deserves as one of the most common and disabling forms of tendinopathy.

This overview will summarise recent findings and their clinical application.

Biomechanics

Dr. Kim Allison and colleagues have published extensively on biomechanical findings in GT. They reported a 32% deficit in hip abductor weakness in subjects with GT compared to healthy controls (Allison et al. 2016). A relationship is likely between this weakness and pelvic control during single leg loading tasks. Allison and colleagues also found differences in kinetics and kinematics during walking with increased hip adduction and contralateral pelvic drop and a 9 to 33% greater external hip adduction moment (Allison et al. 2016). Their most recent work (Allison et al. 2018) found significant differences in walking gait between gluteal tendinopathy and hip osteoarthritis; subjects with GT walked with a more adducted and internally rotated hip.

These findings have relevance for gluteal tendon overload:

  • A larger external hip adduction moment requires balancing with a larger internal hip abduction moment to which the gluteal muscles contribute. In simple terms it means more work for the glutes.
  • It’s likely the glutes will need to produce more force to manage this and yet they appear to be significantly weaker in those with GT.
  • The increase in adduction moment is also thought to increase provocative compressive load on the tendon through increased tension on the iliotibial band.
  • Greater hip adduction and contralateral pelvic drop during walking is likely to increase compressive load further.

Simon Bartold
Director of Bartold Clinical

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