Gluteal Tendon Tears
A gluteal tendon tear is a partial or complete tear of the tendons that attach the gluteal muscles (Buttocks) to the hip bone. These tendons play an important role in hip stability and movement, and injury can lead to pain and weakness on the outside of the hip.
Causes
Gluteal tendon tears can occur from:
- Degenerative wear and tear, often due to chronic overuse or age-related changes
- Repetitive friction or compression over the tendon (as seen in gluteal tendinopathy)
- A fall onto the hip or sudden forceful movement
- Weakness or imbalance in surrounding muscles.
Anatomy
The main gluteal muscle is the Gluteus Maximus, however, the muscles that attach to the hip bone are gluteus medius and gluteus minimus, these are attached to the greater trochanter — the bony prominence on the side of the hip.
They help keep the pelvis level when walking and control sideways movement of the leg.
Tears of these tendons are often compared to a “rotator cuff tear of the hip.”
Gluteal Tendon Tears
Symptoms
Common symptoms include:
- Pain over the outer side of the hip (greater trochanter area)
- Bursitis (inflammation of the fluid-filled sac over the tendon)
- Pain when lying on the affected side, walking, or climbing stairs
- Weakness when lifting the leg sideways or standing on one leg
- A limp or “dropping” of the pelvis on the opposite side when walking
- Swelling or tenderness over the outer hip.
Diagnosis
Your doctor will examine your hip and test muscle strength and movement.
Investigations may include:
- Ultrasound or MRI scans, which can confirm the diagnosis and show whether the tear is partial or complete.
Treatment
Treatment depends on the size and severity of the tear:
- Non-surgical management is suitable for most partial tears and includes:
- Physiotherapy to strengthen hip and core muscles
- Activity modification and avoiding prolonged pressure on the hip
- Anti-inflammatory medication or corticosteroid injections for pain relief
- Shockwave therapy in some cases
- Surgical repair may be recommended for:
- Complete tears or cases not responding to non-operative treatment
- The torn tendon is reattached to the bone using sutures and anchors.
Recovery
Non-surgical recovery may take 3–6 months with dedicated physiotherapy.
After surgery:
- A brace or crutches may be used for the first few weeks to protect the repair.
- Gradual strengthening begins under physiotherapy guidance.
- Return to full activity usually occurs within 6–9 months, depending on progress.
Possible Complications
While most patients recover well, potential complications include:
- Persistent pain or weakness
- Re-tear or incomplete healing
- Stiffness or scarring around the tendon
- Ongoing difficulty lying on the affected side.
When To Seek Help
See your doctor if you experience:
- Persistent outer hip pain or tenderness
- Weakness when walking or climbing stairs
- Pain when lying on your side that does not improve with rest or physiotherapy.
