Blog post produced and written by Clinic Manager and Sports Injury Specialist Jason Dodd.
For those who are not familiar with this term , it is something we see ALOT of within clinic. Typically a patient presents with pain on the outside of the hip which is aggravated with sitting for long periods of time and also with things such as walking up stairs.
This can often seem like osteoarthritis of the hip, which whilst common, it tends to be in the ages of 60+. But when our 40 year old patients turn up with hip pain we know immediately that it I unlikely to be hip osteoarthritis and more likely to be gluteal tendinopathy.
Now the aim of this post is to not go so much into the aetiology of how the condition arises, etc… Instead it is to focus on a strong research paper from 2018 which looked at the treatment of Gluteal Tendinopaty (GT) when compared to other interventions. These interventions included cortisone injection (CSI) and also just a ‘wait and see approach’ (whereby you literally just wait and see if it goes away).
Needless to say with this study, the wait and see approach did not go too well, with patients making significantly less progress over the 52 week study period. Of interest was the difference between CSI and exercise. At the 8 week follow up, the exercise group were doing better than the CSI group in terms of function and pain but at the 52 week follow up both groups had levelled out. What we do not know though is how much activity did the CSI group end up getting back to doing (if any at all)?
The key parts to assess in this study then is if both interventions have the same outcome then why not just go for a CSI and save yourself the time and energy in doing the exercises? Well, this is a great question if you do not like taking part in exercise BUT the majority of people we see at Bodylogics do enjoy exercise so here we can almost kill two birds with one stone.
Not to mention the added benefits of increased cardiovascular activity on our overall health, you can see why we are such big admirers of studies like this and how it helps to spread the word of the many benefits of exercise and helps increase individuals well-being.
There are also inherent risks associated with CSI such as thickening of tendons and making them more brittle, therefore more likey to tear or degenerate. This is a serious consideration to make before having any CSI in any part of the body.
I recently treated a patient with gluteal tendinopathy by using a series of research and evidence based exercises, as proven in the study by Mellor et al, 2016 titled Exercise and load modification versus corticosteroid injection versus ‘wait and see’ for persistent gluteus medius/minimus tendinopathy (the LEAP trial): a protocol for a randomised clinical trial.
I added my own exercises also as the patient was more advance than the exercise provided within the research paper. Whilst the exercise help prove that exercise work, they never mean that those exact ones are the single answer. Knowing the patient in front of you is key to successful outcomes. The progress of this patient over 6 weeks was really good, her adherence to the programme helped ensure a successful return to running and also to a pain free hip.
If you are struggling with hip pain then why not get in touch with us now and see how our team of specialists can help you. Contact us now on 020 8368 9220.
