Gluteal tendinopathy and the Cross Over gait pattern.

Gluteal tendinopathy, often lateral hip pain at or around the region of the greater trochanter. (note: the pain referral of this problem can dispurse far and wide, from low back and even into groin or to the knee). It is not gluteal bursitis, the research barely supports that. You'd be better off using the term "greater trochanteric pain syndrome" (yes, its an ICD10 code).

The problem often involves the abductors, the gluteus medius and/or gluteus minimus tendons as weakness or poor co-contraction stabilization patterning creates a compressive adduction of the tendons and gr.trochanter. But, know this, mere strengthening is not the entire answer, and it is not supported as the cause or cure, it is just part of the solution. As with most problems, resolution is about load, how we load, load over time, tolerance to load, time under tension, loads we can manage, loads we are unprepared for. These are variables certainly pertinent to novice runners and athletes (though for some everyday folk even walking can be vulnerable) but also high level athletes who either mal-adapt, compensate, over protect or under-recover.
About 10 years ago I began my dive into something I was seeing often, something that did not seem to have a name from what I was able to determine, but one that was fraught with mechanical loading issues that was part of my athletes' symptom collage. I referred to it by what it appeared to be, a "cross over gait", and since then have written a few dozen pieces, at least, that go into the problem, pathomechanics, and correction for my athletes and patients. I have often referred this to as a "failure to stack the lower limb joints", but that is so remedial and non-descript. Almost a decade ago I did the 3 part video series (part 1 is below) and it brought a lot of light to gait problems in runners and a huge variable in unresponsive gluteal tendonopathies, amongst others. One can strengthen the glutes all they want, but if the pattern of pathologic loading is not amended, altered, improved, then the model will fail.
And here is another factor that is interesting brought forth at a recent conference,
"@Bill_Vicenzino Imaging over-estimates compared to clinical presentation - MRI positive for Gluteal Tendinopathy in 77% of cases but clinical presentation only positive in 52%"

Watch my 3 part series, starting with the video below. Get to understand the cross over gait variables and you will get better at remedying gluteal tendonopathy. It is more than just prescribing half a dozen glute exercises.

Shawn Allen, the other gait guy.

#gait, #thegaitguys, #gaitproblems, #gaitanalysis, #glutealtendinopathy, #hippain, #crossovergait, #hipadductors, #hipabduction, #greatertrochanter, #hipbursitis

Hip Abductor Strength In Individuals With Gluteal Tendinopathy: A Cross-sectional Study. Kim Allison et al.
https://bjsm.bmj.com/content/48/Suppl_2/A6.2