Gluteus Medius / Gluteus Minimus Injuries Treatment Options

Can gluteus medius tendon injuries be treated without surgery?

The initial treatment for low grade gluteus medius tendon injuries begins with non-operative treatment. Many individuals find relief with lifestyle modifications, including:

• Avoiding activities that worsen symptoms.
• Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, naproxen and celecoxib, help reduce hip pain and hip inflammation.
• Using a cane or crutches to help with walking.
• Physical therapy to increase hip strength and flexibility. This can include stretching the hip joint, rolling therapy, and/or learning to use ice or heat to relieve pain.
• Platelet rich plasma (PRP) Injection(s) to the gluteus medius tendon may help with pain relief temporarily (months) or permanently. These injections include taking the growth factors from your own blood and spinning them down before injecting them into the gluteus medius tendon under ultrasound guidance.

While some minor or partial tears may improve with conservative treatment options, more substantial damage to the gluteus medius tendon typically requires surgery in order to relieve pain and restore normal function in the hip.

What are the surgical options for gluteus medius tendon injuries?

Surgery can be done open (through a 6cm incision) or arthroscopic. An open approach is usually preferred for chronic cases. The goal of surgery is to reattach the tendon to the greater trochanter using small non-metal anchors. In a hip arthroscopy, surgery is performed through small incisions, minimizing tissue damage so recovery is faster. During the procedure, the tendon is also reattached to the bone using small suture anchors.

When the gluteus medius has been torn for a long period of time, the gluteus maximus (a bigger muscle that covers the gluteus medius) can be transferred (change the insertion of the tendon) to restore strength and function to the hip abductors. This is called a gluteus maximus transfer.