Abductor and Tendon Tears
Put your hand on the outside of your hip. Feel that muscle? That's the gluteus medius muscle, a major muscle that helps stabilize your hip during movement and also helps you raise your hip to the side, away from the midline of your body (a movement called abduction). The gluteus medius abductor muscle is attached to the bony prominence of the hip (called the greater trochanter) by a very strong tendon.
Sometimes, the tendon is torn or ripped from the trochanter, or the muscle itself is torn, often as a result of repetitive forces exerted during athletics and other physical activities. For instance, runners who rapidly increase their routine instead of gradually increasing activity often wind up overstraining and tearing the gluteus medius muscle or tendon. Running on inclines or declines or failing to warm up properly before participating in sports can also cause tears. Less often, tears can occur after a traumatic injury or as a result of age-related wear and tear. While some minor or partial tears may improve with conservative treatment options like rest, ice and physical therapy (especially in patients who aren't very physically active), more substantial damage typically requires surgery in order to relieve pain and restore normal function in the hip.
What symptoms are associated with gluteus medius abductor and tendon tears?
Gluteus medius tendon tears are classified by “grades,” with Grade 1 injuries including the mildest tears and Grade 4 comprising the most severe tears. Most patients with tendon tears have a combination of sharp pains and dull aches in and around the hip that become worse when lying on the injured side, and weakness and tenderness often lead to limping. Symptoms also tend to become worse after a long period of standing, sitting or walking.
Diagnosing a tear begins with a comprehensive evaluation and an examination of your hip. Dr. Van Thiel will look for areas of tenderness and swelling, and he'll order imaging tests like X-rays and MRIs to confirm the diagnosis and to evaluate the extent of the injury.
How are gluteus medius abductor and tendon tears treated?
Except in the most mild cases, gluteus medius tears require surgery to correct. In most cases, reattachment can be performed during a hip arthroscopy procedure. In a hip arthroscopy, surgery is performed through small incisions, minimizing tissue damage so recovery is faster. During the procedure, the tendon is reattached to the bone using small suture anchors. When damage is more extensive, a larger incision (or “open” surgery) may be required to provide greater access to the hip.
After surgery, you'll need to use crutches and wear a hip brace during the initial stages of healing, and your activity will be restricted for several weeks. Physical therapy will play an important role in recovery, strengthening your hip as well as preventing a buildup of scar tissue that can interfere with normal joint function.
Don't ignore hip pain.
Gluteus medius abductor and tendon tears typically cause significant pain, but they're just one possible cause of symptoms. Hip pain - even relatively minor discomfort - can be a sign of a serious underlying problem. Having pain evaluated and treated as soon as possible is important for relieving your symptoms, and it's also important for ensuring you'll enjoy a speedy return to the activities you love. To find out what's causing your hip pain - and how it can be treated - call OrthoIllinois at 815-398-9491 and schedule a consultation and evaluation with Dr. Geoffrey Van Thiel today.