Rupture of the gluteal tendons
THE gluteal tendons These tendons connect the gluteus medius and minimus muscles to the greater trochanter on the side of the hip. A rupture corresponds to a partial or complete tear of one of these tendons. It can develop gradually, in a weakened tendon, or occur after an injury.
Pain may be accompanied by weakness, difficulty walking, or trouble bearing weight on one leg. Management aims to determine the extent of the injury and its impact, and then to choose the appropriate measures. Surgery is only considered in certain situations.
UNDERSTANDING A RUPTURED GLUTEAL TENDON
RECOGNIZING THE SYMPTOMS
There rupture of the gluteal tendons It can cause pain on the side of the hip, often near the greater trochanter. Weakness in the muscles that stabilize the pelvis may also occur, especially when walking or bearing weight on one leg.
- Pain on the side of the hip: It may be sensitive to touch and worsen when walking, climbing stairs, or lying on the affected side.
- Weakness when extending the leg: Spreading your leg against resistance or standing on one leg can become difficult or painful.
- Difficulty walking: A limp or a feeling of instability may occur if the gluteal muscles no longer sufficiently stabilize the pelvis.
- Difficulty remaining balanced on one leg: The pelvis may lack stability during certain movements, such as climbing a step or putting on clothes while standing.
Symptoms alone are insufficient to determine the extent of the tear. Other causes can produce similar pain: clinical examination and, if necessary, imaging help to refine the diagnosis.
WHY DOES A GLUTEAL TENDON RUPTURE OCCUR?
A rupture can occur when tendons are weakened or subjected to stress exceeding their resistance capacity. It can develop gradually or appear after a traumatic event. The cause and severity of the injury must be assessed for each patient.
PROGRESSIVE EVOLUTION OF THE TENDON
Some tears develop over time, originating from a weakened tendon. The tear can progress gradually, without any specific trauma, and slowly cause pain or weakness.
TRAUMA
A fall or sudden movement can cause an acute injury, especially if the tendon is already weakened. The context and onset of symptoms are taken into account during the assessment.
REPEATED REQUESTS
A significant increase in activity or stress on the hip can contribute to the onset of symptoms. This does not mean that any particular activity alone is the cause of the rupture.
PRE-EXISTING TENDON FRAGILITY OR INJURY
Tendinopathy can weaken the tendon and lead to a partial or complete tear. Symptoms and examination help determine if the rupture is recent, old, or associated with a pre-existing tendon condition.
MAKE THE RIGHT DIAGNOSIS
The diagnosis is based on symptoms and examination of the hip. An ultrasound or MRI may be recommended to examine the tendons and determine the extent of the tear. The necessary examination depends on the clinical situation.
01 — THE CLINICAL EXAMINATION
The location of the pain, gait, gluteal muscle strength, and pelvic stability are assessed. Certain movements, such as resisted leg abduction or single-leg stance, can help evaluate the impact of the injury.
02 – X-RAYS
X-rays can help examine the bones and joint of the hip and look for other possible causes of symptoms. They cannot directly show a rupture of the gluteal tendons.
03 – ULTRASOUND OR MRI
An ultrasound or MRI may be requested to examine the tendons, determine the location and extent of the tear, and assess the surrounding tissues. The choice of examination depends on the symptoms and the clinical examination.
An abnormality visible on imaging should always be interpreted in conjunction with symptoms and clinical examination.
RELIEVING TENDON RUPTURE WITHOUT SURGERY
The management of rupture of the gluteal tendons The treatment depends on the extent of the tear, the pain, and the weakness observed. Non-surgical management may be offered, particularly for certain partial tears or when the symptoms allow.
ADAPTATION OF ACTIVITIES
Activities that cause significant pain can be temporarily reduced or modified. The goal is to limit irritating strain while avoiding, when possible, a complete cessation of all activity.
PHYSIOTHERAPY AND ADAPTED STRENGTHENING
Physiotherapy can help maintain mobility and improve pelvic stability and hip muscle strength. Exercises should be tailored to the extent of the injury and the level of pain; their progression is determined on a case-by-case basis.
DRUG TREATMENTS
Pain management treatments can be discussed based on the patient's health status, usual treatments, and any potential contraindications. An injection may sometimes be considered after evaluation; its indication and expected effects should be discussed on a case-by-case basis.
MONITORING PROGRESS
Follow-up care allows for the assessment of pain, strength, and activity tolerance. If symptoms persist, worsen, or are accompanied by significant weakness, the diagnosis and treatment options can be reassessed.
Adapting activities and rehabilitation can be part of the treatment, but they must be adjusted to the severity of the tear. The choice of exercises and their progression must be defined according to each patient's situation.
WHEN TO CONSIDER SURGERY?
Surgery is not always necessary. It may be considered when the rupture is significant and causes pain or weakness that limits activities, especially if symptoms persist despite appropriate treatment. The decision takes into account the examination, imaging, and the patient's goals.
ASSESS THE EXTENT OF THE BREAK
The size and location of the tear, the condition of the tendon, and the strength of the gluteal muscles are taken into account. Imaging results are interpreted in conjunction with symptoms and the clinical examination.
TAKE INTO ACCOUNT THE DAILY INCONVENIENCE
Pain, weakness, difficulty walking, and problems with daily activities all contribute to the decision. A rupture visible on imaging does not, in itself, mean that surgery is necessary.
DISCUSSING TENDON REPAIR
For certain symptomatic ruptures, surgical tendon repair may be considered. This option is reserved for selected cases following specialist evaluation; the expected benefits and limitations of recovery are discussed during a consultation.
KEEP MOVING WITH A Ruptured Gluteal Tendon
A ruptured gluteal tendon doesn't necessarily mean you have to stop all movement. Activities can sometimes be modified to avoid movements that significantly increase pain or weakness.
Walking and strengthening exercises should be adjusted according to the hip's tolerance and the extent of the injury. If surgery is recommended, instructions regarding weight-bearing, movement, and resuming exercises will depend on the procedure performed and the program defined by the medical team.
The resumption of activities is gradual, depending on the pain, strength and stability of the hip.
A CARE APPROACH TAILORED TO EACH PATIENT
Pain on the side of the hip accompanied by weakness can have several causes. A consultation allows the doctor to correlate the symptoms, the activities that trigger them, the clinical examination, and, if necessary, the results of imaging.
Treatment depends on the extent of the tear and its impact on walking and daily activities. It may involve activity adjustments, pain management, and rehabilitation tailored to the tendon's condition.
If the tear is significant or if the symptoms remain very bothersome, surgical repair may be considered. The decision is made on a case-by-case basis, after evaluating the expected benefits and the constraints of recovery.
«"Treatment depends on the condition of the tendon, the strength of the hip, and the discomfort experienced on a daily basis."»
FREQUENTLY ASKED QUESTIONS
DO YOU WANT TO BETTER UNDERSTAND YOUR PAIN?
A clinical examination combined with appropriate imaging helps to determine the origin of symptoms and identify the most suitable treatments.
