Current and future advances in practice: tendinopathies of the hip

Key Points

1. Two of the most common hip tendinopathies seen in clinical settings are gluteal tendinopathy and proximal hamstring tendinopathy.

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INTRODUCTION

Hip tendinopathies are common across the lifespan. Gluteal tendinopathy (GT) and proximal hamstring tendinopathy (PHT) are two of the most common hip tendinopathies seen in clinical practice (1,2). When present they are associated with moderate to severe pain and often affect a person’s ability to sleep and be physically active (3). GT is one of the most common lower limb tendinopathies, affecting 1 in 5 middle-aged women (2). Poor understanding of the underlying pathology often leads to patients receiving an incorrect diagnosis and suboptimal clinical care, including use of passive treatment approaches (4).

PHT is a common cause of buttock pain in active and sedentary patients. The complex anatomy and proximity of articular and musculotendinous structures often makes diagnosis challenging for the clinician. Akin to GT, inadequate assessment (including patient history and use pain provocation tests) can lead to incorrect diagnosis and management.

This review sought to highlight recent developments in the pathoetiology, assessment and management of GT and PHT.

Gluteal Tendinopathy is one of the most common lower limb tendinopathies, affecting 1 in 5 middle-aged women.

Education can be used to inform the patient about the underlying condition and outline load management strategies that will help with symptom reduction.

PATHOAETIOLOGY OF HIP TENDINOPATHIES

Similar to other tendinopathies, the aetiology of hip tendinopathies is complex. At its core, tendinopathy results from disorganization of the collagen fibres which affects tendon integrity and load tolerance. Mechanical factors are thought to play an important role in the

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