You've Developed Deep Gluteal Tendinopathy—What Should You Do Now?
Deep gluteal tendinopathy (DGT) can be a frustrating and painful condition, often presenting as pain on the outer hip that worsens with prolonged sitting, standing, or repetitive hip movements. This condition is typically due to overuse, improper loading, or biomechanical imbalances that strain the gluteal tendons. If you're experiencing symptoms of DGT, here’s what you should do to start your recovery.
Short-Term Activity Modifications
Managing symptoms in the early stages involves reducing irritation to the affected tendons. Here are a few key modifications to help calm things down:
Avoid prolonged sitting, especially with crossed legs – This compresses the gluteal tendons against the greater trochanter, increasing irritation.
Limit standing for extended periods with your weight shifted to one side – This places unnecessary strain on the gluteus medius tendon.
Modify aggravating activities – Running, jumping, or any high-impact activity that worsens pain should be reduced temporarily.
Use supportive seating – A firm cushion or a seat wedge can help keep your hips in a neutral position and reduce compression.
Sleep with a pillow between your knees – If you sleep on your side, this prevents excessive tension on the hip.
Once symptoms start to improve, gradually reintroducing loading to the tendon through a structured exercise program is crucial.
Long-Term Strengthening Plan
The key to recovering from deep gluteal tendinopathy is progressive strengthening. This means starting with low-load isometric exercises, then moving into concentric and finally eccentric loading to build tendon resilience.
Phase 1: Isometric Loading
Isometric exercises help engage the gluteus medius without excessive tendon strain, which can alleviate pain and prepare the muscle for progressive loading.
Isometric Wall Press: Stand with your side against a wall, press the outside of your knee into the wall, and hold for 30 seconds. Repeat 3-5 times.
Side Plank with Clamshell: While in a side plank, perform small clamshell movements with a band around your knees. Aim for 3 sets of 10 reps per side.
Phase 2: Concentric Strengthening
As pain decreases, introduce controlled concentric exercises that build glute strength without excessive stress.
Captain Morgan Exercise: Standing on one leg with the other foot resting on a surface like a step, engage your glutes to maintain balance. Hold for 30 seconds per side.
Banded Split Squats: With a resistance band around your thighs, perform split squats to engage the glutes dynamically. Perform 3 sets of 10 reps per side.
Phase 3: Eccentric Strengthening
Eccentric exercises help remodel the tendon, increasing its capacity to handle load.
Single-Leg RDLs (Romanian Deadlifts): Holding a weight, hinge at your hip while keeping a slight knee bend. Lower slowly and return to standing. Perform 3 sets of 8 reps.
Lateral Step Downs: Standing on a step, slowly lower one leg to tap the floor, then return to standing. Perform 3 sets of 8 reps per side.
Final Thoughts
Recovering from deep gluteal tendinopathy requires patience and consistency. Avoid rushing back into high-impact activities too soon, and focus on progressive strengthening to prevent re-injury. If pain persists despite these modifications, seeking guidance from a physical therapist can help tailor a recovery plan specific to your needs.
By following these steps, you can work towards a full recovery and return to your favorite activities stronger than before!
