Gluteus Medius Tear

Written by: Ben Piller

What Is the Gluteus Medius?

The gluteus medius is one of your three gluteal muscles. It is located along the side of your hip and sits underneath your main gluteal muscle, the gluteus maximus. The gluteus medius is one of the most important muscles in keeping your pelvis stable when you walk, run, or stand on one leg. It is also responsible for abducting the leg (moving it away from the body) and internally rotating your hip.

What Causes the Gluteus Medius to Tear?

There are several causes for gluteus medius tears. These tears are commonly seen in runners and athletes involved in high-impact sports. They can occur from quick bursts of activity combined with low flexibility of the hip flexor muscles.

These tears can also occur because of a fall that causes the muscle to be pulled outside of its normal range of motion, which can cause the muscle to tear. They can also be caused by tendinopathy, which is inflammation and degeneration of the gluteus medius tendon.

The gluteus medius tendon is where these tears are usually found, which is the tendon that connects the gluteus medius muscle to the femur (thigh bone).

Different Tear Severities

Gluteus medius tears are characterized by separate grades:

  • Grade 1 tear: Mild pain and little to no loss of strength or mobility.
  • Grade 2 tear: Partial tear with mild discomfort and some loss of mobility and strength.
  • Grade 3 tear: Complete tear of the gluteus medius tendon and complete loss of mobility and strength.
  • Grade 4 tear: Complete tear of the gluteus medius tendon and retraction of the muscle, potentially leading to muscle atrophy. Complete loss of mobility and strength is also present.

Treatment options and prognosis provided by your physician are often informed by the grade of the tear.

Symptoms

Symptoms of gluteus medius tear often include:

  • Pain or swelling/ inflammation on the side of the hip and/or buttocks
  • Difficulty sitting down
  • Limping while walking
  • Decreased range of motion of the hip
  • Discomfort with hip rotation
  • Pain at night, which may prevent sleep

Gluteus medius tears are often mistaken for pain coming from the lower back. Any chronic pain in the hip region that causes prolonged issues or significant loss of function should be evaluated by your physician.

Diagnosis and Treatment 

Diagnosis of a gluteus medius tear will typically begin with a physical examination. This includes palpation, testing the muscle’s strength, and assessing your walking pattern.

Other tests, such as a single-leg squat or positive Trendelenburg, may also aid in diagnosing a gluteus medius tear and various imaging techniques such as MRI or ultrasound.

Treatment is aimed at restoring the normal function of the gluteus medius. The RICE (Rest, Ice, Compression, Elevation) method is often initiated following the tear. Non-steroidal anti-inflammatory drugs (NSAIDs) or steroid injections may be given to reduce the pain and inflammation caused by the tear.

Devices such as a cane or crutches may also be temporarily used to help with pain-free ambulation. If the tear is severe enough, it may need to be repaired surgically. This surgery can be done endoscopically (with a scope) through very small incisions to reattach the torn tendon back to the femur (thigh bone), where it usually attaches.

Conclusion:

If you are experiencing any hip pain following an injury, you may have a partial or complete tear of your gluteus medius muscle. To know for sure, it is essential to be evaluated by an orthopedic surgeon, at which point the best treatment option for you can be determined. Call us or book an appointment online today!

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