Episode Summary
Learn how to recognize and manage gluteal and proximal hamstring tendinopathy by linking pain patterns, movement habits, and key clinical tests. Discover which rehab strategies reduce compression, restore strength, and guide a gradual return despite often slow recovery.
Gluteal and proximal hamstring tendinopathy are presented as tendon problems driven mainly by combined tensile load and compression. For gluteal tendinopathy, the focus is on pain in the gluteus medius and minimus, often linked to hip dropping, hip leaning, altered walking patterns, a wide pelvis, and increased iliotibial band activity. Typical pain is felt over the greater trochanter, and trochanteric bursitis is described as a common secondary issue rather than the main problem.
Key assessment methods include the 30-second single-leg stand, FABER test, de-rotation test, resisted hip testing, and palpation of the upper trochanter, with emphasis on reproducing the patient’s familiar pain. Rehabilitation aims to reduce compression, improve gluteal activation, and avoid aggravating strategies such as stretching into adduction, foam rolling, or dry needling. Cortisone may reduce pain short term but does not provide lasting benefit.
For proximal hamstring tendinopathy, the main issue is load on the hamstrings in hip flexion, especially around the ischial tuberosity and during sitting. Assessment includes palpation, a standing hamstring stretch, and the bent-knee stretch test. Rehabilitation centers on glute and hamstring strengthening, beginning with isometrics for pain relief and progressing to heavy slow and eccentric loading. Improvement is often slow, so patience and load management are important.
