Gluteus Medius / Minimus Tears Treatment Options

What are the gluteus medius and minimus tears?

Gluteus medius and minimus tears are injuries involving the muscles located on the outer aspect of the hip, essential for hip stability and movement. These tears can occur due to sudden trauma, repetitive overuse, or degenerative changes, often leading to pain, weakness, and dysfunction in the hip joint. Gluteus medius and minimus tears commonly present with symptoms such as lateral hip pain, difficulty with walking or climbing stairs, and weakness during hip abduction or rotation movements. Diagnosis typically involves a combination of physical examination, imaging studies such as MRI or ultrasound, and possibly diagnostic injections. Treatment for gluteus medius and minimus tears usually begins with conservative measures such as rest, physical therapy, anti-inflammatory medications, and targeted exercises to strengthen the hip muscles and improve biomechanics. In some cases, especially if conservative treatment fails to provide relief, surgical intervention may be considered to repair or reconstruct the torn muscles. Early diagnosis and appropriate management are essential to alleviate symptoms, restore hip function, and prevent long-term complications associated with gluteus medius and minimus tears.

What non-operative treatment options are available?

1. Rest and Activity Modification: Resting the affected hip and avoiding activities that exacerbate symptoms can help reduce pain and inflammation associated with gluteus medius and minimus tears. Activity modification may involve avoiding activities that involve repetitive hip abduction or rotation movements, such as running, climbing stairs, or prolonged sitting.
2. Physical Therapy: Physical therapy plays a crucial role in the conservative management of gluteus medius and minimus tears, focusing on reducing pain, improving hip joint mobility, and strengthening the hip abductor muscles. Therapeutic exercises may include hip abduction, hip external rotation, clamshell exercises, hip bridges, and functional movements to address muscle imbalances and improve hip biomechanics.
3. Anti-inflammatory Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen may be used to alleviate pain and reduce inflammation associated with gluteus medius and minimus tears.
4. Corticosteroid Injections: In cases of persistent or severe pain, corticosteroid injections may be considered to provide temporary relief of pain and inflammation.

What operative treatment options are available?

If conservative measures fail to provide adequate relief or if there is significant functional impairment or structural abnormalities contributing to gluteus medius and minimus tears, surgical intervention may be considered. Surgical options for gluteus medius and minimus tears may include:

1. Gluteus Medius and Minimus Repair: In cases of partial or complete tears of the gluteus medius and minimus muscles, surgical repair may be performed to reattach the torn tendon to its insertion point on the greater trochanter of the femur. This procedure aims to restore hip joint stability, improve muscle function, and alleviate pain associated with gluteus medius and minimus tears.
2. Gluteus Medius and Minimus Reconstruction: In cases of chronic or extensive tears of the gluteus medius and minimus muscles, surgical reconstruction may be necessary to restore muscle integrity and function. This procedure may involve using autograft or allograft tissue to augment the torn muscle or reinforce the tendon repair, particularly in cases of significant tissue loss or degeneration.

What does rehabilitation entail?

Rehabilitation following conservative or surgical treatment of gluteus medius and minimus tears is essential to optimize outcomes, restore hip function, and prevent recurrence. Physical therapy interventions focus on strengthening the hip abductor muscles, improving hip joint stability, and addressing any underlying biomechanical abnormalities or muscle imbalances. Rehabilitation typically begins with gentle range of motion exercises and progresses to more advanced strengthening and functional activities as tolerated. Patients are encouraged to gradually return to their normal activities, avoiding high-impact or strenuous movements until cleared by their healthcare provider. Close monitoring by a physical therapist and Dr. Shane J. Nho is essential throughout the rehabilitation process to ensure proper progression, address any issues, and optimize outcomes for patients with gluteus medius and minimus tears.

What does return to activity entail?

Return to activity following gluteus repair involves a gradual and progressive approach aimed at restoring hip function, strength, and stability while minimizing the risk of re-injury. Patients typically begin with gentle range of motion exercises and progress to strengthening exercises targeting the gluteus medius and minimus muscles, as well as surrounding hip musculature. As strength and function improve, patients may gradually reintroduce activities such as walking, stair climbing, and low-impact exercises. High-impact or strenuous activities should be avoided initially and reintroduced gradually as tolerated. Close monitoring by a physical therapist or healthcare provider is essential throughout the rehabilitation process to ensure proper progression, address any issues, and optimize outcomes for patients returning to activity following gluteus repair.

Dr. Shane J. Nho is a board-certified fellowship trained sports medicine orthopaedic surgeon who specializes in the treatment of gluteus medius and minimus tears. If you believe you are affected by a gluteus medius and minimus tear, schedule a consultation today with our experienced orthopaedic care team.