The gluteus medius tendon inserts on the lateral and superoposterior facets of the greater trochanter, just behind the gluteus minimus on the anterior facet, via a footprint that can be visualised on MRI and corresponds to the region of tendinopathy and tearing seen in greater trochanteric pain syndrome. Because gluteus medius is the main hip abductor, its tendon is often compared to the supraspinatus, and the two gluteal tendons are called the rotator cuff of the hip. Gluteal tendinopathy is now recognised as the primary cause of lateral hip pain in middle-aged and older women, replacing the outdated diagnosis of trochanteric bursitis.
| Muscle | |
|---|---|
| Attachment | Greater trochanter of the femur (lateral and superoposterior facets) |
Hip abduction force transmission; lateral hip stabilisation during single-leg stance
Gluteal tendinopathy produces lateral hip pain that worsens with single-leg stance, climbing stairs, walking on inclines, and lying on the affected side in bed. It is most prevalent in perimenopausal and postmenopausal women and is associated with altered load on the tendon from increased hip adduction during walking. Management with a load management programme and targeted gluteal strengthening in non-compressive positions has superior evidence to corticosteroid injection or passive treatments. Full-thickness tears cause abductor weakness and a Trendelenburg sign or gait; MRI shows the tear extent and any fatty atrophy, and repair with suture anchors through an open or endoscopic approach mirrors rotator cuff repair.
Degenerative overload of the gluteus medius and minimus tendons at the greater trochanter producing lateral hip pain that worsens with single-leg activities and lying on the side, managed with load management and progressive gluteal strengthening.
Partial or complete tearing of the gluteus medius tendon at the greater trochanter producing lateral hip weakness and pain confirmed on MRI, with surgical repair for complete tears in active patients.
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