Hip Abductor Tendon Tear
What are the hip abductor tendons?
The hip abductors are a group of muscles found in the buttocks. They include the gluteus maximus, gluteus medius, gluteus minimus, and the tensor fascia latae muscles. Overuse or trauma can lead to a hip abductor tendon tear.
The gluteus medius is a large, fan-shaped muscle positioned on the outer surface of the hip. It serves to keep the pelvis steady, assisting in hip abduction and rotation. The gluteus medius muscle is attached to the bone via the gluteus medius tendon.
If the gluteus medius tendon is injured, conservative treatments will always be attempted before surgical management. These approaches may include:
- Resting the hip
- Applying ice to the affected area to reduce inflammation and pain
- Elevating the affected area to help reduce swelling
- Using over-the-counter medication to reduce pain and inflammation
- Using crutches or a cane to assist with walking
- Undertaking physiotherapy to strengthen the muscles
If conservative management doesn’t relieve symptoms, surgery may be recommended to fix the tear. This may happen using an open approach or a minimally invasive (arthroscopic) approach.
What causes a gluteus medius tear?
Hip abductor tears are quite common in athletes who partake in high-impact sports, such as tennis, soccer, and AFL. This is because these sports often include a lot of actions that can injure or aggravate the gluteus medius tendon, such as:
- Trauma to the hip
- Overuse or repetitive use
- Sudden burst of activity
Tears to the gluteus medius can also happen gradually, resulting from degenerative or age-related changes.
Symptoms of the gluteus medius tear
- Pain on the side of your hip
- Weakness of the affected hip
- Limited movement of the leg
Many patients find that these symptoms are aggravated by activities such as walking, running, climbing, sitting for long periods, or lying on the affected side.
How is a gluteus medius tear diagnosed?
Your doctor will ask about your medical history and physically examine the affected muscles. If a gluteus medius tear is suspected, your doctor may request an MRI scan or x-ray of the hip to confirm.
How is a gluteus medius tear treated?
The first step to treating any sports injury is the tried and trusted RICE method: Rest, Ice, Compression, and Elevation. This approach can be used for up to 72 hours after the injury occurs, and can be supplemented with over-the-counter pain medication.
Following referral, your doctor may recommend prescription nonsteroidal anti-inflammatory drugs (NSAIDS) or steroids to help manage pain during recovery.
Tendons which have torn away from the muscle or bone do not reattach on their own, and may cause ongoing pain, difficulty in walking, and muscle weakness. If conservative treatments fail to alleviate symptoms, surgery may be recommended to repair the tear.
Gluteus medius tear surgery
Dr Jonathon de Hoog will clearly explain what results you can expect from the surgery, the procedure itself, and how long it will take to fully recover. Everyone is different, and depending on the severity of the tear, recovery times may differ too.
Before surgery, you will be administered a general anaesthetic. Dr de Hoog will then make two or three small incisions in the hip area, near the hip joint.
An arthroscope is then inserted to give the surgeon visibility of the hip joint. Once the approach is confirmed, surgical equipment is inserted to remove any dead or damaged tissue from the muscle.
The surgeon then places an anchor to secure the muscle in place, and the tendons are repositioned over the bone. The surgical tools are then retracted and the incisions are closed using sutures (stitches) or surgical tape.
Following surgery, you will need to use crutches for about 6 weeks. It will take about 3 months for the tear to fully heal, with more improvements possible over the next 9 months.
Contact Aspire Orthopaedics
At Aspire Orthopaedics, Dr Jonathon de Hoog manages orthopaedic conditions from locations across Townsville, Pimlico and Mt. Isa.