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A Female Runner with Lateral Hip Pain

Louise came to me with right sided lateral hip pain, which is a very common area of pain in runners, and an area in which I also experienced pain when I initially started building up my training volume and frequency.

Louise was increasing her running mileage in preparing for an event, but in doing so, began to experience this pain, not only when running, but when sitting for a period of time, when going down the stairs and when laying on that side at night. She had concerns about future running events she had her eyes set on.

After a 60-minute initial consultation in clinic, it was evident she was experiencing what’s known as a gluteal tendinopathy, which was the exact same injury I’d experienced.

Like any other tendon in the body, the gluteal tendons on the outside aspect of the hip have a load capacity, and when that load capacity is exceeded, the tendon reacts and a tendinopathy develops. There are 3 stages, a reactive tendinopathy, tendon dysrepair, and degeneration. Louise had developed the second stage of this tendinopathy.

Within this stage, there is a separation and breakdown of the collagen, disorganisation within the cell matrix and an increased vascularity and neural ingrowth within the tendon. The changes at this stage to the tendon are reversible with reduced loading, sufficient rest alongside a tailored home exercise programme. Unfortunately rest alone won’t get rid of this stage of tendinopathy, and a combined approach is required to alleviate this problem.

I therefore started Louise on an eccentric loading programme to strengthen her gluteal tendon, along with a strengthening programme to strengthen the gluteal muscle group which were weak in Louise.

Louise also attended our Running Clinic, where aspects of her running technique that were feeding into the development of this tendinopathy were addressed with specific running cues.

After 6 sessions of physiotherapy, along with two visits to our Running Clinic, Louise is now running symptom free, with a superb running technique.

This is what Louise had to say about us on Facebook: –

“When I first went to see Jonathan I was in a lot of pain with my hip. He diagnosed me with tendinopathy. And I had 6 weeks of physio, an exercise programme and eventually acupuncture. After the six weeks and 2 visits to (the lovely) Kerry at the running clinic, who completely changed my running technique and created a strengthening programme to help prevent a recurrence. I am pain free. Would highly recommend!” Louise Fry

If you’re a runner with a gluteal tendinopathy, then don’t delay your treatment. A second stage tendinopathy can persist and progress onto stage 3 if left without the correct advice and treatment, at which point, it takes a lot longer to treat. A typical tendinopathy in this stage takes 3-6 months to overcome.

Jonathan Clark