Gluteal tendinopathy is one of the most prevalent lower limb tendinopathies presenting to general practice and imposes an impact on quality of life similar to severe hip osteoarthritis. The diagnosis is often delayed, and management may be limited to corticosteroid injection for a substantial period of time – a course often resulting in short term gain but frequent recurrence and gradual decline in local musculotendinous health, physical conditioning and activity levels. A substantial body of evidence has now been published that provides guidance around evidence-based strategies for identifying this condition, associated impairments and active management of the condition to achieve early diagnosis and optimal outcomes.
This masterclass will provide an update on the available literature and its clinical implications, as well as practical demonstrations of assessment techniques for diagnosing gluteal tendinopathy and identifying abductor impairments. Treatment strategies will be discussed in detail, along with demonstration and practice of key exercises. Finally, we will do some troubleshooting – managing the more complex patient with co-morbidities and/or those patients that are slow to respond. Participants will leave with plenty of clinical gems to apply immediately.

Do you tend to use the same management approaches for patients with hip pain, regardless of their presentation?

The anterior hip and groin pain literature reveals a minefield of inconsistent diagnostic labels and a high volume of imaging and surgical papers that describe a myriad of pathologies which may or may not be associated with a patient’s presenting signs and symptoms.

In recent years there have been some advances in defining clinical entities and diagnostic processes. Yet there is a persistent lack of clarity and evidence around best management. This may be related to undue focus on remediating a particular structural pathology or physical impairment, without adequately considering mechanisms or drivers of pain and load intolerance.

Within the contemporary biopsychosocial model, health professionals acknowledge that patients may present with varying combinations of psychological and physical overload. While the psychosocial components of management are of high importance, these will not be addressed in detail within this forum, but much education is widely available on this topic.

My primary focus is on helping you understand and address mechanisms of physical overload and impairments associated with anterior hip and groin pain.