Gluteus Medius and Minimus tear vs. Greater Trochateric Bursitis

Рет қаралды 70,033

5 жыл бұрын

In this video I demonstrate how to differentiate between a Gluteus Medius and Minimus tear vs. Greater Trochateric Bursitis. The gluteus medius and minimus act upon the hip almost like the rotator cuff works for the shoulder. Quite rare but you don't want to miss it.
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Пікірлер: 83

@happycamper4193 3 күн бұрын

Thank you for the great video. I hope by now your patient is doing well. I have a 50% tendon tear on my gluteus Minimus. Going in for PRP injections with PT next week.

@pennygill9375 2 жыл бұрын

Thank you Penny from South Africa

@OrthoEvalPal 2 жыл бұрын

Thanks for watching Penny!! More to come.

@majrebel 3 жыл бұрын

Very helpful. Thank you!

@OrthoEvalPal 3 жыл бұрын

Glad it was helpful!

@MrMrAzad 3 жыл бұрын

great vid, thanks!

@OrthoEvalPal 3 жыл бұрын

Glad you liked it!

@island661 4 жыл бұрын

My gluteus medius burns when I touch it. I think I injured it running. It also hurts when I walk. Mine hurts closer to the iliac crest on the side, not the greater trochanter area. What can I do to repair it? Thanks 🙏🏻

@oceanwinds2584 2 жыл бұрын

Since 1990, I was told I had hip bursitis from an auto accident. I was able to get rid of pain for years til recently when it flared WAY up forcing me to seek PT. Turns out, the reason I never responded to bursitis treatment is because I have gluteus medius tendinosos. Different exercises so hopefully pain free in a few weeks.

@GoodByeSkyHarborLive Жыл бұрын

ddi you have an mri to show the tendinosis?

@oceanwinds2584 Жыл бұрын

@@GoodByeSkyHarborLive No, just the PT diagnosing it. I’ve had to stop PT due to finances, so I’m on my own.

@suem.3651 9 ай бұрын

This is the BEST video I’ve seen explaining these often-confused diagnoses! How I wish that someone had put these things together and caught that I had a glute medius tear and significant muscle atrophy of the glue medius! Now I have been told by 2 surgeons that my condition is too bad as to be operable. My case was confusing because I had 3 cortisone shote, 2 this year and only the first one worked. QUESTIONS: What causes the muscle atrophy and will it worsen over time? Will I eventually be in a wheelchair? Could the tendon tearing cause excruciating quad pain and later numbness and weakness down to the foot? Please be honest if so! I am in PT now and finally able to walk with a cane after the tear detached completely and put me in agonizing pain for months. Thank you!!

@OrthoEvalPal 9 ай бұрын

So sorry to hear this. Anytime a muscle is detached, it gets smaller because it has nothing to pull on and inflammation can shut it down. You should not end up in a wheelchair. A glute medius tear should not cause quad pain and foot weakness. Need to look for another cause like nerve root impingement in the back.

@kelleylondon 5 жыл бұрын

Great video! Im working with a patient now who has a suspected full thickness tear. ( I say suspected bc one of her physicians disagrees with the diagnosis) Because of her age and other comorbidites her doctors do not recommend her to have surgery. In your clinical experience or research have you seen any positive outcomes for patients attempting a non conservative approach for glut med tears?

@bjc203 2 жыл бұрын

Same here. I'd like to know.

@suem.3651 9 ай бұрын

I think they meant “conservative “ not “non” in last sentence. This is also my question.

@BBwisco 4 жыл бұрын

Nicely done. I've actually seen a lot of glut med soft tissue injuries not have the Trendelenburg because the nerve is still intact. It's easy to miss sometimes.

@OrthoEvalPal 4 жыл бұрын

Thank you! Yes, often missed. Thanks for the comment! Regards, Paul

@SuzaVision55 Жыл бұрын

If the patient is not a surgical candidate, is there some sort of brace for this ? Or prosthetic that aides with permanent glute med weakness?

@waynecallan4743 2 жыл бұрын

Do partial gluteal minimus tears always require surgery or can rest and specific exercises work?

@unassailable6138 Жыл бұрын

surgery only when more than 50% of the ligament tore, if less , the ligament regenerates

@user-uj6xg5lq1c 7 ай бұрын

This is an excellent video. Thank you! I was diagnosed with proximal hamstring tendinopathy and conservative treatment didn't work (for years!). Eventually had surgery to repair. I have now developed severe pain in my lateral hip, on the same side as hamstring. I suspect glute med tendinopathy, but worried it could be a tear requiring surgery again. I don't want to wait years for surgery this time, so wondering how you diagnosed tear needing repair in this case versus tendinopathy. Is it from a scan, or from the tests you show in the clip? Thanks!

@OrthoEvalPal 7 ай бұрын

MRI would be the best test. Good Luck!! and you are welcome.

@annelanders2462 Жыл бұрын

If the leg cannot be moved but has pain would you still suspect a tear?

@sharonh5399 4 жыл бұрын

I have a gluteus minimus tear. I have pain just below my bottom all the time. I also had a labrum tear, but it was repaired arthroscopicly. The surgeon couldn't find the glut tear at that time, but a post op mri still shows. It hurts when my right hip is moved inward. I also now have hertotopic ossification. Not sure where to go from here since the last surgeon wont do surgery.

@OrthoEvalPal 4 жыл бұрын

Hi Sharon, I might recommend a second opinion with an orthopedic hip surgeon. Good luck!

@GoodByeSkyHarborLive Жыл бұрын

When they couldn't find the tear, what did they do? Just leave it alone?

@sharonh5399 Жыл бұрын

@@GoodByeSkyHarborLive Tried more physical therapy and needling. Yes, other than that nothing.

@AbstractMindsThinkAlike Ай бұрын

I have a partial tear of 1.1 cm. I was told it cannot be operated on unless it tears completely. I'm 40yo, so getting a cortisone shot was not recommended for me as it can make things worse. I was told to do PRP and continued dedicated PT. Thoughts?

@vivianaespinoza4110 4 жыл бұрын

Could you also feel a little pinching feeling from damage to this muscle ?

@prathamgiri2169 3 жыл бұрын

Exactly

@turtlesarecool1488 8 ай бұрын

This sounds like my problem. My surfboard stabbed my right hip/side of my butt on a fast fall into the barrel. My pain is mostly on the outside of my hip towards the glute muscles and not really in the groin area.

@OrthoEvalPal 8 ай бұрын

Would be a good idea to see an orthopedic surgeon to rule in a tear or rule it out

@chickadeeacres3864 Жыл бұрын

How did this lady injure herself? I have similar hip pain but no idea how it happened. Could overstretching during yoga cause it?

@connieashworth3004 2 ай бұрын

Yes - overstretching is exactly how I ended up with a gluteus minimus tendon tear. It happened performing a stitting cross legged stretch (with the foot even wrapped around one leg) where one pulls knee in one direction stretching hip. It's been over four months and I had to demand an an MRI whichshowed the partial tear (NOT bursitis or muscle strain as originally diagnosed). OMG I wish I had just stayed with the yoga I'd been doing for twenty years. It was a yout tube fascia stretch video. :-(

@sashaa911 4 жыл бұрын

My doctor just told me I tore my Glut Med or the tendon attached to it. I have Ehlers Danlos and heard a ripping and definitely felt a ripping/tearing feeling. I often dislocate my hips but this was different. I rolled over in bed from on my back to my side but my leg did not follow my torso. They are saying surgery is not recommended for me, but rest and some PT exercises unless it persists for more than six weeks. Is that a fairly common approach in your experience?

@OrthoEvalPal 4 жыл бұрын

Hi Sasha, I actually just finished a patient who had a repair and she is doing great. I also have another patient who did not have repair and is also doing great. She had injections and PT. Every one has to be treated independently. I would follow your doctor's recommendation. You can never go wrong with some guided strengthening and PT.

@GoodByeSkyHarborLive Жыл бұрын

what can you not do with it?

@GoodByeSkyHarborLive Жыл бұрын

@@OrthoEvalPal what do short intact hip abductors on mri mean? I think it sounds like the muscle has shortened due to injury but the tendon is intact.

@jlamn 2 жыл бұрын

is it safe to do jump rope with a glue tear?

@OrthoEvalPal 2 жыл бұрын

I would not. The Glute contracts a lot when you land

@nemxomen 3 жыл бұрын

Which doctor type of doctor do I need to go to get this eval done. Im still pretty young but it looks like I have a glute min tear based on this video.

@OrthoEvalPal 3 жыл бұрын

An orthopedic surgeon. Some specialize in hips. Best of luck!

@barbarawebb7185 2 жыл бұрын

Can a chiropractic adjustment cause these tears?

@OrthoEvalPal 2 жыл бұрын

Not likely

@MommaBearsCorner 3 жыл бұрын

wonder if those keep you from standing up long

@OrthoEvalPal 3 жыл бұрын

Yes. Painful to stand for long. More painful going up stairs.

@MommaBearsCorner 3 жыл бұрын

@@OrthoEvalPal pressure pain for me, not really all nerve pain. i can't walk anymore further than 25 ft holding on to a roller or cane for life. tires me out trying to stand. is why i cant hardly walk. they finally figuring it out after like this past year 1/2! STEPS? WHATS THOSE? lol

@cbisme6414 3 жыл бұрын

I had a side on car accident in '94 at the age of 41, smashing down a traffic light, back into a steel side rail and then back to the other side of the road shattering the middle console with that hip and with the steel catch of the seatbelt on that hip also (in Australia we drive on the left). From that day I had terrible pain in my left hip, couldn't sit or stand for any length of time, can't lay on that side, walk now with a limp and my hips are uneven. In all this time I've been told by specialists it's pain radiating from your back! When physio, taping, ultrasound, aqua therapy didn't work and collapsed passing out due to the pain in clinical Pilates I was sent for an MRI and was told I has a "full thickness tear of the gluteus minimus, which would be very painful and if it'd been picked up within 6-8 weeks of it being done it could have been easily reattached unfortunately too late now, nothing can be done." It's nice to finally have a diagnosis after all these years of being brushed off with it's back pain just take a tablet!! I'm now 67.5 years and it's impacting on my knees compensating for the weakness of my hip. Is there any hope of repair at this late stage??

@bensago7506 2 жыл бұрын

@@cbisme6414 Yes ! There is a way out . It is called the Whiteside Operation , in which the Gluteus Maximus muscle is mobilized to replace the function of the injured Gluteus Medius and Minimus . Thanks . I am an Orthopaedic Surgeon from Nigeria , West Africa .

@bensago7506 2 жыл бұрын

@kishoreks4382 2 жыл бұрын

I think my tore my gluteas medius about a 1.5 years ago I can't feel the muscle at all but my MRI is normal Shows no tears. What else could be the issue? Is the MRI showing up as normal cause it's been over a year?

@rajgupta6448 Жыл бұрын

How are you doing now ? Do u still experience pain ?

@kishoreks4382 Жыл бұрын

@@rajgupta6448 I still have pain and find difficulty standing or walking for long

@shadaruiz 8 ай бұрын

I had 2 MRI’s that didn’t show a gluteus med tear. I want to a hip specialist and he said he disagreed with the MRI report. I did have arthroscopic surgery and he found a large hole in my gluteus medius and repaired it. I’m 4 weeks post surgery and no longer tender at the insertion point. Long recovery but I think totally worth it.

@kishoreks4382 8 ай бұрын

@@shadaruiz which doctor did you go to? Are you based in Bangalore? How exactly was the damage repaired?

@shadaruiz 8 ай бұрын

@@kishoreks4382 I went to an Orthopaedic doctor in the Los Angeles area. His specialty is hips. He attached 2 anchors into my bone above the hamstring and pulled the edges of the torn area together with sutures. Also removed the ischial bursa sac.

@pocketdrone6930 2 жыл бұрын

cant you do a MRI to see whats going on there?

@OrthoEvalPal 2 жыл бұрын

She went to 3 orthopedic surgeons before one finally ordered the MRI to find it was torn as we had predicted.

@pocketdrone6930 2 жыл бұрын

@@OrthoEvalPal Nice! Congrats for that accuracy!

@GoodByeSkyHarborLive Жыл бұрын

@@OrthoEvalPal did she go through insurance to all of them?

@christinebubwatson1593 Жыл бұрын

I have a Gluten Minius tear. Was wanting to know if surgery helped her. I'm going in for a prp injection Monday.

@OrthoEvalPal Жыл бұрын

Yes. She did very well.

@happycamper4193 3 күн бұрын

I have a 50% glut Minimum tear as well. Scheduled to have A PRP injection on the third. Also going to start PT with dry needling. Did the PRP injection help you? I have a sharp pain in the groin on pivoting when walking.

@colorgravity8153 3 жыл бұрын

Why just do an MRI?

@OrthoEvalPal 3 жыл бұрын

She didn't need anymore. It identified the tear and once she had it fixed, she was better.

@sunrisehealth9652 4 жыл бұрын

I have an new mri showing a gluteal medius low level tear with edema in the gluteal minimums. It’s been 9 months without any improvement. Stretching, PT makes me worse. I cannot stand, sit or walk beyond 20 mins. I fell 9 months ago-4 times!! right after a recent labral hip repair surgery. I’m in excruciating pain. Doesn’t this type of gluteal tear require surgery if I haven’t healed after 9 months from a fall? The mri looks fine inside my hip joint post surgery. The dr tried to tell me I have gluteal tendinitis. He NEVER mentioned the tear: I asked for the mri report and read the tear on there. Any thoughts?

@OrthoEvalPal 4 жыл бұрын

My most recent glute medius repair patient did awesome. Night and day.

@sunrisehealth9652 4 жыл бұрын

Ortho EVAL Pal With Paul Marquis My orthopedist has told me that surgery isn’t indicated for a low level partial tear. He’s recommending a cortisone injection into the gluteal medius. It’s been 9 months since my pain started. 3 rounds of physical therapy. I ice it all day off/on. Rx meloxicam for a year. Muscles relaxers and pain meds barely touch it. The mri shows a low level tear in the medius and inflammation/edema in the minimus. I also had a anterior labral repair FAI in my hip done 9 months ago. I fell 4x on my bottom after surgery and think my gluteal issue is from that. This surgeon is now becoming angry when I ask what’s going on, saying “he’s working after hours to answer my questions” Any opinions on this?

@OrthoEvalPal 4 жыл бұрын

@@sunrisehealth9652 First thing that comes to mind is that there might be something else going on. ie. L5 herniated disc can cause pain there. So hard to say without evaluating you one on one. A cortisone shot can be helpful but more importantly, diagnostic.

@sunrisehealth9652 4 жыл бұрын

Ortho EVAL Pal With Paul Marquis I agree. The surgeon didn’t do an re-exam re the gluteal. Just diagnosed by mri. Getting the ultrasound guided shot today 11/14. How long before a patient knows if cortisone works? I understand your response is an opinion and not medical advice. Thanks for any thoughts. (FYI-The recent mri showed a low level tear on gluteal medius)

@OrthoEvalPal 4 жыл бұрын

usually 2-3 days to see improvement. If there is, then the shot has helped you diagnose it. Best, Paul

@swatireddy1527 2 жыл бұрын

Hi My mri says I got gluten minimum and medium tear in Jan 2021 but no doctor explained to me after looking at my mri report but recently when I visited pain management doctor she told it’s clearly mentioned on mri. It’s almost 2 years not I’m suffering with left gluten pain and since a week the pain is 9/10 on my under cap knees and thighs. Please help me. I spend lot of money and time. Doctors are not really helpful even after I gave my mri report. They are coming and saying I tour mri nothing is there. I feel bad for heard lies from doctors. The mri is readable it says clearly about tear. Please help to recover from this painful issue

@kishoreks4382 2 жыл бұрын

Same issue here

@mariamarino138 Жыл бұрын

I’ve wasted 6 years, thinking everything was my back( doctors didn’t say differently) so, many epidurals, facet joint injections, and now, a doctor tells me I have tears in both hips!!!

@rajgupta6448 Жыл бұрын

@@mariamarino138 Can you still repair those tears after 4-5 years ???

@christinebubwatson1593 Жыл бұрын

@@mariamarino138 I'm at 4 years in now. And just found out about Glute Min. Tear. I had to go through the hole seeing every doctor and doing every procedure. Thought to be back then S I joint, hip, Bursitis on and on. Finally saw the tear in the MRI. Had a couple injections with no luck. Seeing doctor now that specializes in gluteau minimus tears and said that steroid injections only can make it worse. Going in for PRP injection on Monday hoping this helps before I try surgery.

@suem.3651 9 ай бұрын

Same here but Drs did tell me right away. I also have quad and knee pain and weakness to the point it buckled, plus tingling/numbness each time I get up. Best to you.