Tears to the gluteus medius or gluteus minimus, two of the three muscles in the buttocks, can cause pain and instability in the outside of the hips. These injuries can occur acutely due to a traumatic injury or over time due to degeneration of related tendons. Regardless of the cause, gluteus medius/minimus tears can minimize mobility and affect gait and balance.
Falls are a common cause of gluteus medius and gluteus minimus tears, so practicing fall prevention techniques can help limit risks. This can include clearing the home and outdoor areas of tripping hazards, installing handrails on stairs and in restrooms, and ensuring lighting is bright throughout the home.
Overuse injuries can also deteriorate the muscles and adjacent tendons and lead to tears over time, so it’s best to participate in a wide range of physical activities and sports to avoid overtaxing the hip muscles.
Gluteus medius and gluteus minimus tears can also result from improper lifting, so ensure that you’re bending from the knees and lifting upward — not bending down — to lift heavy objects.
Medical history and symptom review. To properly diagnose the nature of your injury, your medical provider will carefully review your entire medical history, lifestyle habits and symptoms, including when your symptoms began.
Physical examination. After discussing your symptoms, your provider will also perform an exam of the lower back, buttocks and hips. This will include a review of your mobility and gait, with particular notice paid to whether you have a limp or tilt to one side. If a fall was the cause of your injury, your provider will also likely examine the rest of your body to ensure no other injuries occurred.
Additional tests. If a bone-related injury is suspected, your medical provider will probably order an X-ray, a CT scan or an MRI. If a muscle tear is suspected, ultrasound may be recommended to see if there’s blood pooling within the gluteus medius or gluteus minimus. If you’re taking a blood thinner, your provider may also order blood tests.
Initial treatment will focus on alleviating pain and limiting the risk of further injury. Your provider will likely recommend you take over-the-counter or prescription anti-inflammatories to limit inflammation and reduce pain. He or she will also likely recommend curtailing certain activities and movements to alleviate discomfort.
In cases where the gluteus medius or gluteus minimus is fully torn, surgical intervention may be required. During a surgical procedure, your medical provider will repair the torn muscle, using either an arthroscopic (minimally invasive) approach or an open procedure to anchor and stabilize the muscle, along with the adjacent tendon.
After undergoing surgical treatment for a gluteus medius or gluteus minimus tear, your medical provider will provide a specific recommendation for postsurgical care. It’s important to adhere to the recommendations, since deviating from them may lead to re-injury or a longer recovery period.
Postsurgical care will likely include a referral for physical and/or occupational therapy to help you recover abilities and restore mobility and gait.