Gluteus Medius and Minimus tear vs. Greater Trochateric Bursitis 

Thanks for watching Penny!! More to come.

Glad you liked it!

ddi you have an mri to show the tendinosis?

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

Same here. I'd like to know.

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

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

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

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

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

Glad it was helpful!

@@OrthoEvalPal Could the leg go inward slightly in this injury while walking and creates walking problems?

@@sevalsonmez96 it could. The telltail sign is pain loading the leg while going upstairs

@@OrthoEvalPal Thank you! Can I ask this means I need a surgery or PT can help to make my leg straight again? It goes to right whenever I bend it (standing up position). IT has been 2 weeks and I feel like my whole body mechanism messed up :(

Exactly

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

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.

@@OrthoEvalPal You mentioned it shouldn't cause foot weakness, but would it cause overall weakness in the leg immediately following injury? The first 3-4 weeks after injury I could put my affected leg into the correct position to stand on tip toe (so not a nerve issue) but the injured side could take ZERO weight. It's better now but still not nearly as strong as it should be. Is what I describe consistant with a Glute Medius tear? ---- My "injury" is currently thought to be caused as a side effect of an antibiotic, ciprofloxin (according to my PCP)

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

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

@@unassailable6138 Would you happen to know how long it takes to regenerate on average?

@@46Orca 6 to 18 months

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.

what can you not do with it?

@@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.

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

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. :-(

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

Not likely

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

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

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.

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

@@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.

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

@@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

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??

@@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 .

@@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 .

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

@@OrthoEvalPal Nice! Congrats for that accuracy!

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

Yes. She did very well.

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.

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

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?

@@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.

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)

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

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

Same issue here

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!!!

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

@@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.

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.