Hip

Gluteus Medius / Minimus Tendon Tears

Gluteus medius and minimus tendon tears are among the most under-recognized causes of chronic lateral hip pain. They are often misdiagnosed for years as trochanteric bursitis. Sometimes called the "rotator cuff of the hip," these tendons anchor your primary hip abductor muscles to the greater trochanter, controlling pelvic stability with every step. At Maryland Orthopedic Specialists, our team evaluates and treats the full spectrum of gluteal tendon pathology, from tendinopathy managed with targeted rehabilitation to complete tears requiring surgical repair.

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What is gluteus medius / minimus tendon tears?

The gluteus medius and gluteus minimus muscles originate from the outer surface of the ilium and insert via broad, flat tendons onto the greater trochanter of the femur. They are the principal hip abductors: muscles that hold the pelvis level during single-leg stance (walking, climbing stairs).

Like the rotator cuff of the shoulder, these tendons are subject to degenerative tearing at their bony insertion, often without a clear traumatic event. Tears are classified as:

Tendinopathy (no structural tear): Intrinsic tendon degeneration causing pain and weakness without macroscopic disruption
Partial-thickness tear: A portion of the tendon footprint is torn
Full-thickness (complete) tear: The entire tendon is detached from the greater trochanter

Who is affected? Gluteal tendon tears are significantly more common in women than men, particularly in the perimenopausal age group (50–70 years). Risk factors include prior lateral hip surgery, prolonged corticosteroid use, obesity, and a history of trochanteric bursitis injections.

Distinguishing from bursitis: Trochanteric bursitis and gluteal tendinopathy/tears frequently co-exist and can be clinically difficult to separate. Persistent lateral hip pain with significant abductor weakness strongly suggests tendon pathology beyond simple bursitis.

Symptoms — do you recognize these?

Lateral hip pain over or just proximal to the greater trochanter
Pain that worsens when lying on the affected side (nocturnal pain is a key complaint)
Pain with single-leg stance, stair climbing, walking on uneven terrain
Hip abductor weakness — difficulty rising from a chair or walking without a limp
Trendelenburg gait: The pelvis drops toward the unaffected side when standing on the affected leg, indicating failure of the hip abductors to stabilize the pelvis
Point tenderness directly over the greater trochanteric footprint
Pain may extend to the outer thigh

Call us at (301) 515-0900. Same-day appointments available at our Bethesda and Germantown locations.

How we diagnose it

Physical examination:

Single-leg stance test (Trendelenburg sign): pelvic drop on the contralateral side indicates abductor weakness
Resisted hip abduction strength testing in the side-lying position
Palpation over the greater trochanteric footprint
FABER test may also provoke lateral hip pain
Comparison of abductor strength between sides

MRI is the gold standard imaging study for gluteal tendon pathology. It characterizes:

Tendon signal change (tendinopathy vs. partial vs. full-thickness tear)
Degree of retraction (how far the tendon has pulled away)
Muscle atrophy and fatty infiltration: critical prognostic factors for surgical repair success

Ultrasound is an accessible, dynamic imaging alternative that can identify tears in real time and guide diagnostic or therapeutic injections.

X-rays may show calcification at the greater trochanteric insertion or trochanteric enthesophytes but do not visualize the tendon directly.

Treatment options

Non-Operative Treatments

Physical therapy is the cornerstone of non-operative management and is effective for tendinopathy and partial tears. Key elements include: Hip abductor strengthening (progressive loading: isometric → isotonic → functional) Load management: avoiding hip adduction postures (sitting cross-legged, standing with hip dropped) Core and lumbopelvic stabilization Activity modification during the acute phase Corticosteroid injection: Ultrasound-guided injection into the trochanteric bursa reduces acute inflammation. However, repeated corticosteroid injections may weaken tendon tissue and are generally limited to 2–3 per year. Platelet-Rich Plasma (PRP): PRP injection at the tendon insertion delivers growth factors that promote tendon healing. Increasingly preferred over corticosteroid for patients with documented tendinopathy or partial tearing, given its potential regenerative mechanism and lack of tendon-weakening effects.

Surgical Procedure

Gluteus Medius / Minimus Repair

Endoscopic repair of abductor tendon tears at their footprint on the greater trochanter, using suture anchors to restore secure attachment. These tears are a frequently missed cause of lateral hip pain and weakness.

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Hip Arthroscopy

Minimally invasive hip scope performed at our ambulatory surgery center, addressing labral tears, cartilage defects, femoroacetabular impingement, loose bodies, and synovial disease through small portals with same-day discharge.

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Recovery & rehabilitation

PT/injection program: 8–12 weeks for initial response; ongoing maintenance program
Surgical repair: Non-weight-bearing or toe-touch weight-bearing for 4–6 weeks postoperatively to protect the repair; progressive strengthening begins at 6 weeks; return to unrestricted activity at 4–6 months; full functional recovery 6–12 months

Frequently Asked Questions

Is gluteal tendon tear the same as trochanteric bursitis?

No, though they often co-exist. Bursitis refers to inflammation of the fluid-filled sac over the greater trochanter. Tendon tears involve structural disruption of the gluteus medius or minimus. Many patients labeled with "bursitis" actually have underlying tendon pathology that requires targeted treatment.

Can a complete tear heal without surgery?

Tendon tissue cannot reliably reconstitute itself once fully torn. Non-operative care may reduce pain but is unlikely to restore full abductor strength or resolve a Trendelenburg gait from a complete tear. Surgery provides the best opportunity for functional restoration.

Will I need a general anesthetic for the repair?

Most gluteal tendon repairs are performed under general or spinal anesthesia as outpatient surgery. You will go home the same day with crutches.

How do I know if my PT program is working?

Measurable improvement in hip abductor strength, reduction in Trendelenburg gait, and decreased lateral hip pain at 8–12 weeks indicate a positive response to conservative care.

How long does recovery take after gluteal tendon repair surgery?

Recovery after endoscopic or open gluteal tendon repair is gradual and typically takes six to nine months to reach full function. For the first six weeks, weight-bearing is allowed but hip abductor loading is strictly limited to protect the repair. Formal physical therapy then focuses on progressive strengthening of the hip abductors, core, and pelvis, with return to unrestricted activity expected around the six-month mark. Your MOS surgeon will monitor tendon healing and guide your rehabilitation to ensure the repair matures fully before high-demand activities are resumed.

Meet the specialists

John J. Christoforetti, MD

Orthopedic Surgery · Sports Medicine · Hip, Knee & Shoulder Arthroscopy · Shoulder Replacement

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Related conditions

Hip Osteoarthritis

Medically reviewed by John J. Christoforetti, MD, FAAOS

Last reviewed May 1, 2026

References

Domb BG, Nasser RM, Botser IB. Partial-thickness tears of the gluteus medius: rationale and technique for trans-tendinous endoscopic repair. Arthroscopy. 2010;26(12):1697–1705. https://doi.org/10.1016/j.arthro.2010.06.002
Grimaldi A, Mellor R, Hodges P, Bennell K, Wajswelner H, Vicenzino B. Gluteal tendinopathy: a review of mechanisms, assessment and management. Sports Med. 2015;45(8):1107–1119. https://doi.org/10.1007/s40279-015-0336-5
Lachiewicz PF. Abductor tendon tears of the hip: evaluation and management. J Am Acad Orthop Surg. 2011;19(7):385–391. https://doi.org/10.5435/00124635-201107000-00001
Walsh MJ, Walton JR, Walsh NA. Surgical repair of the gluteal tendons: a report of 72 cases. J Arthroplasty. 2011;26(8):1514–1519. https://doi.org/10.1016/j.arth.2010.12.004
American Academy of Orthopaedic Surgeons. Greater Trochanteric Pain Syndrome. OrthoInfo. https://orthoinfo.aaos.org/en/diseases--conditions/hip-bursitis/