How Is Chronic Gluteal Tendinopathy Treated?

Our doctor, Dr. Michael K. Shindle, treats chronic gluteal tendinopathy with pain medication and targeted strengthening exercises to improve hip stability. He also offers advanced care like platelet-rich plasma (PRP) therapy, cortisone injections, and regenerative therapies. Beyond this, he guides you through activity modification and load management to support healing.

However, if these methods do not relieve symptoms, he may recommend surgical repair for the damaged gluteal tendon. During surgery, he uses minimally invasive techniques to repair the tendon. He also monitors your recovery through regular follow-up visits to track healing progress. Call 855-321-6784 to consult with our surgeon at Total Orthopedics and Sports Medicine in Linden.

Which Treatments Work Best for Gluteal Tendinopathy?

Activity modification and gentle strengthening exercises, such as clamshells or hip abduction, help reduce compression on the gluteal tendon and improve movement. In some cases, dry needling and corticosteroid injections may help reduce pain and improve daily function. Our hip specialist, Dr. Michael K. Shindle, may also recommend platelet-rich plasma to support healing in the early stages of gluteal tendinopathy.

In fact, a systematic review in the Orthopedic Journal of Sports Medicine found that a single PRP injection supports better long-term healing than corticosteroids. However, if your condition is severe, Dr. Michael K. Shindle recommends dry needling (thin needles used to release muscle tightness) to ease discomfort and restore hip mobility. He may also perform advanced procedures, such as bursectomy, iliotibial band release, and gluteal tendon repair, to support long-term recovery.

Here are some other treatment options that Dr. Michael K. Shindle may recommend based on your diagnosis and activity level:

Soft Tissue Mobilization

Soft tissue mobilization (STM) is a hands-on technique to release tight tissue, reduce stiffness, and improve movement. For example, mobilization with movement (MWM) improves range of motion and reduces muscle weakness. Similarly, cross-fiber massage targets tight areas in the gluteus maximus to improve flexibility and reduce chronic pain.

Heat and Cold Therapy

During recovery, you can use heat and cold therapy to manage pain and support healing of the gluteal tendon. Cold therapy provides relief during sudden flare-ups or after activity, as it helps reduce hip inflammation. However, you should apply an ice pack for 15–20 minutes during the first 48–72 hours to control swelling and discomfort. In contrast, heat therapy helps ease stiffness, especially when applied before activity or exercise.

Neuromuscular Electrical Stimulation (NMES)

According to research published in Frontiers, Neuromuscular Electrical Stimulation (NMES) uses electrical impulses to improve muscle contractions and support rehabilitation. It helps activate the gluteal muscles, especially in people with muscle weakness or low activity levels. It also improves muscle strength and overall function in the hip and buttock areas.

Myofascial Release

Our surgeon, Dr. Michael K. Shindle, recommends myofascial release to reduce stiffness in the glutes, TFL (tensor fasciae latae), and hip flexors, which often cause lateral hip pain. You can perform this technique at home by lying down and placing two massage balls under your hips. Then, slowly move your legs side to side to target tight areas. Also, press a ball against the side of your hip to relieve tension in the gluteus medius, while gently moving your leg to stretch the tissue.

Percutaneous Ultrasonic Tenotomy (PUT)

In severe cases, our surgeon, Dr. Michael K. Shindle, performs Percutaneous Ultrasonic Tenotomy (PUT) to treat damaged gluteal tendon tissue. During this procedure, he uses local anesthesia to numb the area and reduce discomfort. Then he inserts a small device, such as a Tenex or TenJet, to remove damaged collagen from the gluteus medius or gluteus minimus. He also preserves healthy tissue and improves overall tendon health. This process also triggers a natural healing response by promoting growth factors that support tendon repair. In fact, a NIH study analyzed 29 patients with gluteal tendinopathy who did not improve with non-surgical treatments. After a follow-up period of about 22 months, the researchers reported the following outcomes with Percutaneous Ultrasonic Tenotomy (PUT):

• Pain reduction: VAS scores improved from 5.86 to 2.82
• Hip function: Harris Hip Score improved from 60.03 to 77.47
• Overall health: SF-12 score improved from 51% to 64%
• Patient feedback: Most patients reported positive outcomes
• Safety: No complications reported

Taping Techniques

Our surgeon, Dr. Michael K. Shindle, guides you through taping techniques to support the glute maximus muscles and reduce strain on the tendon. This method helps reduce pressure on the painful area and eases pain on the side of the hip. It also improves proprioception (body awareness), which supports tendon health.

In fact, a PubMed study found that taping improves muscle activation and enhances control of the gluteus medius muscles. The study included 90 individuals divided into kinesio taping, rigid taping, and placebo groups. Then, researchers measured muscle activity during exercises such as clamshells and lunges. After immediate testing at 48 hours, all groups reported a significant increase in muscle activation right after taping.

What Causes Chronic Gluteal Tendinopathy?

Repetitive activities like running, walking, or stair climbing, and a sudden increase in training intensity, place excess pressure on the tendons and cause gluteal tendinopathy. Weakness in the hip abductor muscles, such as the gluteus medius and gluteus minimus, also affects pelvic control and places extra strain. In some cases, age-related changes in the tendon structure reduce healing ability and increase the risk of chronic pain. Beyond this, the following risk factors can further increase stress on the hip tendons and delay recovery:

• Structural factors: A wider pelvis or hip instability increases load on the tendons.
• Hormonal changes: Reduced estrogen levels during menopause affect tendon health.
• Body weight: Higher body weight increases pressure on the hips and buttocks area
• Medical conditions: Diabetes or hypercholesterolemia can increase the risk of tendon disorders.
• Previous pain: Back or knee issues can alter the natural movement pattern and place constant strain on the hip joint.
• Medications: NIH research reports that statins and glucocorticoids can increase the risk of tendon injury
• Trauma: A fall directly onto the side of the hip can damage the tendon

How Do Corticosteroid Injections Help Reduce Hip Tendon Pain?

Corticosteroid injections deliver high-concentration anti-inflammatory medication directly to the inflamed area and deactivate cells that trigger pain. As a result, you may experience quick relief and reduced irritation in the gluteal tendons. These injections provide significant pain reduction for 6–12 weeks and help improve movement.

However, long-term use of these injections can lead to complications, tendon damage, infection, or tissue weakening. It can also increase the risk of tendon tears, delayed healing, and recurrent flare-ups. For this reason, doctors recommend 2–3 injections per year to avoid potential tissue damage and long-term complications.

Is Dry Needling Safe for Hip Tendon Strain?

Yes, dry needling is a safe, minimally invasive method for treating hip tendon strain. During the procedure, our hip specialist, Dr. Michael K. Shindle, performs a thorough examination and gently presses the area to find tight trigger points (muscle knots). Then, he inserts a thin needle into the muscle or tendon tissue without injecting any medication. After that, he gently moves the needle to create a small twitch response, which helps release tight muscle bands. This process helps reduce pain, improve movement, and support healing in the hip and buttock areas.

Moreover, an NIH case study followed a 78-year-old active woman with long-term lateral hip pain. She received dry needling treatment to reduce pain and improve function. After eight weeks, her function score (LEFS) improved from 24/80 to 54/80. Her average pain level also improved from 35 mm to 20 mm. In addition, her current pain has decreased from 28 mm to 13 mm, which supports her daily activities.

How Can Stem Cell Therapy Help Tendon Healing?

Stem cell therapy helps repair damaged tendon structure by using mesenchymal stem cells to rebuild tissue and reduce inflammation. These cells replace injured tendon cells and promote healing in conditions like trochanteric bursitis or a torn tendon. At the same time, they release growth factors that improve blood flow and activate the body’s natural repair process. They also promote collagen production and improve overall tendon strength and function.

Here are some of the latest advancements in stem cell therapy for treating gluteal tendinopathy:

Tissue Engineering and Scaffolds

Advanced tissue engineering techniques now use biodegradable scaffolds to create a supportive environment where stem cells can attach, grow, and develop into healthy tendon tissue. These scaffolds mimic the body’s natural structure, improving cell survival and encouraging organized collagen formation. This approach is especially beneficial for chronic tendon injuries because it helps regenerate stronger, more functional tissue while reducing scar formation.

iPSC-Derived Tenocytes

Induced pluripotent stem cells (iPSCs) can be transformed into tenocytes, the specialized cells responsible for maintaining and repairing tendons. These lab-developed cells help restore tendon strength, elasticity, and proper fiber alignment. Researchers are exploring this technology as a personalized treatment option, since iPSCs can be generated from a patient’s own cells, improving healing outcomes.

Exosomes and Paracrine Action

Stem cells release tiny signaling particles called exosomes, which play a major role in reducing inflammation and stimulating tissue repair. Instead of directly replacing damaged tissue, these signals activate the body’s natural healing response by encouraging blood vessel growth, collagen production, and cellular regeneration. In gluteus minimus injuries and tendon degeneration, exosome therapy may help relieve pain, improve mobility, and accelerate recovery without invasive surgery.

Combined Therapies

Combining stem cell therapy with Platelet-Rich Plasma (PRP) has shown positive results in regenerative medicine. PRP contains growth factors that enhance stem cell activity, improve blood flow, and support faster tissue repair. Together, these therapies may improve tendon healing quality, reduce inflammation, shorten recovery time, and increase long-term strength and function in damaged muscles and tendons.

When Is Surgery Recommended for Chronic Tendon Injuries?

Our experienced surgeon, Dr. Michael K. Shindle, usually recommends surgery if symptoms persist despite 3–6 months of conservative care, such as exercise or rest. He also recommends surgery when a torn tendon severely limits daily activities, work, or physical performance. In such cases, surgery helps repair the damaged tendon and restore strength and movement.

However, you should avoid surgical intervention if you have the following chronic conditions and risk factors:

• Advanced joint damage: Severe hip osteoarthritis reduces the success of repair
• Severe tendon damage: A weak or degenerated tendon cannot hold repair
• Medical risks: Conditions like uncontrolled diabetes, heart disease, or poor healing increase surgery risk
• Active infection: Infection increases complications during surgery

Can Tendon Debridement Relieve Chronic Hip Pain?

Yes, tendon debridement can relieve chronic hip pain, especially in greater trochanteric pain syndrome. During the procedure, the surgeon administers general anesthesia to manage discomfort. Then, the surgeon makes 2–3 small cuts around the hip and inserts a camera to view the tendon clearly.

They also use specialized tools to remove the damaged tendon and the inflamed, fluid-filled sac (bursa). However, if a tendon is torn, the surgeon may reattach it to the thigh bone using anchors. These camera-guided procedures support healing and help ease symptoms such as pain, stiffness, and reduced range of motion.

How Long Does It Take To Recover From Gluteal Tendinopathy?

You may notice significant improvement in symptoms of gluteal tendinopathy within 3–6 months of treatment. However, you can start guided exercises within 6–8 weeks of treatment to support healing and restore movement. The overall recovery time varies based on factors such as tendon overuse, injury severity, and your activity level. For this reason, our hip surgeon, Dr. Michael K. Shindle, may recommend the following structured recovery plan to ensure a smooth recovery.

Strengthening Exercise Program (Isometric to Isotonic)

Research published in the JOSPT journal shows that people with hip pain often have weakness in the hip rotator and hip abductor muscles. This weakness can increase pressure on the tendons and delay healing. To address this muscle weakness, you should start with isometric exercises (muscle contractions without movement). These exercises help improve muscle control and strengthen the glutes. Once you notice improvement, you can progress to the following exercises to ensure strength and movement control:

• Side-Lying Hip Abduction: Lie on your side with hips stacked, then lift the top leg, performing 3 sets of 12–15 reps
• Bridge with Band: Perform a glute bridge with a resistance band around your thighs, 3 sets of 10–12 reps
• Clamshells: Lie on your side with knees bent, then open the top knee against a resistance band
• Standing Step-Downs: Stand on a step and slowly lower one leg to the floor to improve control
• Squat with Band: Stand with feet shoulder-width apart, band around knees, then perform slow, controlled squats

Healthy Diet and Tissue Support

According to Science Direct research, proper nutrition supports tendon repair and enhances tendon healing. For example, nutrients such as protein, amino acids (leucine, arginine, glutamine), and vitamins C and D help rebuild tissue and support recovery. Similarly, minerals such as zinc, copper, and manganese also support collagen production and long-term tissue repair.

Reduce Tendon Compression (Load Management)

You can protect the tissue and support faster recovery by limiting excess pressure on the thigh bone and gluteal tendons. For this reason, avoid crossing legs, standing on one leg, and using low chairs. You should also avoid lying on the affected side, as this increases strain on the hip. Instead, sleep on the unaffected side and place a pillow between the knees to keep the hips aligned and reduce compression.

Quit Smoking and Caffeine

Smoking reduces blood flow to the tendon tissue and delays healing from greater trochanter pain syndrome. It also affects oxygen supply, which can weaken the repair process and increase chronic hip flexor pain. However, if you quit smoking and limit caffeine, it can improve circulation and support faster tendon healing.

Weight Management

During recovery, our surgeon, Dr. Michael K. Shindle, guides you through a structured weight-management plan focused on diet and activity. This approach helps reduce stress on the hip and supports healing. Maintaining a healthy weight also lowers joint pressure and improves long-term recovery.

Visit Total Orthopedics & Sports Medicine for Chronic Gluteal Tendinopathy Treatment in Linden!

You often struggle to sleep at night, especially when turning in bed due to hip pain. You may also avoid daily activities such as walking and climbing stairs, which can weaken muscles. In this situation, ongoing pain can lead to loss of independence and mental stress without proper care.

At Total Orthopedics and Sports Medicine, our doctor, Dr. Michael K. Shindle, designs a personalized plan to reduce pain and improve hip muscle strength. As an experienced Orthopedic Consultant for the New York Football Giants, he applies advanced sports medicine techniques, including arthroscopy and ultrasound-guided procedures, to restore mobility. Beyond this, you can use our online patient portal for clear post-surgical instructions. Call 855-321-6784 or visit our clinic for advanced treatment.

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