Gluteal Medius Tendinosis and Illiopsoas Bursitis

[MickyBee]

Thanks,

1. "how recently you were doing sport/activities"

I have tried to restart running several times over this period, but have always stopped because of peroneal/achillies pain (left side - opposite to hip problems), my opinion is that my pelvis was dropping on the left, causing my foot to crossover. I notice this when I walk occasionally, my left foot feels to far over, sometimes causing me to overbalance. I had a volume injection in my achillies last year, so was attempting to run again, before I got these results.
Videos of me running show I wobble from side to side, a bit like Trendelenburg gait.

Even when not running I am active, mountain biking and hillwalking. I guess walking up mountains with a rucksack will not help my tendonosis. I have never tried complete rest, mainly because I never had a proper diagnosis.

I also have herniated L4/L5 and previously had some sciatica like symptoms on my right side (the one with hip pain).

2, "a local physio"

I have seen several, they mainly find:
Everything is tighter on my right side
Hip flexors
Hamstring
Glutes
Quad

They suggest stretching hip flexors and glutes.

Hip impingement has also been suggested, but orthopaedic consultant has looked at x-rays and MRIs and ruled this out. I did try some Mulligan distraction, but this did not help.

I saw one earlier this week that suggested working on glute activation and strength. progressively loading (concentric and eccentric) my tendinosis.

I am seeing a different one this morning so may report back later. Is there anyone you would recommend, in the Staffs/Cheshire area?

Thanks,

Mick

[nmarman]

What side is the bursa and the tendonitis?

As a disc bugle never goes way we know two things:

There is likely some compensatory limp and lean

Second the L5 nerve root may still have slow conduction. This indicates a impingement and reduced nerve flow to feed the glut med muscle.

Long story short you might have a unfixable nerve impingement that you might need to modify your activities around. Reduce running and jump activities ad opt for cyclic ones (avoid cycling shoes)

If you had it sometime ago and didn't go through go rehab for the lower back - it is possible that you have develop and antalgic scoliosis. With you current symptoms I would say this is very very likely.

The condition wont be solved until you look at whole function of spine and pelvic girdle.

Get a x-ray done of the lumbar pelvic region to determine state of scoliosis and corresponding hip tilt.

[MickyBee]

Ok, just seen someone else this morning.

He got me doing one leg tests:
Standing on one leg - I could do without problem

Jumping off a step and landing on one leg:
I did ok on my "good side" (left)
on my "bad side" (right) my left hip drops and I lean over to the right to balance.

This feels like what I do when I run.

He advised that I do:
hip hikes, focussing on endurance by holding at the top
jump forward onto one leg, trying to keep pelvis level
stretch psoas

He also did some dry needling in my glutes.


Back
When I had my back problems, I did Mckenzie exercises which seemed to help.
The MRI said (2010)
At L4/5, broad-based central protrusion is noted indenting the anterior theca. No compression to transiting or exiting nerve roots.
At L5/S1, minor central bulge is noted with annular tear, No canal/foramina narrowing.