Left Hip - Gluteal tendon tears, medialus & minimus, bursitis. Trail running competitor needs recovery ideas.

Hi

I have some Left Hip issues that have been bugging me for several weeks. I asked for a MRI recently and this is what was on the report dated the 18 Dec 2018:

"Partial tera involving anterior fibres of the gulteustendon, measuring approximatly 10mm longitudinally and 9mm transversley. Intrasubstance tear of the gluteus minimus tendon, measuring up to 13mm in lenght. Thickening and mild fluid distension of the trochanteric bursa, in keeping with associated bursitis.

Small left hip joint effusion. No full thickness cartilage defect identified. Subjective mild cartilage thinning at the superolateral acetabulum and femoral head. No marrow oedema at the femoral head or acetabulum. Minor chondrolabral separation at the anterior acetabular."

In my trainin log, the issues started around the 2nd of November. I did a long run in the snowy mountains, snow still covered much of the trail so I did some glissading (standing up sliding on the steep snow slopes), I fell hard on my left butt several times. Then continued to run back to base, not realising I may have injured the Glutes. A few weeks latter I ran a 50km trail ultra and found for the first time in an event I had hip and gulte issues, ouch ! As it was not improving greatly I asked for an MRI as I have some big events scheduled from March to May 2019, and need to know, not guess what the issues were.

My doctor I work with & who wrote the referral, is now away until mid Feburary. A physio & friend have been giving some general advice on the injury.

I am keen to listen to any ideas out there on how to best recover and get back into competitions with these injuries ?

I stopped running on the 16th Dec (after a half marathon trail event in Canberra) & since then for 2 weeks have walked, exercise bike, one road bike workout (today). I have been doing a routine of floor streteches and strength exercises with glute activation clams and bridges. Taking mefloxicam for just under one week.

One big question I have, is how long would a good recovery be for a 60 year old with this sort of injury ?

Thanks in anticipation :)

Well, Steroid injection is out as it would promote tears, but platelet rich plasma (PRP) injections have been found to work as well:
Fitzpatrick, Jane, et al.
The Effectiveness of Platelet-Rich Plasma Injections in Gluteal Tendinopathy: A Randomized, Double-Blind Controlled Trial Comparing a Single Platelet-Rich Plasma Injection With a Single Corticosteroid Injection.
The American journal of sports medicine (2017): 0363546517745525.
SAGE Journals: Your gateway to world-class journal research

Thanks for the reply.

PRP looks like an option. I had been told steroid injections had lost favour with recent research, still OK for the bursitis, but not the tendon issues.

As I traditionally have low Platlets (always under 150), they may have to drain a bit extra blood to get the platlet concentration up for the injection :)