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Shockwave Therapy for Gluteus Medius Tendinopathy

28/07/2020
Clinical

Gluteus Medius Tendinopathy is an increasingly popular diagnosis with rheumatologists and orthopaedic surgeons. It is the most prevalent hip tendon injury and common cause for patients with Greater Trochanteric Pain Syndrome.

Symptoms of Gluteus Medius Tendinopathy
– Overuse of the gluteus medius tendon results in inflammation of the bursa and tendon causing pain around the hip area
– Patients will often have difficulties sleeping on that side of the hip, or getting in and out of a car.
– Gluteus Medius is an important muscle in our body as it allows us to walk, run properly and stand on one leg. Patients who have problems with Gluteus Medius often develop a Trendelenburg gait where the body sways from side to side when they walk.

Treatment Options:
– Initially avoid any activity that would make the pain worse and apply relative rest
– Cold Therapy
– Hip stretching and strengthening exercises
– Biomechanics assessment
– Physical Therapy
– Cortisone injection
– Shockwave Therapy (read more below)

How to Incorporate Shockwave Into Your Treatment Plan for Gluteus Medius Tendinopathy?

Shockwave Therapy has been clinically proven as an effective treatment for greater trochanteric pain syndrome.* Shockwave Therapy promotes regeneration and reparative processes of tendons and other soft tissue. The shockwaves works to stimulate new blood vessel formation and the release of tissue growth factors.

It is important to re-educate the deep muscles in our pelvis, Quadriceps femoris and Gluteus Medius. The collagen of Gluteus Medius may become denatured and patients often present with a very stiff Sacroiliac joint. Treat the patient with hands on release of the sacroiliac joint and Psoas. Shockwave therapy is beneficial to help release a very tight iliotibial band and to treat the collagen attachment of Gluteus Medius. View more in the video above!

Using the Chattanooga Intelect RPW Shockwave, we can apply the following three step approach (information taken from the Chattanooga Shockwave Therapy Training Manual):

(Recommended dosage 3-6 treatments with 5-10 days interval)

1) The Patient lies on the painless side with a small flexion in hip and knee and a small pillow or towel between the knees. On the lateral aspect of greater trochanter at the insertion of gluteus medius and tensor facia latae you’ll often find the tenderest spots. Treat by moving the handpiece with small circular movements at the most painful spots in the area.

Pulses: 2000-3000

Energy Level: 1.6-2.5 bar

Frequency: 12-15 Hz

Transmitter: R15/DI15

2) Radial Shockwave for Triggerpoints in the Tractus Iliobialis

Patients lie on the side with the treated leg on top. Put a small pillow or towel between the patient’s knees in a slightly flexed position. Start the treatment distal to the greater trochanter and move it with a slow gliding movement distally to 5cm from the knee joint line. When you find a painful spot stay there until pain relief with small circulating movements. You will often find the most painful spots in the middle and distal part of the tendon/muscle.

Pulses: 1000-2000

Energy Level: 1.6-2.5 bar

Frequency: 12-15 Hz

Transmitter: R15/DI15/D20

3) Massage – Vibration Treatment using V-Actor.

Treat the same muscle groups as above. Treat the tender and tight spots until the area feels relaxed.

Pulses: 3000-5000

Energy Level: 2.0-3.0 bar

Frequency: 28-35 Hz

Transmitter: V25/V40

*Source: Furia JP Rompe JD Maffulli N. Low-energy extracorporeal shock wave therapy as a treatment for greater trochanteric pain syndrome. The American journal of sports medicine. 2009;37(9):1806-1813. [PubMed]

Shockwave Therapy Can Also Be Used For....

Do You Have Any Questions? Let Us Help You!

DJO Global is here to help you answer any questions you might have about our Shockwave units and Shockwave Therapy. We offer both Chattanooga and Storz branded Shockwaves. Contact us for brochures or to get in touch with a Sales Rep.