Gluteal tendinopathy (and me)

Sometimes in my groin, sometimes at the front of my right hip, sometimes deep in the buttock, the pain started with the long drives to Wales, then got worse when I started golf lessons. A Pilates machine debacle led me to Physio One, who suggested it might be hip arthritis, then never returned my calls. Physio Two said it was deep gluteal syndrome. He gave me exercises (that worked), then switched career to become a tree surgeon.

In May, the pain returned, so I found Physio Three who diagnosed gluteal tendinopathy. She also suggested I get a GP referral for a hip X-ray (which revealed I also had hip osteoarthritis).

Gluteal tendinopathy and hip osteoarthritis in a desk-bound homeworking software engineer have similar treatment plans. My glutes weren’t strong enough to do their job, so my inner thighs and quads were picking up the slack, which was part of the reason I was in pain. My tendons had degenerated because I wasn’t using them enough, and I then hammered them with too much exercise too quickly.

To repair my hip and leg ecosystem, I needed to engage my brain. The physio gave me some rules:

• Reduce daily activity until you find the baseline where symptoms have disappeared
• Any pain that is above 3/10 is the body’s message to do less (“reduce load”)
• Accept that rehabilitation of chronic tendinopathy can take 6-12 months, and shortcuts only delay progress
• Start with daily isometric exercises (holds), then add slow eccentric movements (repetitions)
• Keep walking, but increase distance slowly, reducing if pain is above 3/10 the next day
• Use the gym to safely add heavier loads to strength exercises, but obey the 3/10 rule
• When ready, progress to gentle plyometrics (e.g. low hops and jumping), then to sport-related movements, before returning to sport

The treatment plan requires consistency and control. Life doesn’t always allow that. Right now, I’m on holiday, in a flat on the third floor at the top of a steep hill. When we booked it, this was a good thing, but the reality is I’ve had a couple of miserable days recovering from asking my tender tendons to do too much. I probably overdid it in the gym in August, thinking I was fitter than I really was. Unlike muscles, tendons take twenty-four hours to complain, which is another complication. It can be a stop-start affair.

Four months in, I’m still in the strengthing phase. I haven’t yet reached the excitement of hopping. New exercises mean new stresses on my body. I can’t always tell what’s hurting and why. I also struggle with knowing which type and amount of pain is necessary and which is holding me back. It’s an ongoing physiological education. I’ve watched a lot of YouTube videos.

There’s little online about the mental health aspect of all this. Up to a year is a long time to recover from what the medical profession considers a common problem, and that’s if you stick to the treatment plan and pay rigorous attention to the signals your body is giving you. What if a person’s baseline activity level is below what’s required to do their job, or care for a loved one? I can’t imagine. In that I feel lucky.