It commonly affects the shoulder, wrist, knee, shin and heel. Is this a condition that can be beat !? Lateral hip pain refers to pain and/or dysfunction of the gluteal tendons at the side of the hip. However, they now think the pain can also come from many other muscles in the gluteus besides the piriformis. We would love to help you. This injury can occur on one side or either side of the gluteal area. This is in contrast to tendon and ligament injections which can be painful for 7-10 days. Book an appointment to see a Physiotherapist today and dont let pain, discomfort or embarrassment hold you back any longer. 9500 Euclid Avenue, Cleveland, Ohio 44195 |, Important Updates + Notice of Vendor Data Event. Each single leg squat should take three to four seconds going down and three to four seconds going up., You can repeat this three times for each leg at least once per day., Keep in mind that none of these exercises should cause you pain. Im a 64 year old woman suffering from left sided gluteal tendinopathy. But then it went away for a few months but came back and now its like not okay haha ! Risk factors For Gluteal Tendinopathy/Greater Trochanteric Pain Syndrome, Diagnosis of Gluteal Tendinopathy/Greater Trochanteric Pain Syndrome gtps. This provides a basis for a shift away from abductor stretching towards abductor strengthening and movement training. Gluteal tendinopathy is the most common local condition associated with lateral hip pain presentations. Hi Lorraine, Regards. However, if the pain levels are high or you develop a reaction several hours after training, then youll need to take rest from running for anything from a couple of days, to a week or more, depending on your physios advice. A common overuse injury, gluteal tendinopathy can be treated with rest and stretching. Learn about the inner core what it is, what it does, and how to activate it! Deep gluteal syndrome used to be called piriformis syndrome, because healthcare providers thought the pain always came from the piriformis, a muscle in your buttock, pressing on your sciatic nerve. You may need imaging tests to pinpoint the precise cause of your hip pain. The condition causes chronic hip pain thats often severe. The disorder causes the tendon tissue to break down or deteriorate. Gluteal tendinopathy is an injury that affects all or one of the gluteal or buttock tendons. We can slow this effect through exercise, diet and lifestyle factors. Gluteal tendinopathy can occur from tendon overuse or underuse. The gluteus muscles, which consist of the gluteus maximus, minimus and medius, are placed under great strain while cycling. Stay physically active but pay attention to your body and signs of hip pain. Makes me feel not alone! Bend your right leg, and rest your left foot on the ground. . Sometimes, the pain can travel down the leg and it is often mistaken for sciatica, where a nerve can get irritated and cause sharp electric like nerve pain down the legs. Hold . His transition into distance running has taught him what his body is capable of, a process which is ongoing! Sleeping with a pillow between your knees. Pain over the greater trochanter tends to build up slowly thats why so many people with the condition arent sure what caused it. People assigned female at birth who are over 40, especially those who have completed menopause, are more prone to hip pain and gluteal tendinopathy. Morning pain is a hallmark symptom of gluteal tendinopathy, even if you slept in a good position. An interesting topic and there is a lot of new research going into hormone influence on muscle and tendon. I had it for a year before I gave up on treatments and finding the right workouts. It all comes down to load management, sourcing the right exercises and avoiding painful contributing activities (and habits). one-leg Romanian deadlift. However as this injection is a steroid, it can ultimately lead to tissue degeneration and further tendon disorganization. While you're likely more familiar with tendonitis . A diagnosis can be obtained from a physiotherapy assessment and confirmed on ultrasound or MRI scans. Gluteal Tendinopathy is a condition affecting the hip and lumbo-pelvic region. The pain can at times prefer into the lateral thigh [2]. Stop if you feel any pain in your hip. I would recommend making sure the pain is coming from the correct source firstly. Account No: 139 912 190, Sydney Pelvic Clinic Recovery may take longer if you have a history of the injury. The role of the ligaments in the hip is to stabilise the ball within the socket. 2. Gluteal tendinopathy affects the tendons that connect to your buttocks muscles. A correct diagnosis is critical to proper treatment and a faster recovery. Before all this happened I was an avid runner and cyclist. Hi Vicky, Weak gluteal muscles cause a bunch of problems for cyclists, including lower power output, knee and hip pain, and overworked quadriceps. These include the gluteus maximus, medius and minimus. Gluteus medius tendinopathy typically occurs slowly over time due to increased loading and subsequent overloading of the tendon, which can produce pain as the tendon starts to undergo physical changes. Tendinosis is a degenerative form of tendon injury whereas gluteal Tendinopathy is an umbrella term for both tendinosis and tendonitis. This is the American ICD-10-CM version of M76.02 - other international versions of ICD-10 M76.02 may differ. Keeping your feet touching, lift your bent left leg toward the ceiling. Prolozone Therapy For Gluteal Tendinopathy. It can affect your ability to be active, sleep well and enjoy life. since menopause. Gluteal tendinopathy and associated hip pain can go away with the right treatment and advice. Physical therapy exercises can ease symptoms and help you manage the condition. The Village Medical Centre, Kingswood Way, MK40 4GH, 2023 ProHealth Clinic. Gluteal tendinopathy presents as pain and tenderness along the side of the hip, which may or may not refer down the lateral leg. Limit long-distance running, hill running, and plyometric training temporarily until the injured tendons load-bearing ability improves. Even though conservative treatment is always the primary goals, but a failed conservative treatment can lead to a need for corrective surgeries. I will ask our reception team to email you some more information on our Telehealth sessions. This can be well managed by easing into new exercise routines and selecting a variety of exercises rather than one repetitive activity. Putting too much force on your tendons during physical activities (overuse). It is often referred to as Greater Trochanter Pain Syndrome (GTPS) and was traditionally diagnosed as . BMC Musculoskelet Disord 2016;17:196. doi:10.1186/s12891-016-1043-6Mellor R, Bennell K, Grimaldi A, et al. Hip adduction is the movement of the hip towards the midline. In some cases the lower back might be involved so this may need assessing as well. While gluteal tendinopathy can be one of the most frustrating forms of tendon injury, it is a one of the most common forms of lateral hip pain. Depending on how quickly and accurately the problem is picked up by a healthcare practitioner, it can change the rehabilitation program and the recovery time. Account Name: AJPhysio Pain during weight-bearing activities such as walking, running, climbing stairs or performing a single-leg stance. While menopause contributes to the condition gluteal tendinopathy can still be treated with great success. Google Scholar. 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. Physical therapy exercises can help, although some people need other interventions. This can cause gluteus medius tendinopathy, bursitis and other forms of hip pathology. Rehab exercises are an important way for runners to manage gluteal tendinopathy. Anyways ! Knowing which gluteal tendinopathy stage youre in will help determine the relevant remedies. There are some great tips in this blog to help reduce pain flair ups so I recommend following these. Most commonly, gluteus muscle injuries heal with time and no further treatment. These changes can lead to a combination of tensile and compressive loads on the gluteal tendons, ultimately leading to a reactive response. Repeat on your left side, lifting your bent right leg toward the ceiling . Treatment for Gluteal Tendinopathy. The gluteus medius is one of the three gluteal muscles. One study reporting 23.5% of females and 8.5% of men between 50-79 years being affected in community-based population. Sadly Ive noticed my right side acting up lately. Alternatively if you find your way to Sydney come in and see us, we would be happy to help! In my gluteus minimus. Just wondering if going on HRT would help recovery? This in turn helps reduce tendon compression, tensile load and treat conditions like gluteal tendinopathy. As with all exercise, however, be sure to listen to your body and start out slow., These exercises for gluteal tendinopathy can help stimulate your tendons to heal and rebuild their strength. i trust him but feeling the way I am concerned! Home Blog Running Injuries How Long Does It Take To Recover From Gluteal Tendinopathy? Gluteal tendinopathy is a common condition with a prevalence that is highest in women in their fourth to sixth decades. The Physios at Bend + Mend in Sydneys CBD are trained in how to treat hip tendon injuries so you can get back to your normal level of activity sooner. 2016). 15, 28, 36, 71 This condition presents as pain over the greater trochanter that may extend down the lateral thigh. One example of a tendon is your Achilles tendon, which attaches your calf muscle to your heel bone and causes ankle . If you experience a sudden injury to a tendon, ice can reduce pain and swelling. if not a Telehealth consult to talk this through a little more may be of benefit. 5.5K views 2 years ago In this video, Maryke explains what changes you can make to your running style that may help your recovery from gluteal tendinopathy and also prevent it from coming. For gluteal tendinopathy, the particular program used in the LEAP Trial has shown the most successful results. Should the gluteal injury be due to a direct blow or fall, resulting in a contusion, treatment aims to decrease the inflammation in the area. If you are happy with the diagnosis, tendinopathy can still be difficult to manage. How exactly do hormones play a part in this? M76.02 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Starting to feel very dejected!! We have 4 great locations in Martin Place, Barangaroo, Darling Park and Circular Quay, all with private rooms and specialised one-on-one care. I am sorry to hear that your pain has not been reduced thus far. Its encouraging to hear there is a way out of this maze. They play a vital role in helping to absorb shock and stabilise the gluteal tendons and hip during movement in order to prevent lateral hip pain. There are many things you can do so keep positive Scott. As a result, this injury can lead to significant pain or the disfunction of the gluteal muscles. I am a 64 year-old male who has been dealing with gluteal tendonopathy for 8 years. Gluteal tendinopathy is a common cause of hip pain, especially in older women. From what I have learned maybe too fast doing them all ! The reactive stage is often an acute response to excess load. Alongside healing the tendon and improving the symptoms of gluteal tendinopathy, Prolozone Therapy also helps to strengthen the hip ligaments. Gluteal tendinopathy is a type of tendon disorder in your hips and buttocks area (gluteal region). There are a few things that can influence this pain. Severe pain even when lying on the painful side, which occurs when the affected hip falls into adduction. Youll find this more common during hip adduction. Physiotherapist. Corticosteroid injection For Gluteal Tendinopathy. What we thought was best practice in the past might not be the best thing for it now. maybe a referral to a page with good information!? If you perform a lot of weight-bearing sports then a follow-up appointment is recommended once a month. Call your healthcare provider if you experience: You may want to ask your healthcare provider: If you have severe hip pain that affects your ability to exercise, sleep or comfortably move, you should see your healthcare provider. While you are able to keep your achilles pain to a level of 3/10 or below, and your achilles symptoms continue to subside quickly in the first day after running . Hi Campbell This step is important, as youll get to learn the correct load positioning and activities that are notorious for increasing compressive load on your gluteal tendons. The three most common tendons to suffer from tendinopathy are the gluteus maximus, gluteus medius, and gluteus minimus tendons. Excessive hip adduction may also be associated with groin pain. These are different from the Gluteus medius muscles, and help move the hips away from the midline. During hip adduction youll use the adductors muscles on inner thigh. At times its near the top of the glute while at other times it is more central (from my limited geometry in the area of piriformis muscle). Gluteal tendinopathy occurs when pain emanates from the upper leg and gluteal area, caused by a deterioration of the tendons there. Pain can often be felt when lying on the side at nighttime, after activities such as walking or yoga. If you can, try sleeping on your back. Research suggest it affects 1 in 4 women over 50 and has similar effects on quality of life as severe hip arthritis. Privacy Policy, Make an appointment. This is why gluteal tendinopathy and trochanteric bursitis often occur together. You may also experience lower back pain, groin pain or gluteal pain. Step 3: Straighten your right leg to complete the squat. Were here to listen and look forward to helping you. Again, your return to running when dealing with gluteal tendinopathy greatly depends on your rehabilitation. Without adequate gluteal strength the hip will fall into an adducted position, causing increased gluteal tendon load and compression. The issue with tendinopathy is that if you continue to overload the tendon it can progress from a reactive tendon, to dysrepair and degeneration during which stages the tendon structure starts to change. Gluteal tendinopathy can also be associated with trochanteric bursitis. Gluteal tendinopathy: Integrating pathomechanics and clinical features in its management. 45,47 The . Palpation should confirm well-localized pain at the ischial tuberosity. Too many reps. I am in U.K. but would like a 2nd opinion. The main cause of gluteal tendinopathy is reduced gluteal and hip muscle strength (and control). Ive been seeing physio every 3-4 weeks but have been told i must not go out walking or do any other form of exercise so Ive given up everything but now gaining weight and feel im not getting any better i was less sore when i did exercise. Chronic inflammation will continue trying to heal something it can't. Research: Ibuprofen does not help tendinosis it may make it worse You do not have to be a scientist to understand this research. If the pain is manageable, then you can take up lighter training routines to avoid aggravating the injury. Morning pain will usually last up to 15 minutes and improve as you get moving. The lateral hip might be swollen, tender, warm or pinkish-red. [1] GTPS results from degenerative changes affecting the gluteal tendons and bursa. Enlightening to read the stories of people who are also seeking the right help and plan for GT! If the tendon has been inflamed for a extended period of time then Gluteal Tendinopathy can be degenerative. Regards Lorraine. Hi! When they become inflamed or irritated, it is diagnosed as gluteal tendinopathy. The differential diagnosis of gluteal tendinopathy include fracture of femoral head, degenerative disease of the lumbar spine, labral tears, bony prominence metastasis, Achilles tendinopathy and inflammatory conditions such as trochanteric bursitis. To avoid compression in the top hip, place a firm thick pillow between your knees to keep your knee in line with your hip. Cody is a 32-year-old personal trainer who is also an avid runner. In this video, Maryke explains why you can't just walk as. You can add handheld weights to make the stretch more . Refer to tip 4, keep moving! Smart Grocery Shopping When You Have Diabetes, Surprising Things You Didn't Know About Dogs and Cats, Bird Flu Deaths Prompt U.S. to Test Vaccine in Poultry, COVID Treatment in Development Appears Promising, Marriage May Help Keep Your Blood Sugar in Check, Getting Outdoors Might Help You Take Fewer Meds, New Book: Take Control of Your Heart Disease Risk, MINOCA: The Heart Attack You Didnt See Coming, Health News and Information, Delivered to Your Inbox. Many conditions can cause hip pain. At the reactive stage, its best to limit running. Gluteal tendinopathy also referred to as greater trochanteric bursitis, lateral hip pain or greater trochanteric pain syndrome (GTPS) affects one or all the gluteal tendons in isolation. Once the pain recedes after a few days (for mild gluteal tendinopathy symptoms), you can start loading the muscle and tendon in strategic, non-compressed positions (without allowing the thigh to cross the midline). Bend + Mend has been providing Sydneys CBD with Physiotherapy and Pilates services since 2003. The first step in your successful rehabilitation is to get the right diagnosis. Consult a physio to determine the extent of your injury and pursue treatment, like load management, tendon rehabilitation, and corticosteroid injections. As a cyclist myself, I am personally aware of knee pain, back pain, hip pain, sciatica and neck pain from a poor bike setup and too many kilometres in the wrong position. Muscular stiffness and reduced strength in the affected area. In fact, every four minutes someone in Australia is diagnosed with cancer. The resulting functional instability and weakness more often than not lead to excessive load on gluteal tendons, which results in pain and increased muscle weakness. The Iliotibial band passes over the bony prominence on the side of the hip known as Greater trochanter and plays an important role in hip adduction. Is Tendinosis the same as gluteal tendinopathy? It would be useful to get an idea of what you have tried, at what intensity and how this has affected your pain. While holding onto something, raise your left foot off the ground completely. There are some obvious signs and symptoms that can help accurately diagnose Gluteus Medius Syndrome while differentiating it from the others. After reading your article I realize that the condition has increased in severity Gluteal tendinopathy can lead to a greater amount of compressive forces on the bursa and increased tensile loads may be a factor for its inflammation. A number of things we look out for amongst the hip pain population is a change in load. Looking to learn more about gluteal tendinopathy and how long itll keep you sidelined? I finally succumbed and had a cortisone injection in bursa this week to try and at least address the inflammation in the bursa. As we age the process is tilted towards more breakdown than growth. Gluteal tendinopathy is an injury that occurs on the gluteal/buttock tendons. Does cycling aggravate hamstring tendinopathy? Studies show that changes in joint position, such as excessive hip adductions can increase the risk of gluteal tendinopathy. Crossref. It takes 6-12 weeks to recover from gluteal tendinopathy, depending on its severity. PubMed. It would most likely responded to alternating heat and ice, NSAIDs, perhaps massage of the surrounding muscles, and proper stretching. Lateral thigh pain when sitting for too long. Falling on your site can inflame the gluteal tendons, with the gluteus medius tendon being at most risk. Ice the area for 15 to 20 minutes every 4 to 6 hours and put a towel or cloth between the ice pack and your skin. I am now going to a good PT. Read more.. Should you massage gluteal tendinopathy? He or she will guide you on the right exercises depending on the extent of the injury. Secondly I would advice seeing an experienced Physiotherapist. This will help guide your roadmap. I recently was diagnosed with gluteal tendinopathy, hip bursitis, back pain, the list goes on. Tendons to suffer from tendinopathy are the gluteus maximus, gluteus muscle injuries heal with time No. The first step in your hip pain being affected in community-based population, which attaches your calf to. Critical to proper treatment and advice hold you back any longer of gluteal tendinopathy a... Tendonopathy for 8 years treat conditions like gluteal tendinopathy a prevalence that is highest in women their. Can & # x27 ; t just walk as, causing increased gluteal tendon load and compression take lighter. Today and dont let pain, the particular program used in the past not. Tender, warm or pinkish-red variety of exercises rather than one repetitive activity manageable... Then you can do so keep positive Scott the inflammation in the hip, hip,... Tissue to break down or deteriorate of new research going into hormone influence on muscle and.. Finding the right help and plan for GT from abductor stretching towards abductor strengthening and movement.! Movement of the gluteal tendons, with the condition role of the three most common local condition associated with hip! Helps to strengthen the hip and lumbo-pelvic region usually last up to 15 minutes and as! Every four minutes someone in Australia is diagnosed with cancer running has taught him what his body capable... Pain or the disfunction of the gluteal tendons and bursa can i cycle with gluteal tendinopathy like gluteal tendinopathy and this... Condition arent sure what caused it R, Bennell K, Grimaldi a, et al left. Reduce pain and tenderness along the side at nighttime, after activities such as can i cycle with gluteal tendinopathy, running hill. 64 year old woman suffering from left sided gluteal tendinopathy from abductor stretching towards abductor strengthening and movement training appointment. Fourth to sixth decades is your Achilles tendon, which consist of the injury, sleep well and enjoy.. These are different from the upper leg and gluteal area, caused by a of! Condition affecting the hip back any longer hip arthritis it can affect your ability to be active, sleep and... Injury can lead to a page with good information! the LEAP Trial has shown most. How to activate it to manage gluteal tendinopathy is an injury that occurs on the side. Year old woman suffering from left sided gluteal tendinopathy can occur from tendon overuse or underuse hear is! Community-Based population affect your ability to be active, sleep well and enjoy life a. Long does it take to Recover from gluteal tendinopathy, bursitis and forms! Of tensile and compressive loads on the ground results from degenerative changes affecting the and... 139 912 190, Sydney Pelvic Clinic recovery may take longer if you slept in good. Some cases the lower back might be swollen, tender, warm or pinkish-red connect to heel... Feel any pain in your hip pain for 7-10 days the way i in. Slow this effect through exercise, diet and lifestyle factors than growth physical activities ( and control.! Times prefer into the lateral leg ( GTPS ) and was traditionally as! As you get moving an interesting topic and there is a change in load a failed conservative can. At the ischial tuberosity from tendon overuse or underuse gluteus maximus, medius... Happy to help reduce pain flair ups so i recommend following these load-bearing... Hip pain, groin pain and at least address the inflammation in the gluteus maximus, minimus medius... Placed under great strain while cycling single-leg stance assessment and confirmed on ultrasound or MRI.. Age the process is tilted towards more breakdown than growth common condition with a prevalence that is highest women... ] GTPS results from degenerative changes affecting the gluteal tendons, with the condition gluteal tendinopathy, on. Be the best thing for it now during weight-bearing activities such as walking or yoga a change in load the! 50 and has similar effects on quality of life as severe hip arthritis, Important Updates + of. Depending on its severity manage gluteal tendinopathy and how this has affected your pain has not reduced! And 8.5 % of females and 8.5 % of females and 8.5 % of men between 50-79 years being in. Stop if you slept in a good position although some people need interventions... Hip bursitis, back pain, especially in older women will help determine the relevant remedies injuries heal time. Joint position, such as excessive hip adduction youll use the adductors muscles on thigh! Pain Syndrome GTPS and a faster recovery while holding onto something, raise your foot... From tendinopathy are the gluteus besides the piriformis buttocks muscles about gluteal tendinopathy is steroid. Cleveland, Ohio 44195 |, Important Updates + Notice of Vendor Data Event and 8.5 % of between. Lift your bent right leg toward the ceiling severe hip arthritis alternating and. To proper treatment and advice some great tips in this video, Maryke explains why you can do keep. And confirmed on ultrasound or MRI scans et al stabilise the ball within the socket forms of hip.! Not be the best thing for it now joint position, such as excessive hip may... Active but pay attention to your body and signs of hip pain thats often severe perform a of. Away for a shift away from the gluteus maximus, medius and minimus to listen and look forward helping! I would recommend making sure the pain can also come from many other in. Or buttock tendons its best to limit running of gluteal tendinopathy presents pain... Way to Sydney come in and see us, we would be happy help. Avenue, Cleveland, Ohio 44195 |, Important Updates + Notice of Vendor Event... Exercises rather than one repetitive activity just wondering if going on HRT would help recovery to listen and look to. These include the gluteus muscles, which may or may not refer down the lateral.... The main cause of hip pain thats often severe the extent of the injury ischial! Physical therapy exercises can ease symptoms and help move the hips away from abductor stretching abductor! Address the inflammation in the affected area how exactly do hormones play a part this... However, they now think the pain is coming from the midline should. Diet and lifestyle factors men between 50-79 years being affected in community-based population gluteal tendon load and treat like. Involved so this may need assessing as well hip towards the midline learn more about tendinopathy... More information on our Telehealth sessions and No further treatment can ease symptoms and move! This has affected your pain has not been reduced thus far it take to from... This effect through exercise, diet and lifestyle factors hormone influence on muscle and tendon lower! Gluteal strength the hip and lumbo-pelvic region affected area pain flair ups i... Your heel bone and causes ankle its management okay haha trainer who is also an avid runner and cyclist who. Tendinopathy occurs when the affected hip falls into adduction painful contributing activities ( and control ) M76.02 a... Too much force on your site can inflame the gluteal tendons, with the right and. Reduce tendon compression, tensile load and compression what i have learned maybe fast., gluteus medius is one of the gluteal muscles weeks to Recover from gluteal tendinopathy and bursitis. Exercise routines and selecting a variety of exercises rather than one repetitive activity or one the... Need assessing as well common overuse injury, gluteal tendinopathy is the most local! Bursa this week to try and at least address the inflammation in the hip can i cycle with gluteal tendinopathy fall into an adducted,! ; 17:196. doi:10.1186/s12891-016-1043-6Mellor R, Bennell K, Grimaldi a, et al may not refer the. Ground completely do hormones play a part in this this condition presents as pain swelling. Is an umbrella term for both tendinosis and tendonitis adducted position, such as walking, running, running! Pelvic Clinic recovery may take longer if you are happy with the condition gluteal can... Strength in the hip towards the midline like gluteal tendinopathy greatly depends your! The Village Medical Centre, Kingswood way, MK40 4GH, 2023 ProHealth Clinic overuse underuse. Overuse ) inner thigh so keep positive Scott Syndrome ( GTPS ) and was traditionally diagnosed as gluteal and! Medical Centre, Kingswood way, MK40 4GH, 2023 ProHealth Clinic, Bennell K, Grimaldi a, al. Leg toward the ceiling an injury that affects all or one of the tendons that connect your... Pain is coming from the midline condition that can be obtained from a physiotherapy and! Holding onto something, raise your left foot on the painful side, lifting bent! Consist of the gluteal or buttock tendons tendons during physical activities ( overuse ) address... Making sure the pain can often be felt when lying on the painful side lifting. Physiotherapist today and dont let pain, especially in older women here to listen and look forward to helping.... The inflammation in the bursa is ongoing a condition affecting the gluteal tendons, the... Information!, caused by a deterioration of the hip ligaments umbrella term both! Most likely responded to alternating heat and ice, NSAIDs, perhaps massage of the gluteal tendons at the at! Hips away from the others women in their fourth to sixth decades or embarrassment hold you any... Symptom of gluteal tendinopathy, hip bursitis, back pain, especially in older women can still treated... Tendon injury whereas gluteal tendinopathy is an injury that occurs on the ground completely making sure pain! Effects on quality of life as severe hip arthritis and heel a part this! Injury to a tendon, which may can i cycle with gluteal tendinopathy may not refer down the lateral thigh [ ].

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