Kinematics and kinetics during walking in individuals with gluteal tendinopathy

Kim Allison, Tim V. Wrigley, Bill Vicenzino, Kim L. Bennell, Alison Grimaldi, Paul W. Hodges

Lateral hip pain during walking is a feature of gluteal tendinopathy but little is known how walking biomechanics differ in individuals with gluteal tendinopathy. This study aimed to compare walking kinematics and kinetics between individuals with and without gluteal tendinopathy. Three-dimensional walking-gait analysis was conducted on 40 individuals aged 35 to 70years with unilateral gluteal tendinopathy and 40 pain-free controls. An analysis of covariance was used to compare kinematic and kinetic variables between groups. Linear regression was performed to investigate the relationship between kinematics and external hip adduction moment in the gluteal tendinopathy group. Individuals with gluteal tendinopathy demonstrated a greater hip adduction moment throughout stance than controls (standardized mean difference ranging from 0.60 (first peak moment) to 0.90 (second peak moment)). Contralateral trunk lean at the time of the first peak hip adduction moment was 1.2 degrees greater (P=0.04), and pelvic drop at the second peak hip adduction moment 1.4 degrees greater (P=0.04), in individuals with gluteal tendinopathy. Two opposite trunk and pelvic strategies were also identified within the gluteal tendinopathy group. Contralateral pelvic drop was significantly correlated with the first (R=0.35) and second peak (R=0.57) hip adduction moment, and hip adduction angle with the second peak hip adduction moment (R=-0.36) in those with gluteal tendinopathy. Individuals with gluteal tendinopathy exhibit greater hip adduction moments and alterations in trunk and pelvic kinematics during walking. Findings provide a basis to consider frontal plane pelvic control in the management of gluteal tendinopathy.