Hi Mike, and all of the folks who've written in about the gluteus medius tear. First, I apologize for being so tardy in replying, but we've had some extended (older) family illnesses - so that took priority, such that I wasn't even looking in on this old thread. In any case, I feel for all of your concerns, but have learned the the GM tendon is so pivotal in everything we do (they say it's analogous to the rotator cuff in the shoulder) - and although I didn't feel anything for a few week, when it did kick in, my low back was throbbing intensely. It's now about 2.5 years, and although some quacky PTs say we can "bang" the scar tissue out, that's pure myth. And we all know that tendons don't heal well because of a having a low blood supply and being so pivotal in so many functions. Eva in Australia had surgery about a year ago (and is doing VERY well), but due to some curvature in my spine, about 25 degrees (which isn't a lot to the human eye) - they say it makes a person "load" left and 'rotate' a bit - which I still don't get. All I know is that for a while, I couldn't walk up stairs well, and there was a somewhat 'antalgic' gait - but one doctor thinks that the scar tissue provides some stability in its way - vs. what a tendon tear would be like without it (i.e., MUSH, in the part in which it was affected). Sleep is terrible, especially with throbbing that never stops, and then standing w/o pain is next. However, sitting is okay, and that relates to what I do for a living (writing academic grants and editing manuscripts).
BTW, I think we all need to develop more core strength, and though I used to be an excellent swimmer, just walking in a pool without any weight-bearing stress led to severe sternum pain - which one spine doctor said was from the rotation of the curve. They've tried many epidural steroid injections on me, all to no avail, since I seem to fall into the 45% whose body cannot absorb them. And although Eva did wonderfully with surgery, my curve probably wouldn't allow the screws and hardware to stay in place (not to mention loading L, which could probably disrupt the healing and retear it). I was pushed to do PRP, but I know 50 people who did without any success for many body parts - and I've read many articles on PubMed and nih.gov that call it a scam (even the NY Times)!
In any case, it seems that these kind of injuries take a toll on 'quality of life' - because without normal sleep, your life seems to revolve around the tear. One neurologist said that it's such a critical tendon, that it stabilizes the pelvis - so it's hard to even assess how much is amiss because of it. In the beginning, they took x-rays to rule out any factors of the coccyx or tailbone - but those were fine. And I wasn't savvy enough to ask for soft imaging - until a year later, when I knew that the throbbing was telling me something - and that's when the partial tear was found. Still, steroid injections and PT have not helped a bit - so maybe for me, it's been time, in the sense that there's no antalgic gait anymore, but I do still have throbbing in the low back (which could be from a host of issues, especially the curvature). The idea is that I was "out of whack" to some degree, and then the GM tear just threw everything out even more. I see that Lynda below is writing about full GM tears, but that wasn't my situation, even though it felt that way.
As we all get older (mid-40s now), wear and tear and micro-tears can do a number too - and some spine physicians think that even without my storage bin collapse (the event that seemed to elicit it) - it would've happened sooner or later anyway. Who knows, but trying to live with it has been the most unpleasant pain I've known - and as mentioned, steroid injections do. nothing for me, and I really shouldn't have surgery. So as they say, I'm caught between a rock and a hard place (as they say) - which we probably all are to some degree. And even though philosophy 101 in health matters tells us that the body tries to heal these things, I think that tendons are special issues (a long enough tendon is so strong, that it could hold a small car up in a tree) - but a damaged tendon can truly turn to 'mush,' hard as that it is to say. Not ALL mush, since there's some tendon left that can regenerate, and although they're all pushing PRP, and now Tenex (no independent studies have been done on it) and stem cells - stem cells need a number of years of being refined before they can safely be given (even though clinics are springing up everywhere, but it can cause a number of problems if you guys want to read up on, or a tumor called a teratoma). So I'd stay away from all these things until they're refined. PRP is not even clear yet on the optimal amount of platelet cells to administer - so if they give too little or too much, it probably won't do a thing. Plus, anything injected into us is perceived by the brain as an injury, and certain chemicals and collagen go to the injured area (from the supposed solution, not even the original tear).
It has definitely made a mess of things, and no analgesics do a thing for me either - so sometimes it just simply elicits tears. In any case, until I learn more, please feel free to write and ask away. I do know about the IT band and the piriformis and the glute max, and the like - but I've come to feel like a specialist in GM tendon tears which I've seen can wreak so much havoc. The body and brain are meant to try to heal themselves - but I've had wrist fractures from jogging at night (straight into pot hole) - and they heal fine. So I think that tendons are a very fine-tuned part of us that have special jobs, without which they can inflict so much suffering. Still, my regular doctor knows how I describe the suffering, but he says that the scar tissue alone may be giving you more stability in the area than you know. Plus, don't forget that SURGERY comes with plenty of risks too, which is why so many surgeons specialize in "revision surgery" - so it boils down to persistence and reading on our own and being very careful with what's being promoted. I actually think that surgery can cause more problems than what we might each be facing - but from the other side, it often feels as if we cannot live with it either. So what's the answer, since pain is basically intolerable - and as I wrote earlier, can deplete most of the QoL we used to know.
Would love to hear from all of you, and I'll do my best to answer what I've come to understand - but all the old consumer warning comes into play: BUYER BEWARE, especially since these clinics for PRP or Tenex or stem cells are springing up everywhere, since they know desperate people will do much more than they should. I've worked with a hospital Pain Mgt. department - and although nothing has gone wrong, nothing has helped either.
Hope to hear from you guys soon !!! -Annie