Boston Marathon athlete with gluteal tendinopathy: a case report

This case report demonstrates the importance of progressive loading in our older adult athletes who deal with gluteal tendinopathy. This condition most often affects people ages 40 and older. As the demographics of the nation are shifting towards an older population, the prevalence of this condition might also increase. Despite some goals not being met, this case study shows that common goals such as strength do not always translate into improvement in function and quality of life. As a profession, physical therapists need to be prepared to deal with the sport-specific goals that our older athletes have, while managing the challenges of an often-slow rehabilitation process. The patient is a 55 year old Boston Marathon participant. During training he started to experience right lateral hip pain described as achy and sometimes sharp. He performed in the Boston Marathon, however he was unable to finish the race without walking intermittently due to the pain. The patient was seen for 8 sessions, which comprised of gluteal isometric and isotonic strengthening exercises, followed by neuromuscular control exercises. The patient continued to run and increased his volume while receiving treatment. The patient was able to reduce pain from 7/10 to 3/10 while increasing their volume. They improved in pain, and function as seen in two self-reported outcome measures (Lower Extremity Functional Scale, and Hip Outcome Score). The patient decreased in strength according to data collected by a handheld dynamometer, but he achieved his sport-specific goal of decreasing pain while increasing running distance.