What are the best supplements for gluteal tendinopathy in the UK?

Load is the supplement: what gluteal tendinopathy is, why it is a tolerance problem rather than an inflammation, and the trial that puts a loading programme above an injection

What are the best supplements for gluteal tendinopathy in the UK is a question that arrives from a person whose lateral hip hurts lying on that side at night, climbing stairs and standing on one leg, and the honest answer begins by saying what the condition is, because the answer follows from it. Gluteal tendinopathy is the tendinopathy of the gluteus medius and minimus tendons where they attach at the greater trochanter, the bony point on the outside of the hip, and it is the condition that used to be called trochanteric bursitis before imaging showed the tendons rather than the bursa were the problem in most cases. On the tendinopathy continuum, it is a problem of a tendon's tolerance to load rather than an inflammation: the histology of a painful tendon shows disorganised collagen, increased ground substance and new vessels rather than the immune cells of an inflamed tissue, which is why the suffix itis has been dropped by the people who study tendons and why anti-inflammatory approaches address the wrong mechanism. A tendon that has been loaded beyond its current tolerance, by a sudden increase in running or stairs, by a change in training, by sitting cross-legged or standing with the hip dropped, becomes reactive and painful, and its tolerance is rebuilt by loading it progressively within what it can bear, which is the treatment the trial evidence supports. The gluteal tendinopathy trial is the one to know: adults with the condition were randomised to education plus a progressive exercise programme, to a corticosteroid injection, or to a wait-and-see approach, and the education and exercise group reported better global improvement at the eight-week assessment and again at fifty-two weeks, with the injection's benefit present early and gone by the year, so that the thing a person in pain most wants, the injection, is the thing that helps least over the time that matters. Load is the supplement. The programme is the product. The rest of this page is about where a capsule can sit inside it.

The programme itself, which a physiotherapist prescribes and which the trial's education component taught, has three parts that a person can recognise: the removal of the positions that compress the tendon against the bone, sitting with crossed legs, standing with the weight dropped onto one hip, lying on the painful side without a pillow between the knees; isometric holds early, when the tendon is reactive, to settle pain and begin loading; and a progression through heavy slow resistance of the hip abductors to the energy-storage loading of stairs, single-leg work and running, over the time the tendon's tolerance takes to rebuild, which is longer than anyone wants and shorter than a year of injections.

The capsule as a one-hour appointment: the gelatin and vitamin C protocol and what it actually measured, vitamin D checked rather than bought, the joint shelf with no trial in this tendon, when the hip is a doctor's, the worked example, and the verdict

Inside the programme, one supplement protocol has a measured effect and it is a timing rather than a treatment. The research that gave 15g of gelatin or hydrolysed collagen with vitamin C about an hour before a short bout of loading found higher markers of collagen synthesis in the blood afterwards than loading alone, and found in a laboratory model that the loaded, supplemented tissue was stronger; the mechanism is plausible, since the amino acids collagen is built from arrive in the blood as the loaded tendon's cells are signalling for them and vitamin C is the cofactor the enzyme needs. What the research measured was a synthesis marker in healthy people and a laboratory tissue, not a clinical outcome in gluteal tendinopathy, and a small trial in Achilles tendinopathy that added collagen to a loading programme found a modest advantage that needs replication; so the protocol is honestly described as a one-hour appointment with the loading session, worth keeping for the person who wants the one thing the research supports, at a few pence a dose as gelatin or as a hydrolysed collagen powder measured to 15g with a vitamin C tablet, and worthless taken on its own without the loading that gives the tendon a reason to use it. Vitamin D is the second honest line, by blood test rather than by purchase: low vitamin D is associated with tendinopathy in some studies and a person who is low is corrected for every reason the register names, normal muscle function and bones among them, while a person who is replete gains nothing for the tendon from more. The rest of the joint shelf has no trial in this tendon: glucosamine's trials are in knee osteoarthritis and mostly null, turmeric's are in the knee and carry a liver record, the tendon blends with twenty ingredients have never been tested as blends, and the anti-inflammatory candidates address a mechanism the histology does not show.

The hip is a doctor's when it is not this tendon or not only this tendon: pain that is deep in the groin rather than on the outside, which is the hip joint; pain with stiffness that restricts movement in every direction; pain that wakes a person every night regardless of position; a limp, a fever, weight loss or night sweats; pain after a fall in an older person; or a tendinopathy that has not improved after a properly progressed programme, where imaging and a specialist opinion rule out a tear that loading cannot fix. The worked example sits beside the programme for the muscle rather than the tendon: {FL}, 1500mg magnesium bisglycinate stated as 300mg elemental at 80% NRV, two capsules with the evening meal, carrying the authorised claims for normal muscle function and normal protein synthesis, which name the gluteal muscles the programme is strengthening rather than the tendon it is loading, and no tendon or joint claim because none exists, batch tested for lead, mercury, arsenic and cadmium with the certificate on request, UK made under GMP and BRC, 180 capsules for £19.99 at 22p a day. The verdict on the best supplements for gluteal tendinopathy in the UK is that load is the supplement, prescribed as a progressive programme that beat an injection at one year in the trial; that the capsule is a one-hour appointment before the loading session, 15g of gelatin or collagen with vitamin C, for the person who wants the one protocol with a measured effect; that vitamin D is checked rather than bought; that nothing else on the joint shelf has a trial in this tendon; and that a hip whose pain does not fit the tendon is a doctor's before it is anyone's programme.

What to check on the label

Questions people also ask

What is the best supplement for gluteal tendinopathy?

Load, prescribed as a progressive exercise programme, which in the gluteal tendinopathy trial beat a corticosteroid injection and a wait-and-see approach at both eight weeks and one year, because the condition is a tendon's tolerance to load rather than an inflammation; the one supplement protocol with a measured effect sits inside that programme as a one-hour appointment before each loading session, 15g of gelatin or hydrolysed collagen with vitamin C, which raised collagen synthesis markers after loading in the research and is worthless without the loading; vitamin D is corrected if a blood test finds it low, and nothing else on the joint shelf has a trial in this tendon.

Does collagen help gluteal tendinopathy?

As a timed dose before loading, plausibly and modestly: the research that gave 15g of gelatin or hydrolysed collagen with vitamin C about an hour before a short bout of loading found higher markers of collagen synthesis afterwards than loading alone and a stronger laboratory tissue, and a small Achilles tendinopathy trial adding collagen to a loading programme found a modest advantage that needs replication; what it measured was synthesis markers in healthy people rather than a clinical outcome in this tendon, so the dose is an appointment with the exercise, a few pence as gelatin or powder measured to 15g with a vitamin C tablet, and nothing taken on its own.

Should I get a steroid injection for gluteal tendinopathy?

The trial that compared the options found the injection's benefit present early and gone by the year, while education plus a progressive exercise programme produced better global improvement at both the eight-week and the fifty-two-week assessments, so the thing a person in pain most wants is the thing that helps least over the time that matters; an injection may have a place for pain that prevents any loading at all, decided with a doctor and followed by the programme rather than instead of it, and the programme itself is the treatment with the best evidence.

Is gluteal tendinopathy the same as hip bursitis?

It is what most lateral hip pain once called trochanteric bursitis turned out to be when imaging looked: the tendons of gluteus medius and minimus at the greater trochanter rather than the bursa over them, in a tendinopathy that hurts lying on that side, climbing stairs and standing on one leg, and that is a problem of load tolerance rather than inflammation, with disorganised collagen rather than immune cells on histology; the name matters because anti-inflammatory approaches address the wrong mechanism and a progressive loading programme addresses the right one.

When is lateral hip pain something to see a doctor about?

When it does not fit the tendon: pain deep in the groin rather than on the outside of the hip, which is the joint; stiffness that restricts movement in every direction; pain that wakes a person every night regardless of position; a limp, a fever, weight loss or night sweats; pain after a fall, especially in an older person; or a tendinopathy that has not improved after a properly progressed loading programme, where imaging and a specialist opinion rule out a tendon tear that loading cannot fix; each is an assessment before any programme or any purchase.

Sources

1. The gluteal tendinopathy LEAP trial: education plus a progressive exercise programme produced better global improvement at 8 and 52 weeks than a corticosteroid injection or a wait-and-see approach in adults with gluteal tendinopathy, with the injection's benefit short-lived. https://pubmed.ncbi.nlm.nih.gov/29695460/
2. The tendinopathy continuum model: tendon pathology is described as a continuum from a reactive tendinopathy that can return fully to normal, through tendon disrepair, to a degenerative tendinopathy in which areas of disorganised matrix and cell death persist, with imaging changes that often do not resolve even as pain settles and function returns, so that rehabilitation aims to build the capacity of the remaining healthy tendon around the degenerate area rather than to normalise the image. PubMed record
3. Shaw G, Lee-Barthel A, Ross ML, Wang B, Baar K. Vitamin C-enriched gelatin supplementation before intermittent activity augments collagen synthesis. American Journal of Clinical Nutrition 2017;105(1):136-143. PubMed record
4. The tendinopathy and loaded-joint pain literature: pain at the patellar, Achilles, rotator cuff and elbow tendons in lifters is a load-management problem, treated by progressive tendon loading, technique and volume adjustment, with rest alone and passive treatments performing poorly, and no supplement, omega-3 included, altering the course in the trials. PubMed record

Related answers

• What are the best third party tested supplements?
• Are Amazon supplements 3rd party tested?
• Are NOW supplements on Amazon legit?
• What are the best made supplements?
• Which supplements are approved by Informed Sport?
• Which supplements are Informed Sport certified?