James, 34, had been managing a painful hip for the best part of a year. He had stopped playing Sunday league, and had started to accept that might be permanent.

The assessment

An ultrasound scan showed gluteal tendinopathy with an inflamed bursa — a common but frequently missed cause of lateral hip pain.

The treatment

A guided injection settled the inflammation enough for him to tolerate loading. From there, the work was progressive strengthening: isometrics first, then heavy slow resistance, then running.

The outcome

Fourteen weeks later he played a full ninety minutes. The injection bought the window; the rehabilitation is what kept it open.

PT

Physivity Team

Clinical Specialist in Musculoskeletal Ultrasound & Ultrasound-Guided Injections at Physivity, Stanmore.