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Best practice for patients with gluteal tendinopathy: A qualitative exploration of expert clinical reasoning and management.

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Τίτλος: Best practice for patients with gluteal tendinopathy: A qualitative exploration of expert clinical reasoning and management.
Συγγραφείς: Bremer T; Sports and Exercise Medicine, William Harvey Research Institute, Queen Mary University of London, London E1 4DG, UK. Electronic address: t.bremer@qmul.ac.uk., Lack S; Sports and Exercise Medicine, William Harvey Research Institute, Queen Mary University of London, London E1 4DG, UK. Electronic address: s.lack@qmul.ac.uk., Fearon A; Faculty of Health, University of Canberra, Office 13, Clinical Education and Research Centre, UC Hospital, Canberra, Australia. Electronic address: Angie.Fearon@canberra.edu.au., Morrissey D; Sports and Exercise Medicine, William Harvey Research Institute, Queen Mary University of London, London E1 4DG, UK; Physiotherapy Department, Barts Health NHS Trust, London, UK; Podium Analytics, London, UK. Electronic address: d.morrissey@qmul.ac.uk.
Πηγή: Physiotherapy [Physiotherapy] 2026 Sep; Vol. 132, pp. 101871. Date of Electronic Publication: 2025 Dec 17.
Τύπος έκδοσης: Journal Article
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Chartered Society of Physiotherapy London Country of Publication: England NLM ID: 0401223 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-1465 (Electronic) Linking ISSN: 00319406 NLM ISO Abbreviation: Physiotherapy Subsets: MEDLINE
Imprint Name(s): Publication: London : Chartered Society of Physiotherapy London
Original Publication: London.
Ιατρικοί όροι (MeSH): Tendinopathy*/therapy , Tendinopathy*/rehabilitation , Clinical Reasoning* , Physical Therapy Modalities*, Humans ; Female ; Buttocks ; Male ; Adult ; Qualitative Research ; Middle Aged ; Interviews as Topic
Περίληψη: Background: Best management for the common, severe condition of Gluteal tendinopathy has not been determined, with exploration of expert clinical reasoning notably absent. We aimed to inform clinical care by exploring how experts manage GT.
Methods: An interview topic guide, iteratively developed with experts, was used alongside an online interview prompt with purposively sampled international inter-disciplinary experts during online, semi-structured interviews. Iterative framework and content analysis using a positivist stance was performed alongside recruitment until adequate information power was reached.
Results: Twenty participants including physiotherapists, physicians, and surgeons (14 males, 6 females) were interviewed for a mean (SD) of 52 (20) minutes yielding 5 main themes of: Therapeutic alliance: Developing a positive therapeutic alliance through emphatic engagement. "Give them a stack of reassurance and listen to their story";Service Delivery and multidisciplinary team involvement: "Patients get 45 min…they get a package (of care) …"; Clinical reasoning: "I usually use three things in a patient's specific context. So, it's going to be about the quality of sleep. Yeah, their ability to walk, and their ability to sit and get up from sitting…."; Exercise principles: "frontal plane control being priority for gluteal tendinopathy"; Specific interventions"You need to further that education as you go along. But patients can only take in so much at once."
Conclusion: Expert reasoning prioritises personalised exercise and education as the core management approach in a reflexive therapeutic relationship incorporating individually staged interventions. Future work needs to focus on incorporating expert reasoning into clinical guidelines. CONTRIBUTION OF THE PAPER.
(Copyright © 2026 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Competing Interests: Conflict of Interest The authors have no conflict of interest to declare.
Contributed Indexing: Keywords: Best practice; Clinical reasoning; Management; Qualitative; Tendinopathy
Entry Date(s): Date Created: 20260128 Date Completed: 20260731 Latest Revision: 20260731
Update Code: 20260801
DOI: 10.1016/j.physio.2025.101871
PMID: 41605724
Βάση Δεδομένων: MEDLINE
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  Data: Background: Best management for the common, severe condition of Gluteal tendinopathy has not been determined, with exploration of expert clinical reasoning notably absent. We aimed to inform clinical care by exploring how experts manage GT.<br />Methods: An interview topic guide, iteratively developed with experts, was used alongside an online interview prompt with purposively sampled international inter-disciplinary experts during online, semi-structured interviews. Iterative framework and content analysis using a positivist stance was performed alongside recruitment until adequate information power was reached.<br />Results: Twenty participants including physiotherapists, physicians, and surgeons (14 males, 6 females) were interviewed for a mean (SD) of 52 (20) minutes yielding 5 main themes of: Therapeutic alliance: Developing a positive therapeutic alliance through emphatic engagement. "Give them a stack of reassurance and listen to their story";Service Delivery and multidisciplinary team involvement: "Patients get 45 min…they get a package (of care) …"; Clinical reasoning: "I usually use three things in a patient's specific context. So, it's going to be about the quality of sleep. Yeah, their ability to walk, and their ability to sit and get up from sitting…."; Exercise principles: "frontal plane control being priority for gluteal tendinopathy"; Specific interventions"You need to further that education as you go along. But patients can only take in so much at once."<br />Conclusion: Expert reasoning prioritises personalised exercise and education as the core management approach in a reflexive therapeutic relationship incorporating individually staged interventions. Future work needs to focus on incorporating expert reasoning into clinical guidelines. CONTRIBUTION OF THE PAPER.<br /> (Copyright © 2026 The Authors. Published by Elsevier Ltd.. All rights reserved.)
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  Data: Conflict of Interest The authors have no conflict of interest to declare.
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