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As just another kook discussing medical issues on the interwebz I'm here to commerisate rather than offer actual medical advise. I've been dealing with glute tendonitis for sometime. I too had a surgery in the region (FAI - hip preservation surgery). Initially I thought I had an issue with my back, but my glutes turned off, probably due to the hip being trashed and another underlining issue I have with my SI joint. I addressed the glute issues before my surgery. After the surgery I continue to deal with the glute issues and am religious with my PT exercises. 

It took my PT less than a minute to catch the issue. Specifically my glute medius and glute maximums had shut down. This put A LOT of strain on my piriformis. This pissed the sciatic nerve off. My IT band also overcompensated. A real mess. It was mostly adduction that really got things ramped up. My lifestyle is what overdid it. 

I absolutely had to take MONTHS off. I stuck with a strict PT regime. I went to each session with a detailed description of symptoms.  

Again take these bullet pts w a grain of salt. Maybe you have addressed these things maybe not, I'm  just offering the major points I was dealing with that you can think about before your next PT appt and possibly discuss with a professional. Im sorry to hear you only have one session left.

-Adduction vs abduction (which triggers pain and makes the tendonitis worse)

-to stretch vs to tighten (the muscles/tendons/etc.)

-isolating specific muscles 

-nerve gliding 

-foam rolling

-heat vs ice

-massage (who doesn't love a butt rub?)

Good luck. Feel free to DM me. I don't want to offer up exactly what I was doing/still do as far as PT on this thread as it could make things worse for someone else dealing with glute issues.

Hi Alex!

I'm sorry to hear that you're dealing with this pain and that it's limiting you from participating in the activities you enjoy. Tendinopathy is a tricky thing to treat because the long-term fix is strengthening but you have to do that while managing symptoms. I am a physical therapist who works with climbers so this is something I see often. Resting may be okay advice at first but I would be cautious with too much of that because any strength you lose will cause your symptoms to be triggered more quickly. I'll leave guidelines below for how much discomfort is okay and how much is too much. 

I am also going to attach an article from The Climbing Doctor blog about dealing with tendon pain. It won't be as good as going to actual PT but it can help manage if your insurance will no longer cover PT services. (Although I would ask your PT or call your insurance company to see if there is any way you can appeal for more visits - sometimes insurance companies will start by offering 6 visits and then require an update on measurements before they approve more). Also if it's a priority and in your budget I would consider seeking out of network (cash-based) care from a PT who does not bill insurance (you'd have to pay out of pocket) to continue your care. Some climbing PTs will offer virtual assessments this way but depending on your area there may be someone local to you. 

In terms of continuing management, generally, it is helpful for people with this condition to avoid laying on or compressing the irritated side. Cupping is one of the only ways we can offer decompression so that can be a useful tool to help, especially when putting the cups on and doing exercises with them. This is also a condition that is exacerbated by inflammation so prioritizing hydration, vegetables, quality sleep, and cardio can all help mitigate inflammation levels. Avoiding alcohol, processed carbs/added sugars and red meats can also help limit inflammation. 

Overall, strength and persistence will be the key! It is not uncommon for tendinopathy to take 6-9 months to fully resolve but you should be seeing improvements in the short term to know you're on the right track.

Tendon Management Article

EXERCISE GUIDELINES

• RED is 5+/10 pain = STOP

• YELLOW is 3-4 = monitor 24 hour response to see if loading was appropriate or too much

• GREEN = 0-2 SEND IT

Don't hesitate to reach out if you have any questions! I wish you the best of luck in your rehab and getting back to all your activities!

I had a debilitating back spine issue- still do.
All the doctors would send me to orthopedic doctors who looked at my spine were certain that I didn’t have a bulging disc- a little bit but not enough to cause all that pain. I went through with all the back shots, PT but continued to go down hill and was in constant pain. My left leg would “switch off” without warning - so I had to quit mountaineering because you know falling over is not good.
The PT people were stumped, my doctors also. When they started talking about “walkers” I hit the lowest point in my life ever. Thoughts of suicide even. I was crying with the PA at my doctors office. She looked at my history, MRIs (3) and asked if I had ever seen a neurosurgeon? I hadn’t so she got me hooked up with one. Dr. Gill looked at the MRIs for about 5 minutes and pointed out that over time my nerves were disappearing due to the blood flow being cut off. The muscles had been dying off because of the loss of nerve function over the years. So I got lucky and my crummy HMO approved the surgery to fix me. Dr Gill and his team of about 15-20 folks worked for about 15 hours in surgery. When I came to at about 11 pm that evening I knew something had changed! The constant pain in my left ball was gone!
Six weeks of staying pretty much flat on my back with no bending, lifting or twisting at all wasn’t EZ but my wife helped me get through it. I now go to PT once a week, for the last 3.5 years, and am regaining my ability to walk but the process is so slow I can only gage my progress by looking back 6 months or so.
Good luck to you Alex, being injured really sucks, I hope you get the attention you deserve from “the doctors”.

Take care

Alex …. You deleted this. Weird- I still hope you get better.