Lecture 1

Gluteaus medius tendinitis doesn't exist without L5 metameric syndrome

  • Dr. med. François DASQUE

    Doctor of osteopathy
    Sports medicine

Practice of orthopedics and osteopathy of Bigorre (COOMBI)
5 rue Léon Dalloz
F-65000 Tarbes


How many times have you had to treat lateral hip pain that has already benefited from several infiltrations of the gluteus medius muscle?

For many of our fellow doctors tendinitis of the middle gluteal muscle means physiotherapy and infiltration.

Why? Because many of our collegues do not have the ability to make the link between peripheral muscular impairment and vertebral dysfunction of the corresponding metamere. The main reason is that we assume an anatomical lesion and not sufficiently enough functional neurology. For us osteopathic physicians, this is obvious. Our diagnostic precision is what makes us being doctors!

A hip pain is never just a pain in the hip or a mobilizing tendon. It is also always the consequence of a new organization of the muscular balance, the proprioception, sometimes painful, in connection with the metamere on which the muscles concerned depend.

That’s why we think it’s important to disseminate the diagnostic concept of metameric syndrome regardless of the manual treatment technique we choose, that it focuses on treating the muscle or muscles concerned and/or that it goes through the manipulation of the corresponding vertebral dysfunction.

The hip is an easy joint to replace on the articular plane and difficult to balance on the muscular plane. The L5 metameric impairment is very often associated with an L3 impairment. Why? Does the archaic mechanism of triple bending play a role? In any case we can no longer ignore neurophysiology at the segmentary level (metameric syndrome) and suprasegmentary level (inter-segmental and suprasegmental controls) so that our patients benefit from a complete management.

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1996 Graduated from the Faculty of Medicine of Toulouse (France) as a specialist in Physical Medicine and Rehabilitation

Medical practice in Tarbes in the Pyrenees with a physical, sports and osteopathic medicine activity

Since 2003 teacher and responsible for education for the diploma of manual medicine and medical osteopathy in Toulouse.

Secretary and professor at AMOPY (Association of Osteopathic Doctors of the Pyrenees)

Vice-president of FEMMO (The French-speaking Federation of
Teaching and Study Groups of
Manual Medicine and Osteopathy)

Myember of SOFMMOM (French Society of Orthopaedic Manual Medicine and Osteopathic Medicine)