Are you experiencing pain on the outside of your hip? The hidden condition causing your hip pain could be Greater Trochanteric Pain Syndrome (GTPS), also known as trochanteric bursitis. In this blog, I’ll explore why this often-overlooked condition is a common cause of hip pain, what GTPS is, its causes, and how the team at My Sports Chiropractor can help you recover.

What Is Greater Trochanteric Pain Syndrome (GTPS) – The Hidden Condition Behind Hip Pain?

Despite being one of the most common causes of pain on the outside of the hip, GTPS is often the hidden condition behind persistent hip pain that many people don’t realise they have. GTPS is an umbrella term used to describe pain and dysfunction in the lateral hip region, particularly around the greater trochanter, which is the bony prominence on the side of your hip. The condition is primarily caused by inflammation or degeneration of the gluteal tendons (gluteus medius and minimus) and/or the trochanteric bursa, a fluid-filled sac that reduces friction in the hip.

GTPS was previously referred to as “trochanteric bursitis”, but recent research suggests that tendinopathy plays a larger role than bursitis in most cases (Grimaldi & Fearon, 2015). It is particularly common in women over 40 and/or in individuals who engage in repetitive hip movements, such as runners and walkers.

 

 

 

 

 

 

 

 

https://complete-physio.co.uk, https://aidyourtendon.com

 

If you’ve been wondering what’s causing your hip pain, particularly pain when lying on your side or walking, GTPS may be the hidden culprit. GTPS is often caused by a combination of factors that lead to excessive stress on the hip tendons and bursa, including:

• Weakness or Dysfunction in the Gluteal Muscles: Poor strength or control in the gluteus medius and minimus muscles can lead to overloading of the tendons.
• Repetitive Movements or Overuse: Activities such as running, cycling, or prolonged standing can increase stress on the hip structures. Especially when your load exceeds your capacity to heal.
• Poor Biomechanics: Improper gait patterns, leg length discrepancies, or excessive hip adduction (crossing of legs) can contribute to tendon irritation.
• Hormonal Changes: Postmenopausal women have an increased risk of developing GTPS due to hormonal influences such as a decline in Estrogen levels affecting tendon health.
• Direct Trauma or Injury: A fall or a direct blow to the hip can trigger inflammation and pain.

 

How Long Does It Take to Heal?

Healing time for this common but often hidden cause of hip pain varies depending on the severity of the condition and adherence to treatment. Most patients experience improvement within 6 to 12 weeks with proper care, including manual therapy, exercise, and activity modifications. However, chronic cases may require a longer duration of care.

 

How can we help?

The team at My Sports Chiropractor use a multimodal approach to help manage and treat GTPS. This includes:

• Education, activity/exercise modification
• Soft Tissue Therapy
• Joint Mobilizations/manipulation
• Exercise Rehabilitation
• Dry Needling
• Shockwave therapy
• Taping

 

Some Exercises to try out!

A structured exercise program can be one of the most effective adjuncts to treatment for GTPS. Below are some simple yet effective exercises to help strengthen the gluteal muscles and reduce pain:

1. Isometric Hip Abductions:
   • Lie on your side with the affected leg on top.
   • Press your top leg against a resistance band or a wall without moving it.
   • Hold for 30 seconds, repeat 3-5 times.

 

2. Modified Clamshell:
   • Lie on your side with your top knee bent at 90 degrees.
   • Keep the bottom leg straight whilst keeping the pelvis stable.
   • Raise the top leg and then slowly lower it towards the floor and bring it back up, repeat for 2-3 sets of 10-15 reps.

 

 

 

3. Side-Lying Hip Abduction
   • Lie on your side with legs stacked.
   • Keep the top leg straight and lift it about 30-45 degrees.
   • Lower slowly, repeat for 2-3 sets of 10-12 reps.

 

 

 

4. Bridging with Resistance
   • Lie on your back with knees bent.
   • Lift your hips while squeezing your glutes.
   • For added resistance, place a band around your knees and push outward.
   • Perform 2-3 sets of 10-12 reps.

 

https://au.physitrack.com/exercises

 

 

Greater Trochanteric Pain Syndrome can be a frustrating and painful condition, and for many people it remains a hidden cause of ongoing hip pain for months before they receive the correct diagnosis. If you’re struggling with persistent pain on the outside of your hip, don’t ignore it. Identifying the hidden condition behind your hip pain is the first step towards recovery. If you’re struggling with persistent hip pain that’s stopping you from doing the things you want to do, feel free to give us a call on 0435 819 286 or book an appointment online so our team can get you moving pain-free again as soon as possible!

David Toomeh
 

References

• Allison, K., Vicenzino, B., Bennell, K., & Grimaldi, A. (2016). Hip biomechanics and tendinopathy. Journal of Orthopaedic & Sports Physical Therapy, 46(6), 466-475.
• Fearon, A. M., Stephens, S., Cook, J. L., & Gaida, J. E. (2014). The role of hormones in tendinopathy. Clinical Journal of Sport Medicine, 24(3), 190-194.
• Grimaldi, A., & Fearon, A. (2015). Gluteal tendinopathy: Integrating research and clinical practice. British Journal of Sports Medicine, 49(14), 868-869.
• Harris, I. A., Sidhu, V., Naylor, J. M., & Mittal, R. (2017). Physiotherapy management of hip pain. BMJ Open Sport & Exercise Medicine, 3(1), e000242.
• Mellor, R., Grimaldi, A., Wajswelner, H., & Bennell, K. (2018). Exercise for gluteal tendinopathy: A randomized controlled trial. BMJ, 361, k1662.
• Rompe, J. D., Segal, N. A., Cacchio, A., & Furia, J. P. (2009). Shockwave therapy for chronic greater trochanteric pain syndrome. The American Journal of Sports Medicine, 37(10), 1981-1990.
• Stuber, K. J., Bruno, P., Sajko, S., & Hayden, J. A. (2012). Chiropractic treatment of hip osteoarthritis: A systematic review. Journal of Manipulative and Physiological Therapeutics, 35(5), 367-374