What is Greater Trochanteric Pain Syndrome (GTPS)?
Greater Trochanteric Pain Syndrome (GTPS) is a condition that causes pain on the outer side of the hip, often making simple activities like walking, climbing stairs, or even lying on the affected side uncomfortable. GTPS affects the tendons and bursae around the greater trochanter, the bony prominence on the outer hip. This condition is often linked to gluteal tendinopathy and inflammation of the trochanteric bursa, making it a common issue among active individuals and those with poor hip mechanics.
Causes of GTPS: Why Does It Develop?
Several factors contribute to the development of GTPS, including:
Repetitive Stress: Activities like running, walking, and prolonged standing can overload the hip tendons.
Muscle Weakness or Imbalance: Weak gluteal muscles place excess strain on the hip’s stabilising structures.
Poor Hip Mechanics: Abnormal movement patterns, poor posture, or altered gait can increase stress on the tendons.
Trauma or Injury: A direct impact to the hip or sudden increase in physical activity can trigger symptoms.
Hormonal and Age-Related Changes: Women, particularly postmenopausal women, are at higher risk due to hormonal influences on tendon health.
Common signs and symptoms of GTPS include:
Pain on the outer side of the hip, which may radiate down the thigh.
Discomfort when lying on the affected side.
Increased pain during prolonged standing, walking, or stair climbing.
Tenderness over the greater trochanter when pressed.
A “catching” or weakness feeling in the hip with movement.
Symptoms of GTPS
A physiotherapist will assess your symptoms, medical history, and perform specific movement tests to identify GTPS. In some cases, imaging tests like ultrasound or MRI may be recommended to rule out other conditions, such as hip arthritis or a stress fracture.
Effective Treatment Approaches for GTPS
Phase 1: Pain Management and Protection
The initial focus is on reducing pain and avoiding activities that aggravate symptoms. Strategies include:
Activity Modification: Avoid prolonged standing, excessive walking, lying on the affected side, and crossing legs when sitting.
Ice Therapy: Apply ice packs to the affected area for 15-20 minutes to reduce inflammation.
Pain-Relief Modalities: Techniques like taping, soft tissue massage, and dry needling may help. Anti-inflammatory medication can sometimes be recommended to manage pain and inflammation as well.
Gait Retraining: Adjusting walking mechanics to reduce stress on the hip tendons.
Phase 2: Restoring Strength and Mobility
Once pain subsides, the focus shifts to improving hip stability and flexibility. Key components include:
Targeted Strength Exercises: Strengthening the gluteal muscles (gluteus medius and minimus) to improve hip support.
Stretching Routines: Addressing tight muscles that may contribute to poor movement patterns.
Balance and Proprioception Training: Enhancing control and coordination of hip movement.
Phase 3: Returning to Normal Activities and Sport
Gradual reintroduction of activities ensures a safe recovery. This phase includes:
Functional Movement Training: Preparing the body for daily tasks or sports-specific movements.
Progressive Loading Exercises: Gradually increasing resistance to strengthen the hip muscles further.
Long-Term Injury Prevention Strategies: Ongoing strength training and mobility exercises to prevent recurrence.
Returning to Exercise or Sport
Before resuming high-impact activities, it’s essential to:
Receive clearance from a physiotherapist.
Start with low-impact exercises before progressing.
Continue strengthening and stability exercises.
Avoid sudden spikes in activity levels to prevent re-injury.
Diagnosing and Treating GTPS
The Role of Physiotherapy in GTPS Recovery
A structured physiotherapy program is the most effective way to manage GTPS. Research supports targeted exercise therapy as a primary treatment, often leading to better outcomes than injections or surgery. A physiotherapist will design a personalised rehabilitation plan to restore function and prevent long-term issues.
If you’re experiencing persistent hip pain or discomfort, don’t ignore it. Seeking professional physiotherapy care early can prevent the condition from worsening and help you get back to your normal activities faster. Contact Melbourne Physio Clinic today for expert assessment and tailored treatment.