Greater trochanteric pain syndrome refers to a condition that causes pain on the outside aspect of the hip from either the gluteal tendons or the greater trochanteric bursa. Gluteal tendinopathy is an overuse or repetitive strain injury to the gluteus medius and gluteus minimus tendons that attach to the outside of your hip. Greater trochanteric bursitis refers to irritation of the bursa between your gluteal tendons and the bone underneath or the gluteal tendons and the IT band that lies over top.
Symptoms of greater trochanteric pain syndrome include:
- Pain and tenderness on the outside of your hip, which can radiate into the outside of your thigh
- Worse with lying on your side, prolonged sitting (especially when you initially stand up) or prolonged walking.
- Does not cause any sensory changes such as numbness or tingling
Treatment of greater trochanteric pain syndrome usually starts with a short period of trying to bring the daily loading on the tissues to within their tolerance levels. This will decrease their irritability. Identifying and modifying factors that have led to overloading is important at this point in time. Positions that cause compression of the tendon and bursa should be avoided. Compression comes from crossing your knee over midline (sitting with your legs crossed, lying on your side), standing with your hip poked out to the side or many glut stretches. Stretching is not typically advised for gluteal tendinopathy.
This is followed by a program of progressive loading and strengthening of the gluteus medius and minimus, other hip muscles and the core. This strengthening program is crucial for the successful treatment of this condition.
Studies of the effect of exercise on gluteal tendinopathy conclude that exercise has a high treatment success rate. There are other treatment options available, such as corticosteroid injections. However, corticosteroids can be hard on the collagen tissue in the area and should therefore not be the first treatment. Clinically, we find that exercise treatment should be trialed first for a period of 6 weeks. If pain is limiting performance of strengthening exercises or pain is not improving, at that point in time other treatment options can be considered. Please discuss this further with your healthcare practitioner if necessary.
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DISCLAIMER: This information is not intended as medical advice or a substitute for medical counseling. By choosing to follow the information that follows, you recognize that despite all precautions taken by Physio Fixes Inc. there is a potential risk of injury and you expressly acknowledge such risks and waive, relinquish, and release any claim that you may have against Physio Fixes Inc. You should always get evaluated for exercise by a physician or medical professionals, especially if symptoms occur from a trauma or are worsening. The user agrees by purchasing this program that Physio Fixes will not be held responsible in the event that an injury occurs.
References
Grimaldi A, Fearon A. Gluteal Tendinopathy: Integrating Pathomechanics and Clinical Features in Its Management. J Orthop Sports Phys Ther. 2015 Nov;45(11):910-22. doi: 10.2519/jospt.2015.5829. Epub 2015 Sep 17. PMID: 26381486.
Ladurner A, Fitzpatrick J, O’Donnell JM. Treatment of Gluteal Tendinopathy: A Systematic Review and Stage-Adjusted Treatment Recommendation. Orthop J Sports Med. 2021 Jul 29;9(7):23259671211016850. doi: 10.1177/23259671211016850. PMID: 34377713; PMCID: PMC8330465.
Patricio Cordeiro TT, Rocha EAB, Scattone Silva R. Effects of exercise-based interventions on gluteal tendinopathy. Systematic review with meta-analysis. Sci Rep. 2024 Feb 9;14(1):3343. doi: 10.1038/s41598-024-53283-x. PMID: 38336959; PMCID: PMC10858207.
Speers CJ, Bhogal GS. Greater trochanteric pain syndrome: a review of diagnosis and management in general practice. Br J Gen Pract. 2017 Oct;67(663):479-480. doi: 10.3399/bjgp17X693041. PMID: 28963433; PMCID: PMC5604828.
Wilson R, Abbott JH, Mellor R, Grimaldi A, Bennell K, Vicenzino B. Education plus exercise for persistent gluteal tendinopathy improves quality of life and is cost-effective compared with corticosteroid injection and wait and see: economic evaluation of a randomised trial. J Physiother. 2023 Jan;69(1):35-41. doi: 10.1016/j.jphys.2022.11.007. Epub 2022 Dec 14. PMID: 36526564.
