1. Lateral Hip Pain “Greater Trochanteric Pain Syndrome” (GTPS)
Information for patients suffering from lateral hip pain.
Feb 2016

2. Greater trochanteric pain syndrome – (GTPS) is a common clinical syndrome that used to be called trochanteric bursitis.
More common in females F:M= 4:1
More common in year old patients
Occurs in 10-25% of the population
Occurs in 35% with low back pain

3. Patients usually complain of pain at the side of the hip radiating down the side of the thigh- and sometimes below the knee

4. What makes it worse? Walking Sitting Standing
Getting in and out of the car
Stairs
Laying on the painful side
Laying on the opposite side

5. What causes the pain?
Research shows us that lateral hip pain is caused by wear and tear in the tendons of the muscles around your hip as they insert on the bone.

6. It is unlikely to be “bursitis”
It used to be thought that the pain was caused by the sacs of fluid filled bursa around the tendons.
But research shows us that it is most likely to be the tendons themselves that cause the pain.

7. “Why did this happen to me?”
There are lots of reasons why this may have happened.
But commonly this is down to the muscles’ inability to cope with the demands of daily life that are placed on them.
You may have “asked” the muscles to do to much and they are not strong enough to cope with that demand.
The tendons have been repeatedly compressed by the positions we adopt during daily life causing micro trauma to the tendon over time.

8. What happens next?
This overload or compression to the tendon irritates the tendon, causing the muscle to become stiffer / tighter and tender to touch and can often refer pain down the leg.
The muscle becomes weaker as we use it less, and so the cycle continues.

9. Muscle fatigue and tightness Reduced hip range of motion
Tendon irritation due to overload or compression from day to day activities
Pain
Gluteal weakness
Muscle fatigue and tightness
Lack of use
Reduced hip range of motion
Pain

10. Positions during daily life that can compress the tendons.
These positions often seen in people can cause continual micro trauma to the tendons over time. So if you can avoid these positions it can reduce your symptoms.

11. How can I ease my pain?
Exercise to improve the hip muscle activation and strength is the best way to improve symptoms and stop it coming back in the future.
Often patients are given an injection- and for some patients this can help reduce the pain temporarily- but this will not specifically address the route cause of your problem. Often patients’ pains return a few months later.
Try and avoid aggravating positions or activities that may induce compression on the tendons.
Try some massage around the hip muscles
Try sleeping with a pillow between your knees, to prevent the leg falling across the body and compressing the top hip through over tensioning the thigh soft tissues

12. What exercises should I try?
Side Leg lift hold
Put hand on pelvis and push the top leg nice and long.
This stacks the hips directly on top of each other.
Lift the leg up to hip height
Don’t let the hip hitch up
Push hard with the hand
Hold for 1 minute
Repeat 2-3 times
It should feel achy after the exercise just around your hip bone.
Relax and let the foot go floppy
This static hold will help activate the hip muscle required to support your pelvis alignment and help decrease pain.

13. What exercises should I try?
1 leg balance- 30 secs
Keep shoulders level
Don’t lean to the side
Keep your foot under your shoulder
Don’t let it drop on the opposite side
Keep your pelvis level
Stand on your worst leg
Hold on to the wall if required so that you can feel the exercise working in the side of your hip of your standing leg

14. What exercise should I try?
Step Ups
Put the worst leg on the step
Keep the back leg straight
DO NOT bend and jump / push off the back leg.
Peel the foot slowly from the heel to the toe as you step up
Push up slowly through the worst leg
Leave the worst leg on the step, and step down with the better leg. Slowly paste the foot back down
Keep your knee pointing forwards over your toes, don’t let it fall inwards as you step up and down