If you’ve ever experienced pain on the outside of your hip or noticed discomfort while walking or sleeping on your side, you may be dealing with Greater Trochanteric Pain Syndrome (GTPS). While it’s a common condition, it often goes undiagnosed or misinterpreted, leading to unnecessary frustration. In this blog post, we’ll break down what GTPS is, its causes, symptoms, and how physical therapy can help you get back to feeling your best.
What is Greater Trochanteric Pain Syndrome (GTPS)?
Greater Trochanteric Pain Syndrome refers to a condition that causes pain on the outer side of the hip, specifically around the greater trochanter – the bony prominence on the outside of your femur (thigh bone). The pain is often sharp or aching, and can become worse with certain movements or activities, such as walking, climbing stairs, or lying on the affected side at night.
GTPS isn’t just one condition; it’s an umbrella term that includes several potential causes of pain in this area, most commonly involving inflammation or injury to the tendons, muscles, or bursa around the hip.
Common Causes of GTPS
Several factors can contribute to the development of GTPS. Here are some of the most common culprits:
1. Tendonitis or Tendinopathy
The most frequent cause of GTPS is inflammation or degeneration of the tendons around the hip, particularly the gluteus medius and minimus tendons. These tendons help stabilize your hip and pelvis during walking and other activities. Overuse, repetitive movements, or sudden changes in activity level can lead to tendon irritation, microtears, and weakening.
2. Bursitis
Another common cause of GTPS is inflammation of the trochanteric bursa, a small fluid-filled sac that helps reduce friction between the greater trochanter and surrounding muscles. When this bursa becomes irritated or inflamed, it can lead to pain and tenderness on the outside of the hip. Bursitis can be caused by overuse, direct trauma, or poor posture during movement.
3. Muscle Imbalances
Muscle imbalances in the hip, especially weakness or tightness in the gluteal muscles, can increase the stress on the tendons and bursa. These imbalances often develop due to inactivity, poor posture, or incorrect movement patterns during physical activities.
4. Overuse or Overload
GTPS is common among individuals who engage in repetitive activities that involve excessive strain on the hips, such as running, cycling, or standing for long periods. Over time, the tissues around the hip joint may become irritated or overworked, leading to pain and inflammation.
5. Trauma or Injury
Direct trauma to the hip, such as a fall or impact during sports, can also cause damage to the tendons or bursa, resulting in GTPS. Even minor injuries can have a lasting effect if they lead to changes in movement patterns that put additional strain on the hip.
Symptoms of GTPS
The hallmark symptom of Greater Trochanteric Pain Syndrome is pain on the outer side of the hip, which may radiate down the thigh or up toward the lower back. Some common symptoms include:
Localized pain over the greater trochanter: This pain can be sharp or dull and is often aggravated by physical activity or pressure on the hip.
Pain while lying on the affected side: Sleeping on the painful side often worsens the discomfort.
Difficulty with activities like walking, running, or climbing stairs: Movements that require hip abduction (moving the leg away from the body) often cause discomfort.
Pain after prolonged sitting or standing: Sitting for long periods, particularly with poor posture, can aggravate the pain.
Tenderness to the touch: The area around the greater trochanter may feel sore or sensitive when pressed.
Diagnosing GTPS
If you're experiencing symptoms of Greater Trochanteric Pain Syndrome (GTPS), it's crucial to seek medical advice for an accurate diagnosis. A healthcare provider, particularly a physical therapist, is well-equipped to assess your condition through a series of functional tests. These tests can help pinpoint the underlying cause of your pain, whether it's related to tendinopathy, bursitis, or other issues affecting the hip. A thorough evaluation will also assist in developing a personalized treatment plan tailored to your specific needs, ensuring a more effective recovery.
Treatment Options for Greater Trochanteric Pain Syndrome
The good news is that GTPS can be effectively managed and treated with the right interventions. Most cases of GTPS improve with conservative treatments, including physical therapy, lifestyle modifications, and occasional use of medications. Here are some common treatment approaches:
1. Physical Therapy
Physical therapy is one of the most effective treatments for GTPS. A skilled physical therapist will develop a personalized rehabilitation program that focuses on:
Strengthening weak muscles: Strengthening the gluteus medius, gluteus maximus, and other hip muscles is essential for stabilizing the hip joint. This increased muscle strength helps to better support the joint, reducing strain on the surrounding tissues. As a result, it can alleviate pain and prevent further irritation of the affected areas.
Improving Mobility: Poor movement patterns can place undue stress on muscles and tissues, contributing to overuse and pain. Through physical therapy, a trained therapist can assess and address impairments in tissue length and joint mobility. By targeting these areas, a tailored treatment plan can help restore proper movement mechanics, reducing the risk of overloading irritated tissues and promoting long-term healing.
Refine Movement Patterns: Improving movement patterns is key to preventing further strain on injured tissues. A physical therapist will assess your movement mechanics to identify any faulty patterns that may be contributing to pain. Through targeted activation exercises and corrections, they’ll help you retrain your body to move more efficiently, reducing stress on affected areas and promoting healing.
2. Rest and Activity Modification
Taking a break from activities that exacerbate your pain, such as running or standing for long periods, can help the tissues in your hip heal. If your job or daily routine involves repetitive movements, your healthcare provider may suggest modifications to reduce stress on the hip joint.
3. Anti-inflammatory Medications
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, can help reduce inflammation and alleviate pain in the short term. However, these medications should be used with caution and under the guidance of your medical doctor.
Preventing GTPS
Once you’ve successfully treated GTPS, it’s important to take steps to prevent recurrence. Here are some strategies to help reduce your risk of developing the condition again:
Regular strength training: Keep the muscles around your hips strong and balanced to minimize stress on the tendons and bursa.
Maintain a healthy weight: Excess weight can increase pressure on your hips and joints, contributing to the development of GTPS.
Warm-up and activate muscles before exercise: Properly warming up before physical activities can help prevent muscle overuse and tendon injury.
Conclusion
Greater Trochanteric Pain Syndrome may be a common cause of hip pain, but with the right approach, it can be effectively managed and treated. If you’re experiencing pain on the outside of your hip, don’t ignore it. Early intervention, including physical therapy, can help alleviate your symptoms and improve your quality of life. Whether it’s addressing muscle imbalances, reducing inflammation, or modifying your activities, a tailored treatment plan can put you on the road to recovery.
If you're struggling with GTPS or have questions about treatment options, book a call with a RISE Physical Therapist to discuss the best course of action for your specific needs. With proper care, you can overcome Greater Trochanteric Pain Syndrome and get back to enjoying your daily activities without discomfort.