Understanding Greater Trochanter Pain Syndrome (GTPS)

GTPS is an umbrella term for pain on the outer aspect of the hip which is often caused through irritation of the soft tissues in that region - mostly the gluteal tendons and bursae!

Gluteal tendinopathies are one of the leading causes of GTPS. Tendons are the structures in our body that connect muscle to bone. A tendinopathy is the break down of tendon structure due to repetitive loading and compressive forces. If the loading continues and isn’t given time to heal correctly the tendinopathy becomes chronic.

Bursitis is the name we give to an inflamed bursa. Bursae are slippery fluid filled sacs which prevent friction between tendons and the bony surface beneath them. Often the inflammation is not visible, but in some cases, the swelling can be visible on the outside of the hip.

Who does it affect?

The prevalence of GTPS is 4:1 females to males, most often between the ages of 40-60. Usually post menopausal women are affected due to hormonal changes that affect tendon health and structure. It can be closely linked with hip osteoarthritis as the two conditions present similarly. Often a sudden change or increase in loading around the hips can cause GTPS (e.g rapid increase in running/walking mileage). Excess pressure on the tendons from weight gain as well as inactivity/sedentary lifestyle can also cause symptoms. 

Normal symptoms?

Pain on the outer aspect of the hip when the glutes are stretched, lying on the affected hip, crossing the legs or loading the affected hip.

What should you do?

1. Reduce the load, initial management start reducing what is aggravating that hip as much as possible whether that’s reducing your walking/running mileage.
   
   
2. Avoid compression and over stretching that hip- avoid sleeping or lying on the affected hip. Maybe try placing a pillow between your knees when lying on the opposite side to stop the affected hip crossing the midline of the body. Also stop sitting with your legs crossed!
   
   
3. Progressive loading, a graded strengthening programme aimed at specific muscles around the hip. It might also include trunk and general lower body strength as well as lots of single leg stability work.

GTPS can significantly impact an individual's daily life, but with proper diagnosis and a comprehensive treatment plan, many people can find relief. If you are experiencing persistent hip pain, consult with one of the Real Health Partners for an accurate diagnosis and appropriate management strategies tailored to your specific needs. 
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