Greater Trochanteric pain syndrome (GTPS)

GTPS is a painful condition affecting the outer thigh and hip area. It happens when the tissues over the bony prominence (greater trochanter) at the top of your thigh bone become irritated. These can include tendons, muscle or bursae (fluid-filled sacs that help smooth movement between muscles, tendons and the hip bone).

What are the symptoms of GTPS?

• Pain on your thigh and hip area. This may feel like an aching or burning pain.
• Pain when you lie on your side, especially at night.
• Can become worse with exercise and you may find you limp when you walk.
• You don’t normally need a scan to diagnose this problem and a health care professional will make a diagnosis from a history and specific tests.

What Causes GTPS?

The exact causes are still not fully understood. It is more common in middle aged females. Some things that might contribute are:

• Increased or excessive load, like lots of walking or running. Poor running style can increase the load to the hip.
• A direct fall on the outside edge of your hip.
• Weakness of the muscles around the hip (gluteus medius and minimus)
• Prolonged pressure on your hip area e.g. sitting in bucket car seat or sleeping on your affected side.

To try and reduce the pain in the short term, try the following:

• Avoid sleeping on the painful side. If you sleep on the opposite hip, try placing a pillow between your knees to stop the painful leg crossing over.
• Try to reduce all the aggravating activities like running or excessive walking.
• Avoid sitting with your legs crossed.
• Losing weight.
• When standing still, avoid leaning on one hip and keep your weight evenly through both feet.
• Pain killers may be used to provide short term pain relief.
• As GTPS is usually related to your hip structures not coping with heavy/frequent load, exercises to strengthen this area will help healing and return to normal activity.

Lying on your bed or the floor bring your leg out to the side and then back to the mid
position.
Repeat 10 times. Build up to 3 sets of 10.

Once the above exercise can be done pain-free, move to standing.
Stand, holding a stable surface, such as a chair. Lift your painful leg out to the side and then
slowly lower back to normal standing position. Aim to complete three sets of 10-12 repetitions.

Stand with your painful leg away from the wall. Lift your unaffected leg up to 90 degrees if you can.
Push against the wall with your knee. You should feel the muscles around the edge of your outside
hip working. Hold this position for 20-30 seconds.

Lie on your unaffected side with a pillow between your knees. Make sure your tip leg is in line with your body. Lift the leg up towards the ceiling and slowly lower back to the starting position. Try to do 10-12 repetitions and aim to increase to 3 sets as you get stronger.

2. Exercises for later stages

This exercise can be done with or without a resistance band around your ankles. Stand in a mini squat position. Take 10 slow and controlled steps to the left then repeat to the right. Make sure you stay in a squat position. Repeat 3 times

Without holding on, try to step up and then slowly down from the bottom step of the stairs
with your painful leg. Repeat 10-12 times and aim to build up to 3 sets.