Lateral hip pain, otherwise known as Greater Trochanteric Pain Syndrome (GTPS), is a condition that mostly affects the gluteus minimus and medius tendons. The gluteus minimis and medius muscles are located in the buttocks and attach into the femur (thigh bone).
GTPS is a condition that commonly affects middle aged women, but it can also affect young athletes, particularly runners. Clients will often report pain at the lateral hip that may radiate to the buttocks or down the thigh. It is often aggravated by lying on the affected hip, prolonged standing, rising to a standing position and/or sitting with the affected leg crossed.
How did this happen to me?
Tendons are strong, flexible tissues that connect the muscles to bone. When a tendon is put under increased strain through either being overstretched or overloaded, or both, the tendon may become irritated. One of my favourite analogies is to compare it to a rope. The rope is your strong tendon. If you place a weight at the end of the rope, it will exhibit a small degree of stretch. If you put a larger weight at the end of the rope, then wrap it around the pole, the rope will become overstretched and overloaded.
Steps to reduce lateral hip pain
Like other tendon pathologies in the body, there are a couple of simple rules you need to follow to help settle down your lateral hip pain.
1) Do not stretch the tendon: This means that you do not want to put the gluteus medius and minimus on stretch. Try to avoid crossing your legs or bringing the affected leg across your midline.
2) Do not compress the tendon: You want to avoid putting pressure on the gluteus medius and minimus tendons. In order to do so, avoid laying on your hip in bed.
3) Do not overload the tendon: You want to avoid putting a lot of load on the gluteus medius and minimus tendons. In order to do so, avoid positions that put increased load on the buttock muscles. For example standing on one leg, prolonged walking, hanging off one hip in standing, running up and down hills.
If we go back to the rope analogy, reducing the stretch and load on the tendon will help to reduce strain, thus enabling the tendon to heal.
How can a Physiotherapist help?
A Physiotherapist will help you to understand what activities need to be avoided or modified for your individual case. They will also apply soft tissue techniques, such as dry needling, stretching and massage therapy. These strategies can provide immediate relief of lateral hip pain. Your Physiotherapist will assess your hip strength and set you up with an appropriate tendon rehabilitation program. Evidence suggests that home exercise training has a 80% success rate at 15-months follow up. It is important to not that tendons are difficult to heal when they have been irritated for 3 months or more. Therefore, review with a Physiotherapist at the earliest convenience.
