How physiotherapy helps: Hip Bursitis
Written by Joanne Huynh, Physiotherapist
….or known formally as greater trochanteric pain syndrome, however you may have heard of it as trochanteric bursitis and even gluteal tendinitis.
What is greater trochanteric pain syndrome (or GTPS)?
This is a pain that is located on the greater trochanter, which is a bony prominence on the outer side of you thigh.
Why is the pain in this region of the hip/thigh?
There are two muscles that connect to the greater trochanter via tendons, and they are called your gluteus medius and minimus muscles; these muscles are pelvis stabilisers when you are on your feet. There is also a bursa, which is a sac with fluid in it, that sits underneath the tendons, over the greater trochanter. It serves to reduce friction between the tendon and thigh bone.
Why would this injury occur?
This injury can occur due to the following:
Trauma
Overload or overuse of the tendons in gluteus medius and minimus which can be due to:
Lack of physical exercise or a sedentary lifestyle
A significant increase in activity that requires your hips to work harder than what it normally does
What is actually happening with this injury?
Many people say it is an inflammation of the trochanteric bursa; others talk about a gluteus medius tendinitis or tear. There have been studies that suggest that clients who have this pain, up to 79% of them do not have a bursitis or bursal inflammation on imaging or scans. There is more research to suggest that there is likely to be pathology of the gluteal tendons (whether it be a tendinitis/tendinopathy or a tear) in clients with this hip pain; but keep in mind that imaging findings of gluteal tendon pathology and tears are also quite common age related changes and not all people who have this on scans will have GTPS either.
How is this diagnosed?
This can usually be diagnosed by the physiotherapist who can determine this injury based on your clinical history and a series of diagnostic tests in the clinic. Many people tend to go for an ultrasound scan to check for this as well, but usually scans are not reliable to diagnose this condition alone.
What symptoms would I have that may lead me to suspect I have GTPS?
Pain in the outer side of the hip or thigh
Pain with prolonged walking, standing, stair climbing and running
Usually feels quite sore and stiff in the mornings, but loosens up with movement as the day goes on
Can get sore later in the evening and create sleep disturbances especially if you have been on your feet a lot
Not very nice to lie on the affected side
Can be a dull ache, with sharp pains if the hip goes through a sudden movement that is unpleasant
How can physiotherapy help me?
The physiotherapist can help you with recovery through the following:
Advice on how to manage your symptoms - this can be through modifying your usual activities, or pain relief strategies
Education on the condition, and specifically the contributing factors that led to the pain presentation.
Pain management strategies that can include:
Massage or soft tissue techniques
Specific exercises that can provide short term pain relief
Dry needling or acupuncture
An individualised exercise program that will help to promote healing and strengthen up the muscles around the outer hip
Monitor your condition to advise on other treatment modalities that could be beneficial - such as a cortisone injection (however, hoping for that to be a last resort)
Will I get better? How long will it take?
This injury is can vary in it’s recovery, ranging from 6 weeks through to 6 months. Quicker recovery times will be more likely in those who manage their activities to ensure they are not overusing the hip and are consistently performing their exercises. But rest assured, these conditions will most definitely recover if you take action to seek out physiotherapy support.
Feel free to click below on ‘Book now’, email at joanne@thephysioalliance.com.au or call on 0493 039 286 to get that heel pain sorted so you can get back to the things you want to do.
Citations
Long SS, Surrey DE, Nazarian LN. Sonography of greater trochanteric pain syndrome and the rarity of primary bursitis. AJR Am J Roentgenol. 2013 Nov;201(5):1083-6. doi: 10.2214/AJR.12.10038. PMID: 24147479.
