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At Physio.co.uk we see many patients that suffer from lateral hip pain. This blog will look at the potential causes of this condition… and why for many years it may have been misdiagnosed.

What is it?

This is a topic that I find interesting because lateral hip pain may have previously been incorrectly diagnosed (and therefore mistreated…) for a long time.

A lot of people have heard of ‘trochanteric bursitis’. This involves irritation to fluid-filled sacs called bursa’s that are located on the outside of your hip and are positioned to act as cushions between neighbouring muscles, tendons and bones.

This would be the first thing you find if you type in lateral hip pain into google but the fact of the matter is that bursa’s may rarely be the source of pain.

In a recent study of 75 people with lateral hip pain, only 8 were found to have bursal irritation and another only 20% of the 877 participants had displayed an affected bursa.

More recent studies are now indicating that the tendons of surrounding glute muscles (commonly Gluteus Medius and Gluteus Minimus) may be the guilty culprits of the pain source.

If this was the case then we could term this pathology ‘gluteal tendinopathy’ (or ‘tendinitis’ in old terminology)… however, there is still no guarantee that the tendons are exclusively causing the pain so it would be best to refer to it as Greater Trochanteric Pain Syndrome. 

Current Tendinopathy Research

There has been some fantastic contemporary research and breakthroughs in the way we manage tendinopathy within the last decade.

Cook and Purdham gave us a lovely continuum to guide the management and Ebonie Rio has also contributed to the knowledge base suggesting that isometric contractions are great at reducing pain levels in acute and irritable stages of tendinopathy.

Some of this research goes on the assumption that tendons are only experiencing longitudinal forces which is true in the majority of cases. However, in some locations of the body there are also compressive forces at work further escalating the issue.

The greater trochanter, the plantar heel, and the proximal hamstring are just a few examples of where the attachments of tendons to bones cause compression and are common sites for pain and injury.

The compression force is evident because it is common to have bursa to distribute the forces in these areas.trochanteric pain…Under Pressure!

We all come in different shapes and sizes and unfortunately for some this may carry more risk at developing GTPS. For those with wider hips will have larger forces acting upon the tendons.

If you have a habit of ‘hanging on one hip’ or siting with your legs crossed, you are further putting more compression through that already vulnerable area.

In fact, if you hold any of these stances, they are all a bit risky.

Sound familiar?

If you suspect yourself of having GTPS there are some real tell-tale signs formulated by current hip specialists;

  • Are you unable to stand on one leg on the affected side for 30 seconds without pain?
  • Is the pain localised so much so you can point to it?
  • Is it painful to perform the below stretch?

These are just a few of the tests that we would perform in clinic. If you answered yes to any of them then there may be a chance that you may have GTPS. However, we would recommend that you contact us for a thorough examination.

Some interim advice while you are waiting to attend your appointment

  • Avoid those postures! Refrain from posing like Beyonce just for a bit!

trochanteric pain

  • Have a think about your sleeping position. If you tend to sleep on your side then try a pillow between your knees.
  • Before getting up in the morning, lie on your side, place a pillow between your knees, and then from that position lift the duvet up around 30 cm and hold it there for 30-45seconds. Try to do this up to 5 times. These types of exercises have been shown to reduce pain for similar conditions.

Physiotherapy works!

Ultimately there could be many additional factors contributing to your symptoms so it is important to visit a professional to get it fully checked out. Feel free to contact us to arrange a full assessment.

For more information and for online booking go to www.physio.co.uk

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