What is GTPS
Greater Trochanteric Pain Syndrome, or GTPS, is a common cause of pain on the outside of the hip. It tends to affect women between the ages of 40 and 60 more often, partly due to biological differences in pelvic shape and resulting movement patterns.
If you have hip pain that gets worse with walking, climbing stairs, or lying on your side, GTPS may be the reason.
The pain usually comes from irritated tendons around a bony area called the greater trochanter (the bump you can feel on the outside of your hip).
These tendons belong to muscles called the gluteus medius and minimus, which help support the hip.
In the past, it was thought this pain came mainly from inflammation of a bursa (a small fluid-filled sac), but we now know tendon problems are the more common cause.
What Causes GTPS?
GTPS can develop due to:
- Repetitive movement or overuse, such as long-distance running
- Muscle weakness, especially in the glutes and hips
- Poor posture or body mechanics (how we move)
- Sitting with legs crossed or leaning on one hip often
GTPS is frequently misdiagnosed because its symptoms are similar to those of other conditions, such as hip arthritis or lower back pain. One significant difference is that people with GTPS typically have no trouble putting on shoes and socks, which is difficult with arthritis.
How Is GTPS Diagnosed?
Physiotherapists use several tests to help diagnose GTPS. These include:
- Palpation: Pressing on the outer hip to check for tenderness.
- Single leg stance: Standing on one leg. If this causes pain within 30 seconds, it may suggest GTPS.
- Movement tests to recreate the patient’s symptoms:
- FABER (Flexion, Abduction, External Rotation)
- FADER (Flexion, Adduction, External Rotation)
- Passive adduction in side-lying
- Ober’s test: Checks how tight the IT band is.
- Step-up/down test: Pain during this movement can be a sign.
- Trendelenburg test: Looking for a drop in the opposite hip while standing on one leg, which indicates weakness in the hip stabilizers.
These tests help rule out other causes of hip pain and give a clearer picture of what’s going on.
If there is any remaining uncertainty following these tests, imaging can also be used to rule out other pathologies, such as osteoarthritis.
How Is GTPS Treated?
Physiotherapy is the first line of treatment. A typical program may include:
Stage 1: Gentle strengthening of the gluteal muscles and improving control.
Stage 2: Building hip abductor strength.
Stage 3: Training posture and movement to reduce strain on the hip.
Other helpful tips include avoiding crossing your legs, not stretching the IT band, and managing how much pressure is put through the outer hip.
When to Seek Help
If hip pain is stopping you from moving comfortably or sleeping well, don’t ignore it. GTPS is very treatable, and early care can prevent it from becoming a long-term problem. A physiotherapist can help you feel better, move better, and get back to doing what you love.
If you’ve been experiencing hip pain, come in to see one of the experienced physiotherapists at City Baths Spinal and Sports Medicine Clinic.
They can diagnose causes of hip pain, including GTPS, to help get you moving again!
