Greater Trochanteric Pain Syndrome (GTPS)

Dr Ozello's Sports Medicine Report: Greater Trochanteric Pain Syndrome (GTPS)

Greater Trochanteric Pain Syndrome (GTPS) also known as trochanteric bursitis is a degenerative condition that affects the tendons of gluteal muscles and bursa.

Repetitive friction between the greater trochanter and iliotibial band causes microtrauma of the gluteal tendon where it inserts on the greater trochanter.

***Disclaimer: Viewing this video does not take the place of seeing a medical professional, working with a nutritional professional, working with a fitness professional and receiving proper training in the medical profession. Please visit a medical professional for evaluation, diagnosis and treatment. Please work with a nutritional profession to develop individualized nutrition strategies. Please work with a fitness professional to learn proper exercise technique and to develop a proper training program. Never perform an exercise that elicits or intensifies symptoms. If an exercise elicits or intensifies symptoms, stop immediately and use a viable substitute. Always perform all exercises through a symptom free range of motion. Begin your training at your current health, fitness and strength levels. Increase intensity in small gradual calculated increments. Please use nutritional strategies that are designed to work for your individual needs.

Symptoms
Lateral hip and proximal lateral thigh pain, with tenderness over and around the greater trochanter.
Pain at end range hip external rotation, abduction or adduction, and pain with resisted hip abduction.
Hip pain when lying supine with the affected hip flexed and externally rotated, as if when crossing the ankle of the affected leg over the opposite thigh or knee.
Possible gluteal pain, Possible chronic low back pain radiating to the posterolateral aspect of the thigh and possible tenderness over the iliotibial band.

Usually unilateral but can be bilateral. Aggravated by lying on affected side.
Significantly more common in females.
Middle aged to elderly.
Typically chronic condition. Almost thirty percent still have it after five years.

Aggravating activities
Walking up and down stairs, especially going up stairs, Jumping, Running ,High impact activities, Biking with seat too high, Prolonged sitting and Sitting “Indian style”

Two separate groups are prone to this condition.

Sedentary Group. GTPS has a strong correlation with obesity and sedentary lifestyle.

Overuse Group: Repetitive activity. Mechanical overload. Altered cellular response/failed healing. Training errors: high-intensity training, high mileage. The hip joint withstands loads up to 6 to 8 times body weight during normal walking or jogging. Due to constant mechanical load, this joint is prone to wear and tear injury during athletic maneuvers.

Intrinsic Contributing Factors
Gluteus Medius Weakness, Internal rotation of hip and thigh, Adduction of hip, Hyperpronation, TFL/ITB hypertonicity, Hip Abductor Weakness, Lumbar Spine Hyperlordosis, Scoliosis, Unequal leg lengths, Abnormal pelvic width and OA in LE

Activity Modifications
Pool based exercises to keep cardiovascular conditioning.
No running, especially on circular, domed, uneven surfaces, hills and stairs.
Lower bike seat.
Proper footwear.
Improve body composition by losing fat and building muscle. In beginning of recovery, eliminate squats, stair climbing, lunges, deadlifting and repetitive leg crossing.

Self-Treatment
Stretching: Hip Flexors, TFL and Piriformis

Strengthen Hip Abductors (Gluteus medius and gluteus Minimus) and strengthen feet.
Strengthen hip extensor muscles (Gluteus Maximus and Hamstrings.)

Chiropractic Care helps restore proper skeletal motion and optimize nerve flow.

References
Greater Trochanteric Pain Syndrome https://www.ncbi.nlm.nih.gov/books/NB...

Dr Donald A Ozello DC of Championship Chiropractic in Las Vegas, NV
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