If you are like many people who have experienced pin point pain on the outside of your hip, the bursa is often to blame. This condition is called trochanteric bursitis and it is the result of inflammation of the bursa on the side of your hip bone.
Bursa are fluid filled sacs which lay beneath tendons to reduce friction and stress during contraction of muscles. It has long been thought that the bursa were the painful culprit and cause of this condition that effects 23.5 % of women and 8.5 % of men between the ages of 50 and 79 years. However this notion has now been challenged for some time in scientific research.
Imaging and surgical studies now have identified that the tendons of smaller gluteal muscles (gluteus medius/minimus) are the primary cause of people’s painful hips. Although the bursa may become distended, this is believed to be secondary and is often not due to an inflammatory process. As such the condition is now often referred to as Greater Trochanteric Pain Syndrome (GTPS).
The tendon condition is called a “tendinopathy” which refers to an overuse and degenerative injury to tendons that occurs over time. Essentially it is an imbalance between the rate of wear and repair of a tendon and this leads to degenerative changes causing pain. Furthermore these negative changes can occur if a tendon is continually compressed.
Therefore the two major causes of GTPS are overuse and/or compression of the tendons.
So why does all that matter?
Well what that means is if we are able to treat the gluteal tendons, we can help decrease pain and improve your everyday life. That is where physiotherapy can help.
To treat GTPS specific and tailored gluteal tendon exercises can be utilised to increase the strength and endurance allowing for the tendon to heal. Also physio can help reduce compression of the tendon through changing a person’s positions and postures especially where a person’s leg crosses the midline of their body. This can occur when we sleep on our side or when we sit cross legged.
If you believe you have symptoms or would like treatment from physiotherapy follow the prompts on our website for more information or click here to make an appointment at one of our clinics. If you have enjoyed this blog and wish to know more below is a detailed article.
Grimaldi, A., Mellor, R., Hodges, P., Bennell, K., Wajswelner, H., & Vicenzino, B. (2015). Gluteal tendinopathy: a review of mechanisms, assessment and management. Sports Medicine, 45, 1107-1119. https://doi.org/10.1007/s40279-015-0336-5
