Gluteal Tendinopathy (also knows as Greather Throchanteric Pain Syndrome, or GTPS) is a prevalent condition that affects many individuals, particularly women and those engaged in repetitive physical activities. Characterized by pain and dysfunction around the hip, GTPS can significantly impact quality of life. In this blog post, we’ll explore the diagnosis and management of GTPS with insights from leading experts in the field.
What is Gluteal Tendinopathy?
Gluteal tendinopathy, or Greater Trochanteric Pain Syndrome (GTPS), is a condition that involves the tendons of the gluteal muscles, primarily the gluteus medius and minimus. It is commonly associated with pain over the lateral aspect of the hip, which may radiate down the outer thigh. This condition is often seen in middle-aged women, but it can also affect men and and people of all ages.
Diagnosis of GTPS
Accurate diagnosis of GTPS involves a combination of clinical evaluation and imaging techniques. According to Jo Kemp, a leading physiotherapist and researcher, a thorough history and physical examination are crucial. The clinical presentation typically includes:
1. Pain Localisation: Pain is usually located over the greater trochanter, the bony prominence on the outer side of the hip.
2. Pain Characteristics: The pain is often described as sharp or aching and can be exacerbated by activities such as walking, climbing stairs, or lying on the affected side.
3. Functional Limitations: Patients may report difficulty with activities that involve hip abduction or external rotation.
Imaging techniques such as ultrasound or MRI can sometimes be helpful in confirming the diagnosis and assessing the extent of tendinopathy but are rarely necessary, unless other pathology is suspected.
Management of GTPS
The management of GTPS focuses on alleviating pain, restoring function, and addressing any contributing factors. Alison Grimaldi, an expert in musculoskeletal physiotherapy, emphasises a multifaceted approach:
1. Pain Management:
- Activity Modification: Reducing activities that exacerbate pain, such as prolonged standing or repetitive hip movements, is essential.
2. Physiotherapy:
- Strengthening Exercises: Loading the hip abductors and external rotators is critical.
- Motor Control and Gait Training: Improving motor control and correcting gait abnormalities can reduce strain on the tendons. This may involve retraining movement patterns and optimising walking or running mechanics.
3. Load Management:
- Gradual Loading: Introducing gradual loading and progressive exercise is crucial. Kemp’s research underscores the importance of gradually increasing the intensity and volume of activity to prevent exacerbation of symptoms.
Conclusion
Gluteal tendinopathy is a challenging condition that requires a comprehensive approach to diagnosis and management. Drawing on the latest evidence, we understand the importance of a thorough clinical assessment, targeted physiotherapy, and careful management of activity levels. By addressing both the symptoms and underlying factors contributing to GTPS, patients can achieve significant improvements in pain and function.
At Physio on Patterson, our team is dedicated to helping you navigate your path to recovery with evidence-based strategies and expert care.
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