Lateral hip pain is a blanket term covering multiple conditions including greater trochanteric pain syndrome (GTPS), hip bursitis, gluteal tendinopathy, and gluteal tears. This condition affects anywhere from 10-25% of the population and can equate to disability similar to that of end-stage hip osteoarthritis. These kind of injuries generally come in the absence of a traumatic event but rather an overuse injury as a result of repetitive loading, poor loading, or both. This results in structural changes in the tendon or inflammation of the bursae. These conditions involve the gluteal muscles and tendons, specifically gluteus medius and gluteus minimus. These muscles act like the ‘rotator cuff’ of the hip to control the femoral head, or the thigh bone, in the socket of your hip.
Who is most affected?
- Predominantly women >40yo
- Above average BMI
Signs and symptoms:
- Pain and tenderness on the outside of the hip
- Glute or outer thigh pain
- Relative absence of groin pain
- Pain/difficulty in standing, transitioning from sitting to standing, climbing stairs, side lying (both on the affected and unaffected side), or sitting cross legged
- Weakness (and pain) with hip abduction (moving the leg away from the midline)
- Positive Trendelenburg (a sign of glute weakness)
- Limp, becomes worsened with fatigue
How can exercise help?
Exercise for the treatment and management of lateral hip pain has three main goals: pain management, load modification, and address any modifiable conditions that led to the injury to prevent re-injury. If you are currently experiencing lateral hip pain or have been told you have any of the previously mentioned conditions, exercise is a critical component, whether it be the sole treatment or in conjunction with other treatments. Your Accredited Exercise Physiologist will take a detailed medical history and physical assessment to determine an individualized course of action. Depending on the extent of the injury and length of time it has been of concern, you’ll likely land somewhere on this scale:
- Isometric loading and neuromuscular exercise
- Neuromuscular and low-load pelvic floor exercises
- Improve glute activation and take the load away from the hamstrings
- Improve load bearing capacity of the gluteal tendons
- Improve gluteal muscle endurance during single leg positions
- Progress to ‘functional’ activities
Hot tip: If you’re struggling with lateral hip pain and it is affecting your sleep, even when lying on your unaffected side, place a pillow between your knees to take the load off the glute tendons.