Physical Therapy May Help Against the Common Causes of Hip Pain

It is the side of the hip, right on the bone. It bites on the stairs. It shows up when you stand up from the car. Worst of all, it wakes you when you lie on that side.

So you sleep on the other side. You take the stairs one at a time. You stop the evening walk, because the last block always costs you.

That pattern has a name, and it responds well to the right work.

What greater trochanteric pain syndrome is

The greater trochanter is the bony bump on the outside of your thigh bone. It is where the muscles that steady your hip attach.

Greater trochanteric pain syndrome, or GTPS, is irritation of those tendons and the tissue around them. The two most common drivers are gluteal tendinopathy and partial tears of the gluteal tendons.

It accounts for roughly 10 to 20 percent of the hip pain people bring to a provider, and it shows up most in women over 50. Typical signs:

• Tenderness when you press on the bony bump, or when you lie on that side
• Pain that climbs during stairs, hills, or getting out of a low chair
• Pain on weight bearing, so walking and standing both nag
• Ache that sometimes spreads down the outside of the thigh

Notice what is missing from that list. Groin pain and deep, in-the-joint stiffness point somewhere else, often the hip joint itself. Which is exactly why guessing is expensive.

What the LEAP trial found

Australian researchers ran a study, featured in a British Journal of Sports Medicine blog, that compared three ways of handling this. It enrolled 204 patients aged 35–70 who had lateral hip pain for at least three months.

One group got education about managing load on the tendon plus a personalized exercise program: 14 sessions over 8 weeks, aimed at strengthening and steadying the hip. One group got a single corticosteroid injection. One group waited and watched.

At 8 weeks, 77 percent of the education and exercise group rated themselves at least moderately better, against 58 percent for the injection and 29 percent for waiting.

At 52 weeks the gap held: 78 percent, against 57 percent and 52 percent. That group also gained hip abduction strength and walked with more stability.

Read the last two numbers again. Waiting eventually caught up to the injection. Neither caught up to the exercise.

What actually changes it

An irritated tendon needs two things: less of what overloads it, and more capacity so normal life stops overloading it. Both, in that order, at the same time.

That is what a licensed physical therapist builds with you:

• Strength in the muscles that hold your pelvis level, especially the glutes
• Better movement patterns for stairs, standing up, and walking
• Small changes that take stress off the tendon while it settles
• Sleeping positions that stop you compressing it for eight hours a night
• Standing and sitting habits that quietly aggravate it, corrected

Crossing your legs, standing with all your weight on one hip, sleeping with the top knee dropped forward: those cost you more than they look like they should.

When to get it assessed

The longer lateral hip pain runs, the more it settles in and the harder it gets to shift. If it has been more than a few weeks, that is reason enough to have it looked at.

Get it assessed sooner if the hip is giving way, if you cannot bear weight, if the pain followed a fall, or if there is fever or swelling. Those belong with a physician first, and imaging may be part of the answer.

Hip pain does not have to be the thing that shrinks your week. Look at how we treat hip and knee pain, see what the therapeutic exercise side of it involves, then request an appointment and get a plan with an endpoint.