Patient education: Exercises for greater trochanteric pain syndrome (GTPS) (The Basics)

What is greater trochanteric pain syndrome? — 

Greater trochanteric pain syndrome, or "GTPS," is a kind of tendon strain (figure 1). Tendons are strong bands of tissue that connect muscles to bones. GTPS is caused by overusing 1 of the tendons near the hip, which can lead to hip pain. The pain is usually worse when walking, standing for a long time, climbing stairs or hills, and lying on the affected side.

Why do I need to do exercises if I have GTPS? — 

Exercises for GTPS can help ease hip pain and might help prevent future hip pain. Long term, it is important to strengthen the muscles in your hips, thighs, buttocks, and belly. Stretching exercises are also important to keep your muscles flexible.

Below are some stretching and strengthening exercises that might help you. These might not be appropriate for everyone. Talk to your doctor, nurse, or physical therapist before starting new exercises.

Other forms of movement can help ease or prevent hip pain, too. For example, some people like to walk, do aerobic exercise, or do yoga or tai chi. The most important thing is to move your body. Your doctor, nurse, or physical therapist can help you find different types of activity that work for you.

What stretching exercises should I do? — 

Below are some examples of stretching exercises.

Warm up your muscles before stretching to help prevent injury. To warm up, you can do light exercise that does not make your symptoms worse. Examples include walking or cycling for a few minutes. Other ways to warm up your muscles are to soak in a bath, take a shower, or use a heating pad or warm, moist towels.

Start by repeating each of these stretches 3 to 5 times, holding each stretch for 15 to 30 seconds. Try to do the stretches 2 to 3 times each day. Breathe slowly and deeply as you do them. Never bounce when doing stretches.

●Single knee-to-chest stretch (figure 2) − Lie on your back, bend your knees, and have your feet flat on the floor. Pull 1 knee toward your chest until you feel a stretch in your lower back and buttock area. Repeat with the other knee. If you have knee problems, pull your knee up by grabbing the back of your thigh instead of the front of your knee.

●Deep hip stretch lying down (figure 3) – Lie on your back, and bend 1 knee, keeping that foot flat on the floor. Cross the other leg over your knee. Grab the thigh of the leg that has the foot on the floor. Slowly, pull the bottom leg toward your chest until you feel a stretch in the other buttock. Repeat using the opposite leg as the bottom leg.

●Hamstring stretch (figure 4) – The hamstrings are the muscles in the back of the thigh, just above the back of the knee. To stretch them, you need a stable stool that does not roll (or a stair) and is about knee height. Place your hands on your hips. Place your right heel on top of the stool, keeping your leg straight. Bend your left leg, keep your back straight, and slowly lean forward until you feel a stretch in the back of your right leg. Repeat with your left leg on the stool or stair.

●Tensor fascia lata stretch (figure 5) – The tensor fascia lata is a muscle on the side of the hip, just below the hip bone. There is 1 on each side. To stretch it, stand up straight. Then, cross your left leg over your right leg, keeping your right leg straight and your left knee bent. Try to point your left pinky toe toward your right pinky toe. Then, lean your upper body toward the left until you feel a stretch near the right hip. Repeat on the other side, with your left leg straight and your right knee bent.

What strengthening exercises should I do? — 

Below is an example of a strengthening exercise.

Start by repeating the exercise 2 to 3 times, working up to 10 repetitions. Try to do the exercise 2 to 3 times each day. Do the exercise slowly, and hold it for 3 to 5 seconds.

●Side leg lift (figure 6) – Lie on your left side. Keep both legs straight, and move your right foot a few inches behind you. Lift your right leg about 18 inches (46 cm) off the floor. Slowly lower your leg back to the bed or floor. Repeat while lying on your right side, with your right leg on the bottom and lifting your left leg.

What else should I know?

●Exercise, including stretching, might be slightly uncomfortable. But you should not have sharp or severe pain. If you get severe pain, stop what you are doing. If severe pain continues, call your doctor or nurse.

●Do not hold your breath when exercising. If you tend to hold your breath, try counting out loud when exercising.

●Always warm up before exercising. Warm muscles stretch much easier than cool muscles. Stretching cool muscles can lead to injury.

●Doing exercises at the same times each day can be a good way to get into a routine. In general, it's a good idea to avoid exercising soon before going to bed or immediately after eating.

More on this topic

Patient education: Hip pain in adults (The Basics)
Patient education: Exercise and movement (The Basics)
Patient education: Exercise and movement as you get older (The Basics)

Patient education: Exercise (Beyond the Basics)