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Greater Trochanteric Pain Syndrome Cheat Sheet (DRAFT) by

Presentation, Management etc

This is a draft cheat sheet. It is a work in progress and is not finished yet.


- Collection of conditions that causes latera­l-sided hip pain
- GT Bursitis
- ITB syndrome
- Strain­/te­ndi­nopathy of hip abductor muscles (more common)


- Painful inflammed bursa (GT bursa - inbetween ITB and GT) by acute traum and or repetitive mechanical overlo­ading
- TFL + ITB tightness - excessive lateral hip compre­ssion
- Hip abductor weakness, foot hyperp­ron­ation, pes planus, leg length inequality
- Glut med weakness allows contra­lateral pelvis to drop during loading
- Causes excessive thigh adduction and medial rotation
Kinematic chain disruption
Increased tension on ITB and compre­ssion of GT bursa

Risk Factors

- Can occur at any age, but more common in middle aged - elderly population
- Both active and sedentary popula­tions
- Common in females
- Can present bilate­rally


- Chronic, persistent pain in the lateral hip, buttock and proximal thigh
- Provoked by prolonged sitting (legs crossed), transi­tioning to a standing position, climbing stairs, prolonged standing, high impact activities (running)
- Limits activity
- May have an antalgic gait
- Sleep distur­bances - lying on affected side
- TTP of GT - if TTP in posterior aspect of GT, think glut med. If anterior to GT, think Glut min
- Hypertonic hip adductors, psoas, TFL, Gluteal and lx muscles
- PROM painful on adduction or external rotation
- RROM painful on abduction if glut med tendon involv­ement (can rule out bursitis)
- +ve Thomas , Obers test, _ve Trende­len­berg, -ve FABER (SI problems)


- Only needed if diagnosis cannot be confirmed clinically ruling out trauma, AVN , OA, osseous FAI


- Hip OA
- Lx radicu­lopathy
- Stress f#
- Avulsion F#
- Neoplasm
- Osteoid osteoma
- Metastasis
- Infection
- Labral injury­/tear
- Iliopsoas tendin­opa­thy­/te­ndinits
- Chronic mechanical LBP
- SI dysfun­ction
- Meralgia Parast­hetica
- Piriformis syndrome
- Rheuma­tologic disease
- Fibrom­yalgia
- Viscer­oso­matic referral - GI/GU


- Rest, activity modifi­cation and pain relief
- Ice, US, electrical stimul­ation, shockwave therapy
- Stretching and myofascial release of TFL, ITB, external hip rotations, flexors, glut max, quads, hip abductors
- Foam roller
- Streng­thening of hip abductors and external rotators
- Proper squatting and hip hinge techniques
- Orthotics for pronation
- Check for joint restri­ctions in Lx, hip and pelvis - SMT/mo­bil­isation
- Overweight patients should consider weight loss reduction programs