Lateral Hip Pain: It could be Greater Trochanteric Pain Syndrome (GTPS)

Have you been experiencing a nagging pain on the outside of your hip, especially when walking, standing for long periods, or lying on your side? You might be dealing with Greater Trochanteric Pain Syndrome (GTPS), a common but often misunderstood condition that affects many adults, particularly women between 40–60 years of age.

What is GTPS?

Greater Trochanteric Pain Syndrome is an umbrella term that includes several issues involving the outer hip:

• Trochanteric bursitis (inflammation of the bursa near the hip bone)
• Gluteal tendinopathy (injury to the gluteus medius and/or minimus tendons)
• External coxa saltans (also known as ‘snapping hip syndrome’)

These conditions cause pain and discomfort along the greater trochanter – the bony point on the outside of your hip.

Common symptoms of GTPS

GTPS often presents with the following symptoms:

• Deep, aching pain on the outer hip
• Pain that may radiate down the outer thigh toward the knee
• Discomfort when weight-bearing, such as standing or walking
• Pain when lying on the affected side
• Increased pain with squatting, using stairs, or sitting/standing for extended periods

What causes GTPS?

The main cause of lateral hip pain in GTPS is tendinopathy of the gluteus medius or minimus. These muscles play a key role in stabilising the hip during movement.
In tendinopathy, the structure of the tendon changes:

• There’s a reduction in Type 1 collagen (the strong, load-bearing kind)
• An increase in Type 3 collagen, which is less structured and mechanically weaker

This structural shift decreases the tendon’s ability to handle stress, making it more prone to irritation and injury.

Risk factors

GTPS is more likely to occur in individuals who:

• Are aged 40–60 years
• Are female
• Have a higher BMI or obesity
• Suffer from osteoarthritis (hip, knee, or lower back)
• Have a leg length discrepancy

How can Physiotherapy help?

The good news is, GTPS is highly manageable with conservative (non-surgical) treatment. Physiotherapy plays a key role in recovery, focusing on reducing pain and improving hip function.

1. Activity modification
   • Avoid aggravating positions (e.g. crossing legs, lying on the affected side)
   • Reduce repetitive or high-impact activities like running
2. Load management
   • Use strategies like pacing and rest breaks
   • Consider low-impact exercises such as swimming
3. Weight management
   • Reducing body weight can ease the load on the hip
   • Improving cardiovascular fitness also supports overall recovery
4. Nutrition for tendon health
   • Stay hydrated (aim for 2 litres of water daily)
   • Ensure adequate Vitamin C and Vitamin D intake to support tissue healing
5. Strengthening exercises
   • Focus on glute and core strengthening
     • Hip abductions – lying on your unaffected side with the legs straight and lifting your top leg away from the bottom. Hold this movement e.g. for 30 seconds before coming down and repeating again. Complete 3x30secs 1-2x daily. This is called an isometric contraction and can help reduce pain.
     • Clamshells– lying on your unaffected side with your knees bent – lifting up your top knee away from the bottom. Hold this movement e.g. for 30 seconds before coming down and repeating again. Complete 3x30secs 1-2x daily. This is called an isometric contraction and can help reduce pain.
     • Glute bridges – lying on your back with your knees bent at 90 degrees and feet flat on the floor. Lift your bottom up in the air and hold. Hold this movement e.g. for 30 seconds before coming down and repeating again. Complete 3x30secs 1-2x daily. This is called an isometric contraction and can help reduce pain. This can also be done with a theraband around the thighs to add greater resistance for the gluteus minimus muscle.
6. Stretching
   • Gentle stretching of the IT band and Tensor Fascia Latae (TFL) may relieve tension and improve mobility
     • IT band stretch – Standing with your legs crossed one over the other. Lean over to the side with your arm over your head towards the direction of the leg crossed in front. Hold each stretch for 30-40 seconds. Complete 3×30-40secs 1-2x daily.
     • TFL stretch – start in a lunge position and lean over to the side with your arm over your head towards the direction of the leg in front. Hold each stretch for 30-40 seconds. Complete 3×30-40secs 1-2x daily

Additional pain management strategies

While physiotherapy and lifestyle changes form the foundation of treatment, other options may include:

• Anti-inflammatory medications or topical gels – helpful short-term, but may impair tendon healing if overused
• Hyaluronic acid injections – can reduce inflammation and promote tendon regeneration

If you’re struggling with persistent pain on the outside of your hip, don’t ignore it. Greater Trochanteric Pain Syndrome is common and treatable – especially when addressed early. A physiotherapy-guided approach, combined with small lifestyle adjustments, can significantly improve your quality of life and get you back to moving comfortably.
Listen to your body, and don’t wait for the pain to get worse – support is available. Book an appointment with a physio online.