Hip pain is a frequent issue that can originate from several regions, including the spine, pelvis, and knee. Greater trochanteric bursitis or gluteal tendonitis (GT) is a specific condition that occurs five times more often in women than men, affecting about one in four women over the age of 50.
Individuals with GT typically report discomfort on the outer side of the hip, often radiating towards the buttocks. This pain can make it difficult to find a comfortable sleeping position and may be as severe and limiting as the discomfort from an osteoarthritic or degenerated hip joint.
Conventionally, cortisone injections have been used to manage GT. However, this treatment approach has shown only modest medium-term benefits, with long-term outcomes comparable to simply waiting without intervention. Recently, treatment plans combining targeted exercise routines, load management, and patient education on tendon care have become more recognized for their notable advantages over both the short and long term. Importantly, these strategies are non-invasive.
In a 2018 study, patients with GT who underwent a combined program of exercise, education, and load management experienced a one-year success rate of 78.6%. This was significantly higher than those treated with cortisone injections (58.3%) or those who did not receive any specific intervention (51.9%).
This effective protocol involved fourteen treatment sessions spread over eight weeks, along with a daily home exercise routine that consisted of four to six targeted exercises. Patients were advised to keep a weekly diary and were given recommendations for tendon care. The exercises focused on functional retraining, strengthening—particularly the hip abductor muscles—and improving dynamic control during movement. The exercise plan followed a pain-guided approach, permitting activity up to a pain intensity of 5 out of 10, as long as the discomfort stopped promptly when the activity ceased.
Some of the exercises incorporated in this regimen include:
Static hip abduction:
– Supine: Lying on your back, place a belt around the lower thighs with feet just wider than hip-width apart. Position a pillow behind your knees, then gently and slowly push your legs outward against the resistance of the belt.
– Imaginary splits: While standing with feet just wider than hip-width, gently mimic the motion of doing sideways splits, moving slowly and gently.
Supine bridges:
– Double leg bridge: Lying on your back with knees bent and feet flat on the floor, draw in your abdominal muscles. Press the heels down and gently lift the buttocks only as high as comfortable.
– Offset bridge: Bring one foot closer to the body and use that leg primarily to slowly lift the buttocks (taking three to four seconds to go up and the same to come down). A variation includes lifting one leg and straightening the knee. Both static holds and controlled up-and-down movements are used. Additional exercises in the protocol may include partial squats, step-ups, and sideways floor slides.
If you have been diagnosed with or suspect you may have GT, consulting a chiropractic professional can help you learn how to properly carry out these exercises and receive other supportive care to assist in your recovery.
