Lateral Hip pain that can run down the outside of the leg past the knee can occur due to a multitude of pathologies but it is collectively coined as Greater Trochanteric Pain Syndrome (GTPS). The incidence of GTPS is between 1.8 and 5.6 per 1000/year making it quite a common problem.  It is more common in women then men at a ratio of 4:1.

The Leap Trial which looked at the effects of three methods of treatment for GTPS was recently published in the British Medical Journal. Our clinical director Kim Snellgrove was involved in the Leap Trial as a treating physiotherapist when she worked for Alison Grimaldi in 2013/2014 and assisted with the education and exercise group.

The Leap Trial compared three groups over a 12 month period. There was a corticosteroid group, an education and exercise group and a wait and see group. At eight weeks it was found that the education plus exercise group and the corticosteroid group both reported a global improvement in their function and pain compared with the wait and see approach. The education and exercise group at 8 weeks actually performed better than the corticosteroid group. At 12 months education plus exercise showed better global improvement than the corticosteroid injection.

The education and exercise group was educated in ways to avoid compressive load to the lateral gluteal tendons. Participants posture and functional activities were corrected.  Exercises involved progressive loading of the lateral gluteals commencing with a very gentle isometric program and progressing through a series of graded loaded exercises as the participant was able to tolerate the load. Reformers where also utilised in the later stage loading program in the Leap Trial.

If you are struggling with lateral hip pain at Bangalow Physiotherapy we can assist you using evidenced based rehabilitation and education.

References

Barratt, P., Brookes, N., Newson, A., Conservative treatments for greater trochanteric pain syndrome: a systematic review.  British Journal of Sports Medicine 2016; 51 97-104 Published Online First: 10 Nov 2016. doi: 10.1136/bjsports-2015-095858

Grimaldi, A., Conservative management of lateral hip pain: the future holds promise http://dx.doi.org/10.1136/bjsports-2016-096600

Mellor, R., Bennell, K., Grimaldi, A., Nicolson, P., Kasza, J., Hodges, P., Wajswelner, H., Vicenzino, B., Education plus exercise versus cortisosteroid injection use versus a wait and see approach on global outcome and pain from gluteal tendinopathy: prospective, single blinded, randomised clinical trial. doi: 10.1136/bmj.k1662 | BMJ 2018;361:k1662