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Do you have Hip Pain at Night: A Closer Look at GTPS

Do You Have Hip Pain at Night?

If you find yourself tossing and turning at night due to hip discomfort, you may be dealing with Greater Trochanteric Pain Syndrome (GTPS). This condition manifests as pain on the outer side of your hip, buttocks, and thigh. Let’s delve into what GTPS is and how it can possibly be the cause of your nocturnal hip woes.

Unveiling Greater Trochanter and Its Role

The Greater Trochanter is a crucial bony landmark located at the hip joint on the femur, your thigh bone. This area serves as a point of attachment for muscles supporting and facilitating hip joint movement. When pain arises in this region, it often stems from injury or irritation to the soft tissue structures—muscles, tendons, and bursa—connected to or lying over the Greater Trochanteric part of the femoral bone.

GTPS: Not Just Bursitis

Previously known as Trochanteric Bursitis, GTPS is now clinically diagnosed as lateral hip pain, encompassing bursitis (involving the Gluteus Minimus, Subgluteus Medius, or Subgluteus Maximus bursas) and tendinopathy of either the Glute Medius or Gluteus Minimus muscle tendons. This lateral hip pain tends to worsen during prolonged sitting, climbing stairs, high-impact physical activity, or when lying on the affected side.

The Role of Bursa in Your Hip

Ever wondered what a bursa is? Think of it as a fluid-filled sac that acts as a cushion in your joints, reducing friction between tissues like muscles and tendons as the joint moves. In GTPS, the bursa can become inflamed and swollen, triggering pain and further irritation to surrounding tendons.

Causes of Hip pain

Hip pain can be attributed to various causes, and Greater Trochanteric Pain Syndrome (GTPS) is one specific condition that contributes to hip discomfort. Here are some common causes of hip pain and factors associated with GTPS:

  • Overuse and Repetitive Stress:
    • Engaging in repetitive activities or overusing the hip joint, such as prolonged walking, running, or cycling, can lead to irritation of the soft tissues around the greater trochanter.
  • Muscle Imbalances:
    • Weakness or imbalances in the muscles around the hip, particularly the gluteal muscles, can contribute to GTPS. These imbalances may alter the mechanics of the hip joint, leading to increased stress on the greater trochanter.
  • Trauma or Injury:
    • A direct injury or trauma to the hip area, such as a fall or impact, can cause inflammation and pain around the greater trochanter. This may contribute to the development of GTPS.
  • Tendinopathy:
    • Tendinopathy involves degeneration or damage to the tendons, and in the case of GTPS, it often affects the tendons of the gluteus medius or gluteus minimus muscles. Tendinopathy can result from overuse, aging, or inadequate healing after an injury.
  • Bursitis:
    • Bursitis is inflammation of the bursa, a fluid-filled sac that cushions and reduces friction between tissues. In GTPS, bursitis may affect the bursa around the greater trochanter, leading to pain and discomfort, especially during certain activities.
  • Mechanical Overload:
    • Activities that place excessive stress on the hip joint, such as climbing stairs or high-impact physical activities, can contribute to mechanical overload and exacerbate GTPS symptoms.
  • Incomplete or Failed Healing:
    • If a previous hip injury did not heal properly or was incompletely rehabilitated, it may increase the risk of developing GTPS. Failed healing can result in ongoing stress on the greater trochanteric region.
  • Compression of Tendons:
    • Weakness in the surrounding muscles may lead to compression of the tendons against the greater trochanter during certain movements, contributing to GTPS symptoms.

Seeking Relief at Clearcut Physiotherapy

At Clearcut Physiotherapy, we kick off the healing journey with a thorough assessment. We evaluate your hip’s range of movement, identify painful movements, assess hip and abductor strength, recognize aggravating factors, and pinpoint potential causes of tendinopathy. Our goal is to understand the root of your hip pain comprehensively.

Following the assessment, our treatment plan unfolds. Unfortunately, GTPS responds slowly to treatment and requires a lengthy recovery period, usually around six months. We recommend an initial 12-session physiotherapy plan over three months, with a reassessment to gauge progress and determine the next steps.

Comprehensive Treatment Approach

Our treatment toolbox includes various effective tools to address GTPS:

1. Soft Tissue Release

Soft tissue release is employed to desensitize the painful area and kickstart the healing process.

2. Cupping Therapy

Cupping therapy enhances circulation and blood flow to the affected area, promoting the healing of tendinopathy.

3. Therapeutic Ultrasound

We use a state-of-the-art therapeutic ultrasound machine to expedite tissue healing in the affected region.

4. Graded Exercise Program

A graded exercise program is implemented, incorporating strengthening exercises to support the lateral hip, prevent future injuries, and mobility exercises to restore hip joint function.

Exercises for Hip Pain

Greater Trochanteric Pain Syndrome (GTPS) can benefit from a targeted exercise program to strengthen muscles, improve mobility, and reduce pain. Here are some example exercises that may be included in a GTPS rehabilitation plan. However, it’s important to consult with a healthcare professional or physiotherapist before starting any new exercise regimen to ensure it is appropriate for your individual condition.

  • Clamshell Exercise:
    • Lie on your side with your hips and knees bent.
    • Keep your feet together and lift your top knee while keeping your feet in contact with each other.
    • Hold for a moment, then lower your knee back down.
    • Repeat on both sides.
  • Side-Lying Hip Abduction:
    • Lie on your side with your bottom leg bent slightly for support.
    • Lift your top leg towards the ceiling, keeping it straight.
    • Hold for a moment at the top, then lower it back down.
    • Perform on both sides.
  • Hip Hikes:
    • Stand with one foot on a step or block.
    • Drop your pelvis on one side, then lift it back up by engaging the muscles on the side of your hip.
    • Perform controlled movements up and down.
    • Switch sides and repeat.
  • Gluteal Stretch:
    • Sit on the edge of a chair.
    • Cross your ankle over the opposite knee.
    • Gently press down on the crossed knee to stretch the outer hip.
    • Hold for 15-30 seconds and switch sides.
  • Standing Hip Flexor Stretch:
    • Stand with one foot in front of the other.
    • Bend your front knee and lunge forward, keeping your back leg straight.
    • You should feel a stretch in the front of your hip on the back leg.
    • Hold for 15-30 seconds and switch sides.
  • Resisted Hip Abduction:
    • Attach a resistance band around your ankles.
    • Stand with your feet hip-width apart.
    • Lift one leg sideways against the resistance of the band, keeping your toes forward.
    • Slowly return to the starting position and repeat on the other leg.
  • Bridge Exercise:
    • Lie on your back with your knees bent and feet flat on the floor.
    • Lift your hips towards the ceiling, engaging your glutes.
    • Hold at the top for a moment, then lower back down.
    • Repeat for several repetitions.

Remember to start with a few repetitions and gradually increase as your strength improves. If you experience pain or discomfort during any exercise, stop and consult with a healthcare professional. These exercises are general examples and may need to be adapted based on your specific condition and the guidance of a physiotherapist.

Taking the First Step to Recovery

If you’ve had enough of your lateral hip pain, there’s no need to delay. Book an appointment with Clearcut Physiotherapy today and embark on your journey to recovery. Connect with us on social media: Facebook and Instagram. Your path to relief starts now—don’t wait any longer!