Wondering about the best treatment for gluteal tendinopathy and trochanteric bursitis (sometimes also referred to as Greater Trochanteric Pain Syndrome)? This is what my research team and I also wanted to find out. As an expert physiotherapists of over 30 years, with a special interest in hip pain, I see so many people with gluteal tendinopathy and trochanteric bursitis. Before we started our research trial, I was finding that so many patients who were coming to me with this condition had tried other treatment unsuccessfully. There were common themes in what was going wrong.
So, I teamed up with a University Professor and tendon expert, Professor Bill Vicenzino and we put together a research team and a plan for a large multicentre randomised clinical trial (high quality research), the LEAP Trial, to test the most common treatments for this condition against each other. I wanted to test the treatment program I'd been using in clinic successfully, to see if this was the best treatment for gluteal tendinopathy and trochanteric bursitis.
Do you have hip bursitis or gluteal tendinopathy? Not sure where to start on your road to recovery? Or what your next steps should be?
This FREE resource provides a suggested treatment pathway, based on the available scientific evidence and Dr Alison Grimaldi's 30+ years of clinical practice as a physiotherapist and 20+ years as a researcher and educator in this field.
If you go to see your general medical practitioner or local doctor about your pain over the side of the hip, the first treatment you might be offered is some reassurance and basic advice. The Doctor might suggest you wait and see if it calms down by itself.
So we included 'Wait & See' with some basic advice in our research trial. Patients were seen once by a physiotherapist to explain a little about the condition and from some basic advice. This advice was mainly around controlling painful activities but remain active. Patients were advised to avoid complete rest but control how much and how often vigorous activity (hill and stair walking or running) is done - allowing the pain to settle and then gradually rebuilding activity levels, avoid any rapid peaks or changes.
Within 8 weeks, 30% of people were moderately, much or very much better. But 12 months, this had increased to 50% of people in this group. For some people then, that might be all that is needed, but progress can be much slower than other treatments. As you will see below, a more comprehensive education and exercise approach for gluteal tendinopathy and trochanteric bursitis had much greater success in both the short and longer term.
The other 2 treatment groups received either a corticosteroid injection (cortisone injection) with the same basic advice, or a physiotherapist led education and exercise program that was delivered over 8 weeks.
People with gluteal tendinopathy or trochanteric bursitis will usually be offered a cortisone injection by their doctor, particularly if the 'wait-and-see' approach has not been successful. Our study showed that a cortisone injection, while providing short term relief for about 60% of people, was no more successful in managing this problem in the longer term, than the wait-and-see approach. There are also concerns that cortisone injections may have negative effects on tendon tissue, particularly multiple injections, so if you have not tried any treatments yet, try an Education & Exercise Approach. I have developed a self guided program for gluteal tendinopathy and bursitis for you, that you can find via the button here, or you can look for a Hip Pain Professional to guide you through a rehabilitation program.
While you may have tried physiotherapy (physical therapy) before, research has shown that different treatment programs are not equally helpful.
Passive treatments such as massage and electrotherapy (machines) may provide some short-term relief.
However, only exercise can improve the health of muscles and tendons.
For gluteal tendinopathy, the particular program used in the LEAP Trial1 has shown the most successful results.
Do you have hip bursitis or gluteal tendinopathy? Not sure where to start on your road to recovery? Or what your next steps should be?
This FREE resource provides a suggested treatment pathway, based on the available scientific evidence and Dr Alison Grimaldi's 30+ years of clinical practice as a physiotherapist and 20+ years as a researcher and educator in this field.
Author
This blog was written by Dr Alison Grimaldi, and expert physiotherapist, educator and researcher with over 30 years working in the field, a special interest in the hip and 20+ years contributing to hip research.
Dr. Alison Grimaldi BPhty, MPhty(Sports), PhD is Practice Principal of PhysioTec Physiotherapy Clinic in Brisbane, an Australian Sports Physiotherapist, an Adjunct Senior Research Fellow at the University of Queensland, and a Fellow of the Australian College of Physiotherapists.
