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Greater trochanteric pain syndrome (GTPS)/Trochanteric bursitis/Gluteal tendinopathy (Part 1)

Greater trochanteric pain syndrome (GTPS) is a term used to describe pain overlying the outer aspect of the hip, it was also described as trochanteric bursitis. Ultrasonography and MRI has revealed that the deep abductor muscle tendons (gluteus medius and minimus) develop changes (tendinopathy) and these muscles develop weaknesses. The adjacent bursae (fluid filled pouch) may also become inflamed.

Symptoms of GTPS consist of persistent pain on the outside of the hip and can radiate along the outer aspect of the thigh to the knee or into the buttock. Physically pressing reveals tenderness of the bony area on the outside of your hip (Greater Trochanter).

These symptoms are three times more common in women than men, particularly over the age of 50. This is due to women’s hips generally being wider increasing the force on the gluteal tendons.

Repetitive overuse or a sudden change in activity can cause increased compression and tension on the tendons particularly if there is an underlying weakness of the muscles around the pelvis. Examples include starting to run or doing high impact classes after a long lay-off.

Part 2

The latest proposed treatment regime is to reduce the compression of the deep abductor tendons on the greater trochanter (bone), by initially reducing the work load on the tendon and then progressively strengthening these deep muscles. In 2018 a randomised control trial in the BMJ compared advice/exercise versus corticosteroid injection versus wait and see. The patients were followed up over 1 year. The advice/exercise gave the best results. Marked improvements occurred within 8 weeks of performing the progressive exercise programme.

Continuing to do the exercises long-term will provide a long-term preventative programme.

Here at Fontwell the physiotherapist will initially perform an examination to establish:

1. the diagnosis and exclude other pathologies.

2. the underlying cause/s which will be unique to your posture and the movement mechanics pertaining specifically to your activities.

The exercise programme is progressive and will take at least 3 sessions. For best results you will be expected to do exercises daily. The advice below is key to the success of the programme and you can start on these prior to your visit.

In the case of severe pain (with no response to the programme) an ultrasound guided injection may be helpful, if the bursae are inflamed (this can be seen on the ultrasound). The injection is not put into the tendons. The injection may reduce pain and thus allow the exercises to be performed which improves the muscle/tendon unit’s ability to withstand load. Shockwave therapy directed at the tendon is an intervention sometimes used if there is no response to the treatments outlined.

Why Hydrotherapy?

1. Pain Relief: Immersion in warm water can help relieve pain and discomfort associated with various conditions such as arthritis, fibromyalgia, and muscle strains.

2. Muscle Relaxation: Warm water helps to relax muscles, alleviate tension, and reduce muscle spasms. This can be particularly beneficial for individuals suffering from muscle injuries, chronic pain, or stiffness.

3. Improved Circulation: Hydrotherapy promotes better blood circulation by dilating blood vessels and increasing blood flow to tissues.

4. Enhanced Range of Motion: Exercising in water allows for gentle resistance without putting excessive strain on joints.

5. Cardiovascular Health: Engaging in aquatic exercises can strengthen the heart and cardiovascular system, leading to better heart health and endurance. Water provides natural resistance, making it an effective medium for low-impact cardiovascular workouts.

6. Improved Rehabilitation: Hydrotherapy is commonly used as part of rehabilitation programs for various orthopaedic and neurological conditions. Its low-impact nature makes it suitable for individuals recovering from injuries or surgery, facilitating faster recovery and improved functional outcomes.

Power of Pilates: A Path to Physical and Mental Wellness

The power of Pilates. Developed by Joseph Pilates in the early 20th century.
Pilates is a system of controlled movements that engage the mind and condition the body. By emphasizing proper alignment, breath control, and mindful movement, Pilates works to strengthen the core, improve posture, and enhance overall body awareness.
Beyond its physical benefits, Pilates also holds profound benefits for mental health and emotional well-being. The emphasis on mindful movement and breath awareness promotes relaxation, reduces stress, and enhances mental clarity.
Pilates is its accessibility to individuals of all ages and fitness levels. Whether you're a seasoned athlete looking to enhance performance, a newcomer seeking to improve overall health, or someone recovering from injury, Pilates can be tailored to meet your specific needs and goals.

If Pilates sounds like something that you would like to get involved with, we have two great Pilates instructors in both Amanda and Louise. Please get in touch if you would like to know more.

The power of Cardio!

🌟 Unlock Your Potential with Exercise! 💪

🏋️‍♀️ Exercise isn't just about losing weight; it's about gaining life! Here's why it's so crucial:

1️⃣ Boosts Mood: Exercise releases endorphins, the feel-good hormones, helping reduce stress and anxiety.

2️⃣ Strengthens Heart Health: Regular physical activity lowers the risk of heart disease, stroke, and high blood pressure.

3️⃣ Improves Energy Levels: You'll feel more energized as exercise enhances blood flow and oxygen delivery to tissues.

4️⃣ Enhances Sleep Quality: Say goodbye to restless nights! Exercise promotes deeper, more restful sleep.

5️⃣ Builds Strength and Flexibility: Strengthen muscles, improve flexibility, and maintain bone density to stay agile and resilient.

6️⃣ Boosts Brainpower: Exercise stimulates brain function, enhancing memory, concentration, and overall cognitive abilities.

7️⃣ Promotes Longevity: Regular exercise is linked to a longer, healthier life, reducing the risk of chronic diseases.

🚀 Whether it's a brisk walk, a yoga session, or a gym workout, prioritize exercise for a happier, healthier you! Your body and mind will thank you. 💫 #ExerciseIsKey #HealthyLifestyle #UnlockYourPotential 🌟

A quick guide to a healthy heart

1. Eat a Heart-Healthy Diet:

- Include a variety of fruits, vegetables, whole grains, and lean proteins in your meals.

- Reduce saturated and trans fats, cholesterol, and sodium in your diet.

- Prioritize foods rich in omega-3 fatty acids, such as fatty fish (salmon, mackerel, trout), flaxseeds, and walnuts.

2. Exercise Regularly:

- Aim for at least 150 minutes of moderate-intensity aerobic exercise or 75 minutes of vigorous-intensity exercise per week.

- Include both aerobic exercises (walking, jogging, swimming) and strength training in your routine.

3. Maintain a Healthy Weight:

- Strive for a body mass index (BMI) within the recommended range.

- Losing even a small amount of excess weight can significantly benefit heart health.

4. Quit Smoking:

- Smoking is a major risk factor for heart disease. Seek support and resources to quit smoking.

- Avoid exposure to second hand smoke, as it can also contribute to heart problems.

5. Limit Alcohol Intake:

- If you consume alcohol, do so in moderation. For most adults, this means up to one drink per day for women and up to two drinks per day for men.

6. Manage Stress:

- Practice stress-reducing techniques such as mindfulness, meditation, deep breathing, or yoga.

- Establish a healthy work-life balance and prioritize activities that bring joy and relaxation.

7. Get Quality Sleep:

- Aim for 7-9 hours of sleep per night.

- Establish a consistent sleep schedule and create a relaxing bedtime routine.

8. Monitor Blood Pressure:

- Regularly check and manage your blood pressure.

- Follow a low-sodium diet and take any prescribed medications as directed by your healthcare provider.

9. Control Cholesterol Levels:

- Monitor cholesterol levels and work with your healthcare provider to manage them.

- Include soluble fibre in your diet, which can help lower cholesterol.

10. Stay Hydrated:

- Drink an adequate amount of water throughout the day.

- Limit the intake of sugary beverages and excessive caffeine.

11. Regular Health Check-ups:

- Schedule regular check-ups with your healthcare provider to assess your heart health.

- Discuss any concerns, symptoms, or family history of heart disease.

Remember, these steps contribute to overall heart health, and it's essential to personalise them based on your individual needs and any specific recommendations from your healthcare provider. Making gradual, sustainable changes in your lifestyle can significantly enhance the health of your heart over time.

The Lower Back Basics – Feb 2024 Blog

Welcome to our physio blog, where we explore the fundamentals of lower back pain, a common ailment that affects many individuals. In this guide, we'll cover the basics, causes, prevention strategies, and exercises to help you manage and alleviate lower back pain.

Anatomy of the Lower Back

The lower back, or lumbar region, consists of five vertebrae (L1-L5) and supports much of the body's weight. Intervertebral discs, muscles, ligaments, and nerves work together to provide stability, flexibility, and movement.