Explanation of Diagnosis

Greater Trochanteric Pain Syndrome (GTPS) is inflammation of the tendons, bursae, or muscles around the greater trochanter (the bony bump on the outer hip). It is caused by repetitive stress, weak hip muscles, poor biomechanics, or direct trauma to the hip. Symptoms include pain on the outer hip, tenderness when lying on the affected side, stiffness, and discomfort when walking, climbing stairs, or standing for long periods.

Specific Work Modifications

• Avoid prolonged standing or walking; take sitting breaks if possible.
• Use a cushioned seat with proper lumbar support to prevent hip strain.
• Avoid sitting with legs crossed, which can worsen hip pain.
• Modify tasks to avoid repetitive side-to-side movements or excessive stair climbing.
• Apply ice or heat to the hip during breaks to relieve pain.

Specific Activity Modifications

• Avoid high-impact activities like running, jumping, or excessive side-to-side movements.
• Modify workouts by switching to low-impact exercises like swimming, cycling, or water aerobics.
• Perform proper warm-ups and stretching before activity.
• Use proper footwear and arch supports to maintain good biomechanics.

Recommended Supplements

• Collagen peptides (10 g daily) – Supports tendon and ligament healing.
• Vitamin D3 (1000-2000 IU daily) – Aids in bone and joint health.
• Magnesium (300-400 mg daily) – Helps with muscle relaxation and recovery.
• Omega-3 fatty acids (1000 mg daily) – Reduces inflammation and stiffness.
• Turmeric (500 mg twice daily) – Natural anti-inflammatory.

Recommended Nutrition and Hydration

Diet Recommendations:

• Anti-inflammatory foods: Fatty fish (salmon, sardines), turmeric, berries, nuts, and leafy greens.
• Collagen-boosting foods: Bone broth, citrus fruits, and bell peppers.
• Protein-rich foods: Chicken, eggs, lentils, and dairy to support tendon repair.
• Limit processed foods, sugar, and alcohol, which can worsen inflammation.

Hydration Tips:

• Drink at least 2–3 liters of water daily to maintain tissue hydration.
• Limit caffeine and alcohol, which can slow healing.

Home Exercise Prescription

Perform 2-3 times daily to improve hip strength and flexibility:

Phase 1: Pain Relief & Mobility (Days 1-5, Reduce Swelling & Stiffness)

1. Ice Therapy

1. • Apply ice for 15-20 minutes, 3-4 times daily to reduce swelling.

2. Hip Flexor Stretch

1. • Stand or kneel, lunge forward, and stretch the hip flexors.
   • Hold for 20-30 seconds, repeat 3 times per leg.

3. Gluteal Stretch (Seated or Lying Down)

1. • Cross the affected leg over the opposite knee and pull toward the chest.
   • Hold for 20-30 seconds, repeat 3 times.

Phase 2: Strengthening & Stability (After 5-7 Days, Once Pain Improves)

4. Clamshell Exercise (Hip Abductor Strengthening)

1. • Lie on your side with knees bent, lift the top knee without moving your hips.
   • 10 reps per side, 2 times daily.

5. Side-Lying Leg Lifts

1. • Lie on your side and lift the top leg while keeping it straight.
   • 10 reps per leg, 2 times daily.

6. Bridges (Glute Strengthening)

1. • Lie on your back, bend knees, and lift hips.
   • 10 reps, 2 times daily.

Phase 3: Return to Activity (After 2-3 Weeks, If Pain-Free)

7. Standing Hip Abduction

1. • Stand tall and lift one leg sideways.
   • 10 reps per leg, 2 times daily.

8. Mini Squats (If Comfortable)

1. • Keep weight in the heels, perform shallow squats.
   • 10 reps, 2 times daily.

⚠ Avoid running, jumping, or repetitive side-to-side movements until symptoms improve (typically 4-6 weeks).

Helpful Books

1. "Rehab Science: How to Overcome Pain and Heal from Injury" – Tom Walters, DPT
2. "The Hip Pain Handbook: A Guide to Preventing and Treating Hip Injuries" – Nicolas Piuzzi, MD

Contact the Key West orthopedic clinic or reach out to Dr. Jason Pirozzolo.