PT Treatment
This is the best place to go to help with GTPS!
What is see a physiotherapist for exercise at Zone Physiotherapy!!!
This is an intrinsic (1) and extrinsic risk factor (1) for GTPS.
What is:
Intrinsic:
female, 40-60yo, menopause/perimenopause, LLD, scoliosis
Extrinsic: LBP, OA, ITB tenderness, obesity, sedentary, repetitive activity, mechanical overload, training error
This physio finished IN FIRST PLACE at 2:08.46s at the Frank Dunn Triathalon this year.
Who is Brad Spokes? BEAST mode.
This is an isometric exercise for progressive load management that I (you the physio) like to prescribe.
What is:
isometric hip abduction
30-45s hold, daily 3-4x
This image is commonly ordered due to accessibility to clinically diagnose GTPS (along with positive clinical tests).
What is ultrasound?
MRI - yes but hard to access
Xray - to r/o OA
This is the ideal sleep or sit position to reduce pain or function irrespective of an exercise program.
What is:
sleep - on back, or on side with pillow between legs and mattress topper
sit - cross legged
These are the most common causes of GTPS. (name 1)
What is:
Gluteal Tendinopathy
Partial tear of gluteal tendons
This is the name of the physio in this picture.
Who is Ted Tilbury?
This isotonic exercise can follow isometrics as the next progression.
What is.. e.g double leg glute bridge with loop band, goblet squat
3 sets 10-12 reps, 3 x/ week 3s up 3s down
These are the number of months (without sig. relief) a physio may consider a referral for an injection.
3 months ...but still need to exercise! Biomechanical faults still need to be addressed along with load management.
A systematic review showed this exercise to have the highest maximum voluntary isometric contraction (MVIC) on EMG of the gluteus Medius muscle.
What is side plank with hip abduction?
This is a differential diagnosis (a few correct answers) for GTPS that need to be ruled out.
What is
Hip OA
FAI
ITB Syndrome
Great Trochanteric Bursitis
This physio tidied and cleaned up decades of abandoned therabands.
Who is Colin Dyck? YAY!
This aysmmetric exercise can follow isotonics as the next exercise progression.
What is
an exercise that involves single leg asymmetric loading (e.g. clam shells, SLS kickstand, 3 sets 8-10, 3 x/ week)
These medications are commonly prescribed for GTPS.
What is
tylenol, advil, diclofenac cream
These are the parameters for shockwave that can benefit as an adjunct to exercise.
2.6 bars / 2000 hits/ 12 bars - 3-4 treatments
Side note: Research:
- at 12 mo shockwave group better pain/ function compared to corticosteroid injection group (RCT)
- shockwave and exercise better than only shockwave (RCT)
These are 2 symptoms patients may report with GTPS (there are more than 2).
What is:
Pain with palpation
Pain worse with adducted hip positions
Pain with Wbing
Pain with resisted hip abduction
This is the average number of laundry loads the front staff graciously wash in a day.
What is 3-4? Thank you Rachel!!!!
This energy storage/ plyometric exercise is prescribed in the late stages progressive loading.
What is...
controlled pogo hops, curtsey step ups, lateral band walks
2-3 sets low reps
These injections are commonly offered for gluteal tendinopathies.
What is corticosteroid injections?
(this can be effective for symptom management but repetitive injections can have a poor impact on tendon health). PRP is sometimes considered with emerging evidence though low at this time.
Describe a progressive load exercise program for gluteal tendinopathy.
What is:
Isometrics first
Isotonic loading
Energy storage loading
RTS
Discomfort is kept mild <4/10 and pain returned to basline in 24 hours.
When positive, these3 clinic based tests (there are more than 3) would point toward GTPS.
What is
Palpation of greater trochanter
30s single leg stance test
FABER test
Resisted Hip Abduction
Fader Test with Resistance
Adduction with Resistance
This is how you spell _____ backwards in 30 seconds.
Y-H-T-A-P-O-N-I-D-N-E-T
This is the length of this loop band (within 2 inches).
What is 19inches
This is the best treatment for GTPS.
What is exercise and education?
According to the LEAP Trial, comparing
1. PT exercise and education
2. corticosteroid only
3. wait and see
At 52 weeks education and exercise group showed much better long term results than both groups.