Greater trochanteric pain syndrome (GTPS) -- formerly called trochanteric bursitis -- is a common cause of lateral hip pain, affecting up to 15% of women and 8% of men over 50. The current understanding has shifted from a primary bursitis model to one of gluteal tendinopathy (degeneration of the gluteus medius and minimus tendon attachments) with secondary bursal inflammation. Regardless of the precise pathology, lateral hip pain during walking and lying on the affected side are the cardinal features.
GTPS Symptoms Relevant to Walking
- Pain at the outer hip (greater trochanter) during walking, particularly at a faster pace
- Pain when crossing the legs or sitting with the hip in adduction
- Pain on ascending and descending stairs
- Pain when lying on the affected side (limiting sleep)
- Trendelenburg sign or lurch -- the pelvis drops to the non-affected side during stance, indicating gluteus medius weakness or pain inhibition
Walking Cane Placement in GTPS
A walking cane for GTPS should be placed in the hand opposite to the painful hip (contralateral placement). This is the standard recommendation for any unilateral hip condition. The contralateral cane provides an external moment that reduces the required force from the ipsilateral hip abductors (the gluteus medius and minimus at the greater trochanter) -- directly reducing load at the pain source.
Using the cane on the same side as the painful hip (ipsilateral) does not achieve this hip abductor load reduction and may reduce the therapeutic benefit.
GTPS and Load Reduction
Peak hip abductor force during normal walking is approximately 2-3 times body weight. A contralateral walking cane reduces this by creating an external moment arm:
- The cane-to-ground contact at the opposite side reduces the lever arm of body weight about the hip joint
- This reduces the muscle force required from the gluteus medius to prevent pelvic drop
- The net effect is less compressive force at the greater trochanter -- less tendinopathic loading
GTPS Severity and Cane Use
| GTPS Severity | Walking Impact | Cane Strategy |
|---|---|---|
| Mild GTPS | Pain at end of long walks or stairs; minor Trendelenburg | Cane for longer distances; gluteal strengthening programme |
| Moderate GTPS | Pain within minutes of walking; visible Trendelenburg lurch | Cane contralateral for daily walking; reduces gluteal load |
| Severe GTPS (acute flare) | Pain limits all walking; severe lurch | Cane essential; corticosteroid injection may be needed; physio |
Explore DaiWalk walking canes. Related: Walking Cane for Bursitis.
