Studies support that Tendinopathy of the Gluteus Medius and Minimus muscles, with or without bursitis, are significant causes of the greater trochanteric pain syndrome (AJR 1999; 173:1123-1126). Clinical criteria of the American College of Rheumatology defines hip OA as:hip pain and < 15° of internal rotation and < 115° of flexion al rotation and < 115° of flexion in the hip joint, OR, patient with hip internal rotation > 15° / pain with hip internal rotation / morning stiffness of the hip for > 60 minutes / and age > 50 yr. (Altman et. al. 1991).

As for patients with hip OA, studies have shown provides better outcomes than exercise alone. These patients had better outcomes on pain, stiffness, hip function, and ROM. 81% of patients treated with manual therapy showed success as opposed to 50% with exercise only treatment (Hoeksima et. al. 2004). Interesting enough, severe radiologic findings are non-prognostic and not contraindication of receiving this kind of therapy. In fact, patients showing more changes are the ones who benefit most from manual physical therapy treatments.

Physical therapy can help to reduce use of medication and increase mobility / function for this patient population. The process starts with an initial evaluation and treatment plan including home exercises, ther-ex in gym, manual therapy, and use of modalities as needed.