2 of 12 Top Hip Papers of 2025 | Functional Test Performance in Women With and Without GTPS
Welcome to day 2 of my 12 Top Hip Papers of 2025 miniblog series. On day 2, we are going to take a look at a new paper this year that investigated if functional tests discriminate between women with and without Greater Trochanteric Pain Syndrome (GTPS), and reported how those with GTPS perform on these tests. This information is useful for both clinical practice and research, providing guidance on functional tests for GTPS that can be used to assess and monitor change in physical function for those with lateral hip pain, gluteal tendinopathy or GTPS.
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2 of 12 Top Hip Papers of 2025: Do functional tests discriminate between women with and without GTPS, and how do those with GTPS perform?1
Background:
Gluteal tendinopathy or GTPS is known to have a substantial impact on physical function, particularly weightbearing tasks, but there has not been adequate guidelines in the literature as to which functional tests for GTPS may be most useful for assessing these physical impairments and monitoring progress over time. This study, a cross-sectional study of women with and without Greater Trochanteric Pain Syndrome (GTPS) was designed to help address this gap in the evidence.
Study Aims:
- To compare functional capacity of women with and without GTPS,
- To assess the reliability and validity of functional tests that simulate the movements that exacerbate lateral hip pain, and
- To establish which functional test best discriminates between those with and without GTPS.
What was done:
Method:
Patient rated outcome measures and functional performance tests were completed by 23 participants with, and 23 without GTPS in this cross-sectional study.
GTPS Group: (Mean age 47.8 years)
- Unilateral trochanteric pain (VAS ≥3) for at least 3 months
- Pain on palpation over the greater trochanter
- Reproduction of trochanteric pain on at least 1 of FABER, Resisted External Rotation Test, Resisted Abduction or 30sec Single Leg Stance Test.
Painfree Group: (Mean age 47.1years)
- No pain or disability.
Assessments
Patient Rated Outcome Measures (PROMs):
- Numeric Pain Scale, VISA-G, IPAQ-SF (physical activity score).
Physical Tests:
- HipSIT- isometric strength in ‘clam’ position, in 20° hip abduction.
- Functional Tests
- 30-sec sit to stand test,
- stair ascent test,
- stair descent test, and
- the Timed Up and Go.
Tests were performed by 2 blinded assessors. Participants filled out the VISA-G, a gluteal tendinopathy/GTPS specific PROM. This was followed by a single measure of hip strength, termed the HipSIT - an isometric strength test in the 'clam' position and 4 physical performance tests:
- the 30 second Sit - Stand test
- time to ascend 9 steps without support
- time to descend 9 steps without support
- the Timed Up and Go (TUG) test.
Reliability of functional tests for GTPS was assessed, and validity was tested against the VISA-G and discriminatory ability was examined.
Key Findings:
This study found that those with GTPS scored more poorly on all of the physical tests, except the HipSIT 'clam' strength test. The stair ascent test and the TUG were shown to be most reliable functional tests for GTPS and may be therefore most useful as functional outcome measures for patients with GTPS and gluteal tendinopathy.
The Stair Ascent Test and the TUG also closely reflect key difficulties that people with GTPS/Gluteal Tendinopathy experience - ascending stairs and getting up out of their chair and walking off quickly.
Clinical Implications:
- Women with GTPS have worse functional capacity in single leg weightbearing activity compared to asymptomatic women.
- The lack of between-group difference in hip strength using a clam type action (HipSIT), suggests it is preferable to test, and arguably to strengthen, the abductors in a more targeted manner.
- Walking up stairs, and rising to stand and walk, are common problems for those with GTPS. These findings suggest these tests may be useful as functional outcome measures for this group. Also collecting a pain index may improve correlation with the VISA-G.
Using the Stair Ascent Test and the Time Up and Go as functional performance measures is a great way to test and track your patients' progress over time. Also, the authors suggest that collecting a pain score during the test performance may improve correlation with the VISA-G - it's quick and easy to get them to rate the intensity of their trochanteric pain during the tests.
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Like to learn more about managing gluteal tendinopathy or Greater Trochanteric Pain Syndrome (GTPS)?
In this course, you can find detailed information on pathoaetiology, assessment and management of lateral hip pain associated with gluteal tendinopathy (greater trochanteric pain syndrome, trochanteric 'bursitis'), and many other conditions. To learn more, take the online course, or join me in a workshop.
This online course is included in Hip Academy and Hip Academy members receive discounts for online workshops.
I hope you enjoyed the infographics and key learnings from Day 2 of my 12 Top Hip Papers of 2025. There are 10 other papers to come, so keep an eye out on the graphics below, to see what other top papers and infographics I have prepared for you!
Missed paper 1? Click above to read it!
Paper 3 comes out tomorrow!
Want to catch up on the 12 Top Hip Papers from 2021, 2022, 2023, and 2024?
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