Case Study of a High-Functioning Walker With Lateral Hip Pain

The patient had three months of right lateral hip pain that came on after two hours of walking and lingered for two days. She was postmenopausal and positive on palpation, resisted abduction and single leg stance. Neil first mapped her weekly activity, which showed 14.5 hours of walking over four days with little recovery. Spreading the long walks out and handing some dog walks to her husband cut her pain from 8 to 4 out of 10 in three weeks. Isometric testing of gluteus minimus, medius and maximus showed weakness on the affected side, and a high step-up revealed loss of pelvic control after about 20 reps. Based on Ganderton and colleagues, where hip hitch variations reached 60 to 95% MVIC across gluteal segments, she began loaded hip hitches, then Bulgarian split squats and reverse dips. By week 11 she walked six hours with pain at 2 out of 10. Neil stresses education first, shared planning and testing in real-life positions.