Education, Tendon Loading and Kinetic Chain Exercise for GTPS

Three randomized controlled trials show that exercise combined with education about avoiding gluteal tendon compression and advice on load management helps GTPS. Rachel gives practical education on sleeping with pillows between the thighs, sitting with hips above knees, avoiding crossed legs, sand, stretches into adduction, and stairs early on. Good tendon outcomes usually need 6 to 12 months of quality rehabilitation. The proposed framework starts with isometric loading through the standing hip hitch, which shows the highest gluteus medius and minimus activity, while clams show the lowest and compress the tendon. Easier options use a belt for abduction or bridges, and progressions add toe taps, a leg swing, weights or a hip abduction machine for heavy slow resistance. Kinetic chain work includes bridge progressions, wall squats and calf raises from double leg to single leg, then step ups and planks. An MRI study supports targeting gluteus maximus and the posterior segment of gluteus minimus, and found no difference in tensor fasciae latae.