Inclusion criteria |
Lateral hip pain, worst over the greater trochanter, present for a minimum of 3 months |
Age 35–70 years |
Pain at an average intensity of ≥4 out of 10 on most days of the week. |
Tenderness on palpation of the greater trochanter |
Reproduction of pain on at least one of five diagnostic clinical tests (FABER test, Static muscle contraction in FABER position, FADER test, Adduction test, Static muscle contraction in Adduction position i.e. resisted abduction) or single leg stand |
Demonstrated tendon pathology on MRI (see Table 2 for criteria) |
Exclusion Criteria |
Previous cortisone injection in the region of the lateral hip in the last 12 months |
Physiotherapy intervention or regular appropriate Pilates in the last 3 months |
Lumbar spine or lower limb surgery in the previous 6 months |
Any known advanced hip joint pathology where groin pain is the primary complaint and/or where groin pain is experienced at an average intensity of ≥2 on most days of the week, or Kellgren-Lawrence score of >2 (mild) on XRay. |
Where range of pure hip joint flexion is <90° |
Significant signs of lumbar pathology |
Known advanced knee pathology or restricted range of knee motion (must have minimum 90° flexion and full extension) |
Any systemic diseases affecting the muscular or nervous system, and uncontrolled diabetes |
Malignant tumour |
Systemic inflammatory disease |
Any factors that would preclude the participant from having an MRI (e.g. pacemaker, metal implants, pregnancy, claustrophobia) |
If the participant is involved in a legal/workcover/TAC or other injury claim |
If the participant is unable to commit to an 8 week exercise programme with twice weekly supervised sessions |
Fear of needles (trypanophobia) |
If the participant is unable to write, read or comprehend English |