Differential Diagnosis:

Trochanteric Similarities Differences

1. Bursitis - Pain on the lateral - Inflammation of the

portion of the thigh bursa
- Tightness in ITB

2. LCL - Pain, swelling and - Caused by a

tenderness on the sudden bending,
knee area twisting, or a quick
change in direction.
- Injury to the
meniscus

3. PFPS - Pain seen generally - Causes is unclear

on knee area
- Gradual onset
- Overuse of
quadriceps muscle
- Affected individuals
typically have
difficulty describing
the location of pain
- MC runners

Prognosis:

- 40% of patients reported unfavourable recovery at 1-year PT treatment.

- 57% of the patients reported unfavourable recovery at 5 to 8 years after
treatment.
- Self-limiting -”although PFPS has traditionally been viewed as self-limiting, it is
common for pain to continue in the long term.

Surgical management:
● Surgical excision of bursa, cyst, or a portion of a lateral synovial recess.
● Surgical intervention is not indicated for ITB except in rare cases.
o If the conservative Treatment failed either to alleviate Pt. symptoms or
resolve the ITB syndrome.

PT management:
● Acute phase:
o PRICE
▪ Used in the early phase to protect injured tissue from aggravation
and start the healing process. Mainly to reduce inflammation and
irritation of tissues.
o Modalities
▪ TENS
● used to reduce pain and mask pain sensation
 ▪ US
● provide non thermal and thermal treatment to injured tissues
and tissue increase vascularization and healing
▪ HMP
● Increase tissue vascularity and decrease muscle tightness or
spasm.
▪ SHOCKWAVE THERAPY
● Is an alternative treatment therapy that is considered safe
with minor adverse effects in worsening symptoms over a
short period of time. It is believed to stimulate healing of soft
tissues and to inhibit nociceptors. It stimulates tendon
healing response. Shockwave treatment may stimulate
neovascularization in the tendon-bone and bone junction
thus promoting healing.
o AROM/AAROM/PROMS
▪ Increase circulation and Joint mobility or prevent contractures
o Pt. Family Education
▪ Help educate Pt. and family to reduce risk factors and avoid re-
injures and encourage Pt. to maintain and improve exercise
outcome.
● Sub-Acute Phase:
o AROM/AAROM/PROMS
o PRE’S
▪ Used to strengthen injured muscles and prevent from weakening to
stabilize Hip structures while performing activities. It is done by
using weights and progress by adding more weights in increments
o Isometrics
▪ Are performed by applying resistance/ or muscle contracts without
any joint movement. It is done if there is pain upon movement.
o Activity modification
▪ Is to prevent further aggravation of the Pt’s symptoms should be
the primary concern during treatment. It is done by promoting a
period of active rest or substantially decreasing the intensity of the
aggravating activities. Like suggest alternative exercise with lesser
aggravation to the symptoms. Ex: Swimming.
o Aerobic Exercises
▪ Improves Pt. endurance and vitality.

● Chronic Phase:
o Plyometric:
▪ There are powerful aerobic exercises to increase speed, endurance
and strength. It exerts maximum potential in a short period of time.
o Cross training:
▪ It is a great way to condition different muscle groups and develop a
new set of skills. It allows the ability to vary the stress placed on
specific muscles or even your cardiovascular system.
o Calisthenics
▪ Are a form of exercises for strength training that focuses on large
muscle groups such as running, standing, grasping and pushing or
even cycling. Exercises are often performed rhythmically and with
minimal equipment as bodyweight exercise.
▪ Sports specific training
● Training on sports activities specifically for fitness and
enhancing athletic performance and it is done in a correct
way to prevent re-injury and efficiency of movement.