Greater Trochanteric Repair Rehabilitation.
What is greater trochanteric repair surgery?
Greater trochanteric repair is a surgical procedure performed when conservative management of gluteal tendinopathy or greater trochanteric pain syndrome (GTPS) has not produced sufficient improvement, or when there is a significant structural tear of the gluteal tendons — the gluteus medius and gluteus minimus — at their attachment to the greater trochanter of the femur. The most common procedures include open or endoscopic repair of a partial or full-thickness gluteal tendon tear, with or without concurrent bursectomy to remove the inflamed trochanteric bursa. In some cases iliotibial band (ITB) lengthening is performed at the same time to reduce the compressive load on the repaired tendons.
Surgery is typically considered after a sustained period of structured conservative physiotherapy and load management has not resolved symptoms, or when imaging confirms a significant tendon tear that is unlikely to heal without surgical intervention. Understanding what was repaired — and the degree of tear and tissue quality at the time of surgery — is important context for the rehabilitation that follows.
Why is physiotherapy important after this surgery?
The gluteus medius is the primary stabiliser of the pelvis during single-leg loading activities — walking, stairs, running and any activity that requires balance on one leg. When the tendon is torn or significantly degenerated, this stabilising function is compromised, and the muscle itself becomes inhibited and weakened over time. Surgery restores the structural integrity of the tendon, but it cannot restore the muscle strength, neuromuscular control and movement patterns that have been lost — that is the role of rehabilitation.
Without structured post-operative physiotherapy, patients frequently recover from the surgical wound itself but continue to experience pain, weakness and altered gait patterns because the underlying muscle inhibition and movement dysfunction has not been addressed. The evidence for gluteal tendon repair is still maturing, but outcomes data consistently identify the quality of post-operative rehabilitation as a key determinant of long-term function.
What does rehabilitation involve?
The early post-operative phase is governed by the surgeon's specific precautions, which typically include avoiding positions that compress or tension the repaired tendon. The most important precaution after gluteal tendon repair is avoiding hip adduction past neutral — crossing the legs, sitting with knees together or allowing the hip to drop during walking — as this places high compressive and tensile load on the repair site. A wedge or abduction pillow is sometimes used in the first few weeks to maintain a neutral position. Weight-bearing status varies depending on the extent of the repair, and crutches are commonly required for several weeks.
In the early phase, the focus is on gently activating the hip stabilisers within the permitted range, managing pain and swelling, restoring normal gait mechanics within weight-bearing guidelines, and protecting the repair from the positions and loads most likely to stress it. Education in movement modification — particularly around the adduction precaution — is central to this phase and has a direct impact on the integrity of the repair.
Through the middle phase, progressive strengthening of the gluteus medius and minimus is the primary goal. This begins with low-load, low-compression exercises in positions that avoid tendon compression — side-lying work, supported single-leg exercises and gradually progressing to standing stabilisation. The hip abductors, external rotators and lumbopelvic stabilisers are all trained progressively as load tolerance improves.
The late phase addresses higher-load functional strengthening, return to full walking tolerance, stair negotiation, and eventually return to exercise or sport. Return to running and impact activity is typically not considered until strength symmetry is well established — commonly beyond six months for more significant repairs.
How long does recovery take?
Recovery from greater trochanteric repair is measured in months rather than weeks. Patients can generally expect to be off crutches and walking independently by six to ten weeks, returning to low-impact activity by three to four months and more demanding functional activities by six months or beyond. Full recovery — including return to running or higher-impact exercise — may take nine to twelve months for significant tendon repairs. These timelines are approximate and depend on the extent of the surgical repair, tissue quality and the patient's pre-operative strength and fitness.
How can physiotherapy help?
Our physiotherapists develop a post-operative rehabilitation program based on your surgeon's specific precautions, the nature of the repair and your individual goals. Assessment, manual therapy, exercise prescription and progressive loading are provided throughout each phase of recovery. Real time ultrasound can be particularly useful in the early and middle phases to assist with deep hip stabiliser activation — the inhibition of the gluteus medius after surgery makes it difficult to activate reliably without biofeedback. Physio and exercise physiology-led Pilates offers an excellent progression environment in the middle and later phases of recovery.
For background on the underlying condition that led to surgery, our pages on greater trochanteric pain syndrome and gluteal tendinopathy cover the conservative management pathway in detail. For patients managing this condition alongside hip bursitis, our hip bursitis page may also be relevant. For patients whose surgery followed a workplace or motor vehicle injury, WorkCover and CTP funded physiotherapy is available.
Mauricio Bara is an APA Sports Physiotherapist with experience in hip conditions and post-surgical rehabilitation. Eliane Machado and Bethany Kippen also see patients following hip surgery and have experience in gluteal and hip rehabilitation. All are members of the Australian Physiotherapy Association.
To book or find out more, call us on 07 3706 3407 or book online below. We see patients from across Brisbane's southside including Tarragindi, Coorparoo, Holland Park, Greenslopes and Mt Gravatt.
Greater trochanteric repair is a surgical procedure performed when conservative management of gluteal tendinopathy or greater trochanteric pain syndrome (GTPS) has not produced sufficient improvement, or when there is a significant structural tear of the gluteal tendons — the gluteus medius and gluteus minimus — at their attachment to the greater trochanter of the femur. The most common procedures include open or endoscopic repair of a partial or full-thickness gluteal tendon tear, with or without concurrent bursectomy to remove the inflamed trochanteric bursa. In some cases iliotibial band (ITB) lengthening is performed at the same time to reduce the compressive load on the repaired tendons.
Surgery is typically considered after a sustained period of structured conservative physiotherapy and load management has not resolved symptoms, or when imaging confirms a significant tendon tear that is unlikely to heal without surgical intervention. Understanding what was repaired — and the degree of tear and tissue quality at the time of surgery — is important context for the rehabilitation that follows.
Why is physiotherapy important after this surgery?
The gluteus medius is the primary stabiliser of the pelvis during single-leg loading activities — walking, stairs, running and any activity that requires balance on one leg. When the tendon is torn or significantly degenerated, this stabilising function is compromised, and the muscle itself becomes inhibited and weakened over time. Surgery restores the structural integrity of the tendon, but it cannot restore the muscle strength, neuromuscular control and movement patterns that have been lost — that is the role of rehabilitation.
Without structured post-operative physiotherapy, patients frequently recover from the surgical wound itself but continue to experience pain, weakness and altered gait patterns because the underlying muscle inhibition and movement dysfunction has not been addressed. The evidence for gluteal tendon repair is still maturing, but outcomes data consistently identify the quality of post-operative rehabilitation as a key determinant of long-term function.
What does rehabilitation involve?
The early post-operative phase is governed by the surgeon's specific precautions, which typically include avoiding positions that compress or tension the repaired tendon. The most important precaution after gluteal tendon repair is avoiding hip adduction past neutral — crossing the legs, sitting with knees together or allowing the hip to drop during walking — as this places high compressive and tensile load on the repair site. A wedge or abduction pillow is sometimes used in the first few weeks to maintain a neutral position. Weight-bearing status varies depending on the extent of the repair, and crutches are commonly required for several weeks.
In the early phase, the focus is on gently activating the hip stabilisers within the permitted range, managing pain and swelling, restoring normal gait mechanics within weight-bearing guidelines, and protecting the repair from the positions and loads most likely to stress it. Education in movement modification — particularly around the adduction precaution — is central to this phase and has a direct impact on the integrity of the repair.
Through the middle phase, progressive strengthening of the gluteus medius and minimus is the primary goal. This begins with low-load, low-compression exercises in positions that avoid tendon compression — side-lying work, supported single-leg exercises and gradually progressing to standing stabilisation. The hip abductors, external rotators and lumbopelvic stabilisers are all trained progressively as load tolerance improves.
The late phase addresses higher-load functional strengthening, return to full walking tolerance, stair negotiation, and eventually return to exercise or sport. Return to running and impact activity is typically not considered until strength symmetry is well established — commonly beyond six months for more significant repairs.
How long does recovery take?
Recovery from greater trochanteric repair is measured in months rather than weeks. Patients can generally expect to be off crutches and walking independently by six to ten weeks, returning to low-impact activity by three to four months and more demanding functional activities by six months or beyond. Full recovery — including return to running or higher-impact exercise — may take nine to twelve months for significant tendon repairs. These timelines are approximate and depend on the extent of the surgical repair, tissue quality and the patient's pre-operative strength and fitness.
How can physiotherapy help?
Our physiotherapists develop a post-operative rehabilitation program based on your surgeon's specific precautions, the nature of the repair and your individual goals. Assessment, manual therapy, exercise prescription and progressive loading are provided throughout each phase of recovery. Real time ultrasound can be particularly useful in the early and middle phases to assist with deep hip stabiliser activation — the inhibition of the gluteus medius after surgery makes it difficult to activate reliably without biofeedback. Physio and exercise physiology-led Pilates offers an excellent progression environment in the middle and later phases of recovery.
For background on the underlying condition that led to surgery, our pages on greater trochanteric pain syndrome and gluteal tendinopathy cover the conservative management pathway in detail. For patients managing this condition alongside hip bursitis, our hip bursitis page may also be relevant. For patients whose surgery followed a workplace or motor vehicle injury, WorkCover and CTP funded physiotherapy is available.
Mauricio Bara is an APA Sports Physiotherapist with experience in hip conditions and post-surgical rehabilitation. Eliane Machado and Bethany Kippen also see patients following hip surgery and have experience in gluteal and hip rehabilitation. All are members of the Australian Physiotherapy Association.
To book or find out more, call us on 07 3706 3407 or book online below. We see patients from across Brisbane's southside including Tarragindi, Coorparoo, Holland Park, Greenslopes and Mt Gravatt.
