Volume 2,Issue 1
Zhang Zhenyu Treating Greater Trochanteric Pain Syndrome with Tuina Therapy of “Four-Step Linkage Method”
Greater Trochanteric Pain Syndrome (GTPS) is a common clinical disorder, mainly presenting with lateral hip pain and potentially leading to walking difficulties. Based on the theories of myofascial chains and precision mechanics, Professor Zhang Zhenyu argues that localized hip pain in this condition can be alleviated through targeted manual manipulation, with the gluteus medius, gluteus minimus, and tensor fasciae latae serving as the primary target areas for treatment. However, to restore the stability of the hip, gluteal region, and pelvis while comprehensively improving symptoms, a holistic approach is essential. This approach adheres to the principle of “strengthening tendons to stabilize bones, regulating the abdomen to treat the hip, loosening tendons to resolve adhesions, and restoring knee-ankle alignment”, and implements the Four-Part Coordinated Regulation targeting the lumbar region, abdomen, knee, and ankle. Combined with self-directed functional exercises, this intervention achieves simultaneous improvement in pain relief and functional recovery and has demonstrated significant clinical efficacy.
[1] Soi-disant A, Andrade AJ, Baillou A, et al., 2023, The 2022 International Society for Hip Preservation (ISHA) Physiotherapy Agreement on Assessment and Treatment of Greater Trochanteric Pain Syndrome (GTPS): An International Consensus Statement. Journal of Hip Preservation Surgery, 10(1): 48–56.
[2] Bicket L, Cooke J, Knott I, et al., 2021, The Natural History of Greater Trochanteric Pain Syndrome: An 11-year Follow-up Study. BMC Musculoskeletal Disorders, 2021(22): 1–10.
[3] Zhang LL, Zhao YY, Jia ZS, et al., 2023, Research Progress in the Diagnosis and Treatment of Greater Trochanteric Pain Syndrome. Chinese Journal of Bone and Joint Surgery, 16(8): 762–768.
[4] Alker-Santiago R, Wojnowski NM, Lall AC, et al., 2020, Platelet-rich Plasma Versus Surgery for the Management of Recalcitrant Greater Trochanteric Pain Syndrome: A Systematic Review. Arthroscopy, 36(3): 875–888.
[5] Su H, Zhang ZY, Fan S, et al., 2022, Professor Zhang Zhenyu’s Experience in the Treatment of Knee Osteoarthritis with the “Four-in-one” Method Combining Local and Overall Regulation. China Medical Herald, 19(13): 140–144.
[6] Myers TW, 2009, Anatomy Trains: Myofascial Meridians for Manual and Movement Therapists. Elsevier Health Sciences, Munich.
[7] Pan JJ, Zhang ZY, Fan S, et al., 2020, Clinical Experience of Professor Zhang Zhenyu in Treating Long Thoracic Nerve Entrapment Syndrome with Precision Biomechanical Manipulation. Chinese Journal of Basic Medicine in Traditional Chinese Medicine, 26(8): 1183–1186.
[8] Xu Y, Zhang C, Ran MS, et al., 2022, Clinical Study on Precision Manipulation Combined with Resistance Training in the Treatment of Frozen Shoulder Dysfunction. Shandong Journal of Traditional Chinese Medicine, 41(1): 33–36 + 43.
[9] Zhang C, Lü X, Liu JY, et al., 2022, Greater Trochanteric Pain Syndrome: Anatomy, Pathology, Differential Diagnosis and Treatment. Chinese Journal of Tissue Engineering Research, 26(2): 296–301.
[10] Ge WL, Fan XC, Wei L, 2023, Case Reports of Misdiagnosis and Mistreatment of Two Cases of Atypical Lumbar Disc Herniation. Orthopaedics, 14(4): 381–384.
[11] Zhang LL, Jia ZS, Zhang XT, et al., 2023, Research Progress in the Etiology and Risk Factors of Greater Trochanteric Pain Syndrome. Academic Journal of Chinese PLA Medical School, 44(12): 1415–1419.
[12] Gogu S, Gandbhir VN, 2022, Trendelenburg Sign. StatPearls Publishing, Treasure Island.
[13] Fan S, Zhang ZY, Ran MS, et al., 2022, Professor Zhang Zhenyu’s Experience in Treating Primary Dysmenorrhea with Tuina Manipulation Based on Myofascial Pain Theory. Chinese Journal of Basic Medicine in Traditional Chinese Medicine, 28(8): 1351–1354.
[14] Pain Medicine Branch of the Chinese Medical Association, 2020, Guidelines for the Diagnosis and Treatment of Pain Diseases in China. People’s Medical Publishing House, Beijing, 595.
[15] Shi MX, Shi ZX, Yuan ZP, et al., 2025, Effects of Meridian Tendon Huici Needling Combined with Traditional Chinese Medicine Fumigation on NF-κB Signaling Pathway in Knee Osteoarthritis Model Rats. Journal of Clinical Acupuncture and Moxibustion, 41(6): 77–82.
[16] Sun H, Wang JQ, 2021, Research Progress on Hip Rotator Cuff Injury. Chinese Journal of Sports Medicine, 40(5): 380–384.
[17] Reimer LCU, Jacobsen JS, Mechlenburg I, 2019, Hypermobility among Patients with Greater Trochanteric Pain Syndrome. Danish Medical Journal, 66(4): 1–5.
[18] Tian N, Yue Y, Wang PZ, et al., 2021, Magnetic Resonance Imaging Findings of Greater Trochanteric Pain Syndrome. Chinese Journal of Orthopaedic Surgery, 29(23): 2197–2199.
[19] Wu M, Fan XX, Ding K, et al., 2022, Exploration of the Application of Myofascial Chain Theory in Pain Diagnosis and Treatment. Massage and Rehabilitation Medicine, 13(1): 71–74.
[20] Simons DG, 1996, Clinical and Etiological Update of Myofascial Pain from Trigger Points. Journal of Musculoskeletal Pain, 4(1–2): 93–122.
[21] Shah JP, Gilliams EA, 2008, Uncovering the Biochemical Milieu of Myofascial Trigger Points Using in Vivo Microdialysis: An Application of Muscle Pain Concepts to Myofascial Pain Syndrome. Journal of Bodywork and Movement Therapies, 12(4): 371–384.
[22] Travell JG, Simons DG, 1992, Myofascial Pain and Dysfunction: The Trigger Point Manual. Lippincott Williams & Wilkins, Pennsylvania.
[23] Brennan KL, Allen BC, Maldonado YM, 2017, Dry Needling Versus Cortisone Injection in the Treatment of Greater Trochanteric Pain Syndrome: A Noninferiority Randomized Clinical Trial. Journal of Orthopaedic & Sports Physical Therapy, 47(4): 232–239.
[24] Shao K, Yang Y, 2022, Positive Effects of Abdominal Tuina on Low Back Pain in Patients with Lumbar Disc Herniation during Recovery Period. Modern Medicine and Health Research Electronic Journal, 6(9): 29–33.
[25] Dorsher PT, 2009, Myofascial Referred-pain Data Provide Physiologic Evidence of Acupuncture Meridians. The Journal of Pain, 10(7): 723–731.
[26] Bennell KL, Hunt MA, Wrigley TV, et al., 2010, Hip Strengthening Reduces Symptoms but not Knee Load in People with Medial Knee Osteoarthritis and Varus Malalignment: A Randomised Controlled Trial. Osteoarthritis and Cartilage, 18(5): 621–628.
[27] Du JL, Wang ZY, Kang X, et al., 2023, Time-course Relationship between Pain-associated Anxiety and Depression Changes and Neuronal Activation in the Medial Prefrontal Cortex and Anterior Cingulate Cortex of Mice. Journal of Air Force Medical University, 44(11): 1034–1040.
[28] Li H, Fan K, Ma J, et al., 2021, Massage Therapy’s Effectiveness on the Decoding EEG Rhythms of left/right Motor Imagery and Motion Execution in Patients with Skeletal Muscle Pain. IEEE Journal of Translational Engineering in Health and Medicine, 2021(9): 1–20.
[29] Nakano H, Kodama T, Ueda T, et al., 2019, Effect of Hand and Foot Massage Therapy on Psychological Factors and EEG Activity in Elderly People Requiring Long-term Care: A Randomized Cross-over Study. Brain Sciences, 9(3): 54.