The greater trochanter is a significant bony landmark on the femur, the large bone of the upper leg. Locating this prominence provides a direct reference point for understanding the anatomy of the hip. Palpating this structure is a foundational skill that offers insight into the surrounding soft tissues and contributes to self-assessment of the lateral hip area.
Defining the Greater Trochanter
The greater trochanter is an irregular, quadrilateral bony eminence located at the top of the femur, positioned where the neck meets the shaft. This structure projects laterally, making it the outermost point of the upper thigh region. It is a traction epiphysis, developing where major muscles attach and pull on the bone.
The prominence is not the hip joint itself, but a distinct feature of the thigh bone, sitting approximately 2–4 centimeters lower than the femoral head, which forms the ball of the hip joint. Its position makes it easily accessible for touch on the side of the hip, even through clothing. This bony projection serves as a large attachment site for several powerful muscles responsible for hip movement and stability.
Step-by-Step Palpation Technique
The process of locating the greater trochanter begins with finding an ideal position, such as standing with weight distributed evenly or lying on the side with the hip relaxed. Place the flat palm of your hand on the lateral side of your hip, feeling for the general area of the thigh bone.
The initial landmark to find is the iliac crest, the curved top edge of the pelvis felt by placing your hands on your hips. From this high point, gently slide your fingers downward along the side of the thigh until you encounter a hard, distinct bony mass. This prominence, often the widest point of the upper thigh, is the greater trochanter.
To confirm the location, feel how the bone moves under your fingers. Keep your fingers firmly pressed against the bony prominence and slowly rotate your entire leg inward and outward. During this rotation, you should feel the greater trochanter shift or roll beneath your fingers.
When the leg is internally rotated (turned inward), the greater trochanter becomes more prominent and easier to feel. Conversely, when the leg is externally rotated (turned outward), the prominence will move slightly away or become less distinct. This rolling movement confirms that you are directly touching the bony structure of the femur, rather than just soft tissue.
If you are having difficulty locating the structure, try applying slightly firmer pressure using the pads of your index and middle fingers, as the bone may be obscured by muscle or adipose tissue. Comparing sides can be helpful, as the trochanter on the non-painful side provides a baseline. Once the initial prominence is found, you can refine the palpation by exploring the four distinct facets or borders of the greater trochanter.
Identifying Related Anatomical Structures
The greater trochanter is a crowded anatomical junction, serving as the insertion point for a complex group of muscles and housing a set of bursae. The gluteus medius and gluteus minimus muscles, the primary abductors of the hip, attach directly onto the superoposterior and anterior facets of the trochanter. These tendons stabilize the pelvis when standing on one leg.
A number of deep lateral rotators, including the piriformis, obturator internus, and gemelli muscles, insert onto the greater trochanter, particularly into the trochanteric fossa. The lateral surface of the trochanter also serves as the origin point for the upper part of the vastus lateralis muscle, one of the quadriceps muscles. The presence of many tendons makes the area susceptible to overuse injuries, such as tendinopathy.
The area is home to a complex of bursae, small, fluid-filled sacs that reduce friction between moving parts. The largest is the trochanteric bursa, situated between the greater trochanter and the overlying iliotibial tract and gluteus maximus muscle. Other bursae, such as the subgluteus medius and subgluteus minimus bursae, lie beneath the respective tendons.
Practical Applications of Accurate Palpation
The ability to accurately palpate the greater trochanter is a foundational skill with several applications in movement and health assessment. For physical therapists and trainers, it acts as a reliable reference point for measuring leg length discrepancies or assessing joint alignment. It helps correctly identify the axis of rotation for the femur, which is helpful when analyzing gait or providing exercise cues.
For individuals experiencing lateral hip discomfort, palpation is the primary method for localizing tenderness that may indicate a soft tissue issue. Localized pain upon pressing the trochanter is a common finding in conditions like Greater Trochanteric Pain Syndrome (GTPS) or gluteal tendinopathy. This tenderness helps differentiate between pain originating from the bone, the tendons, or the inflamed trochanteric bursa. Accurate localization informs the subsequent course of action, whether it involves activity modification, targeted strengthening exercises, or a medical consultation.