Hip bursitis

Definition

Hip bursitis is also known as trochanteric bursitis. A painful inflammation of the bursa which separates the greater trochanter of the femur and the muscles and tendons of the thighs and buttocks. However many well regarded studies prove that there is no inflammation in patients with hip bursitis.

The scientific consensus concluded that patients presenting with symptoms of what used to be known as trochanteric hip bursitis should be called greater trochanteric pain syndrome (GTPS).

SO WHY

HIP BURSITIS

IS NO LONGER

CALLED AS SUCH?

Based on literature review of recent studies only 15% of patients with pain and tenderness around lateral hip had one of the hip bursas inflamed. Over 70% of patients with lateral hip pain had some kind of abnormalities in tendons attaching to greater trochanter (lateral hip bone). Some patients also had coxa sultans (snapping hip).

Research doctors concluded that the evidence showed inflammatory etiology (causation) is too weak. The current belief is that the etiology in GTPS is of degenerative overuse nature with secondary involvement in bursal tissue.

The most common activity associated with trochanteric bursitis is running and jumping. Patients usually complain of lateral hip pain even though the hip joint is not involved in this ailment. The trademark of trochanteric bursitis is tenderness over the greater trochanter.

Anatomy

A bursa is a small fluid-filled sac that reduces friction between bone and soft tissue. In the case of a patient suffering from trochanteric bursitis- there is an increase of friction causing inflammation in the bursa between the muscles (gluteus medius), tendons, and bones.

The hip abductor muscles (gluteus maximus, gluteus medius and gluteus minimus) are the main stabilizers of the hip joint during weight bearing. Their relative tendons as well as TFL and IT band attach to different facets (bony attachment surfaces) of the lateral femur.

ETIOLOGY

Variety of abnormalities of hip muscle tendons attaching to the greater trochanter such as tendinopathy and/or snapping tendons are the main stake of this pathology.

FUNCTIONAL
PATHOLOGY

  • Hip and pelvic instability
  • Poor adductor /abductor balance
  • Abnormal weight shifting
  • Compensatory weight distribution imbalance

Incidence and Prevalence:

GTPS is a condition prevalent in middle-aged women, people suffering from low back pain and middle age runners.

Statistic data shows
10-20%
incidence in this population

Risk Factors:

  • Work or play activities that causes overuse
  • Stress on soft tissues
  • Gout
  • Rheumatoid arthritis
  • Previous surgeries
  • Playing sports
  • Poor posture
  • Poor weight bearing
  • Short leg syndrome
  • Low back pain

Diagnosis

Clinical history and proper examination is usually sufficient, however diagnostic ultrasonography or an MRI is very accurate and preferred in determining the stage and extent of GTPS.

Prognosis

According to research, individuals responded to treatment very well and within the first 6 months.

TREATMENT at NYDNRehab

At NYDNRehab we have extensive experience treating Trochanteric bursitis. Based on sonographic and functional evaluation we create an individual treatment plan. Treatment options may very depending on type and stage of the bursitis, tendinopathy and may involve: combination of manual therapy, ESWT (extracorporeal shock wave therapy), physical therapy exercises to eliminate hip muscle imbalance, hip pelvic instability and normalize weight bearing distribution.

We use our unique CAREN (computer assisted rehabilitation environment) technology to retrain symmetrical weight bearing and equalize weight shifting.

We also utilized our advanced Gait Analysis which can help in pinpointing the insufficiencies and deficits of hip movement which is crucial to assigning an individualized treatment plan.

How we treat

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phone: 1-866-311-5889
e-mail: info@nydnrehab.com
address: 130 West 42 Street, Suite 1055, New York, NY 10036

Trochanteric Hip Bursitis Treatment

Hip bursitis also known as trochanteric bursitis is when the fluid filled sack called trochanteric bursa is inflamed or irritated. The trochanteric bursa is located between the iliotibial band and the greater trochanter. The pain caused by this is typically felt on the side of the hip. In order to get a hip bursitis treatment that works the cause needs to be established and adressed with consideration of individual factors at stake.
There are different causes for trochanteric bursitis the most common comes from a fault in mechanics. The mechanical fault is usually found at the pelvis and hip. Typically it is due instability and lack of muscle control of the femur during activity. These activities could be intense athletic activities such as running or jumping to everyday activities such as walking or using stairs. Another cause is pronation of the foot while performing any of these weight bearing activities. Again it is important for the therapy of hip bursitis to treat the cause. This will insure long lasting results.
There are several treatments that only provide temporary relief but since the root of the problem is not fixed the pain will continue to return. The correct treatment for hip bursitis is to strengthen the muscles around the femur and learn how to activate these muscles correctly. This allows for proper mechanics of the hip and pelvis while performing weight bearing activities. Also to help with pronation of the foot orthotics or different footwear can be used along with exercises.
We have a variety of treatment plans for therapy of hip bursitis along with advanced equipment to help you get on the road to recovery. Our doctors and physical therapist are very experienced with treating trochanteric bursitis and many other activity induced pains. The goal is for you to learn the exercises and information to keep you active and pain free for life.

 

PREVENTING HIP BURSITIS PAIN

  • Always warm up before exercising
  • Do not sit with your legs crossed
  • Do not stand hanging on one leg
  • Do not sit with your feet under your buttocks
  • Create proper ergonomic workstation
  • Roll your IT bands regularly
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