Hip pain is a common complaint, especially as we age. Although there can be many different causes we will focus here on hip pain caused by bursitis — specifically greater trochanteric bursitis.
A bursitis is inflammation of the fluid-filled sac between tendon and bone. The purpose of the bursa is to decrease friction in an area where tendons often rub back and forth over the bone as you move. The bursa most often inflamed in the hip is over the greater trochanter, as the IT Band snaps back and forth with walking or running.
The involved structures are the bursa surrounding the greater trochanter (which is injured) and the iliotibial band (which is the culprit).
What Causes Hip Pain?
As noted, the focus of this article is on pain caused by bursitis. Other potential causes include arthritis, injuries, disease (notably cancer), and osteoporosis or synovitis with children.
Bursitis-realted hip pain is caused by increased friction on the bursa from tendons passing back and forth over it as you move. If the gluteus muscles are weak the iliotibial band tightens to compensate for a lack of lateral stability at the hip, which increases friction over the greater trochanter, leading to inflammation.
Symptoms
The primary symptom of greater trochanteric bursitis is palpable pain and tenderness when touching the greater trochanter (lying on that side, for example) and pain in the outer hip with running, walking, and lunging. Sometimes the pain can radiate down the outer side of the thigh to the knee.
Prognosis
Often the cause of the bursitis dictates the course of treatment and how long that treatment will take. Training errors with running, swimming or cycling can lead to trochanteric bursitis so correcting those errors can make pain disappear rather quickly. Usually this involves facilitating use of a weak or inhibited muscle. If chronic, healing can take up to 3 months, sometimes longer when training.
How Apex Can Help
Treatment usually focuses on correcting muscle imbalances and training errors, such as weak gluteals, tight IT bands and quadriceps dominance. Once these are corrected the pain will decrease. During this initial period of pain it is important to ice the painful area and rest.
Taping, acupuncture, ultrasound and interferential current therapy are also modalities that can help calm the area and speed healing. The first step is always an accurate diagnosis of problem, which is where our team comes into play.
Each of our therapists are trained in gait analysis, postural analysis, and can perform functional movement screens. These movements screens give a quick snapshot into what isn’t moving well and what asymmetries your body has between left and right.
Resources
- https://www.mayoclinic.org/symptoms/hip-pain/basics/definition/sym-20050684
- https://www.arthritis-health.com/types/bursitis/hip-bursitis-symptoms
