Hip burisitis, also known as greater trochanteric bursitis is a frequent condition that causes pain which is felt on the outside of the hip. The root cause of hip bursitis is the continued aggravation of the greater trochanteric bursa. The bursa is essentially a lubricated sac that allows tendons to move over the top of bones.
What Causes Hip Bursitis?
The inflammation of the trochanteric bursa is causes from continued compression of the bursa between the tendons that sit over the top of it. This is mostly commonly caused through weakness/poor endurance of the lateral hip muscles, in particular the gluteus medius, and to a lesser extended gluteus minimus. Once aggravated movements that cause further compression of the bursa cause the condition to continue. These mostly commonly include;
- Sleeping on the affected side
- Freuqnetly crossing legs
- "Hanging" off the hip when standing
Signs of Hip/Trochanteric Bursitis
Trendelenburg gait pattern. Most easily recognised as the "model" walk. When the hips move excessively side to side it causes compression of the trochanteric bursa.
Pain felt over the outside of the hip
Pain from getting out of a deep seat
Reproduction of pain with;
Up and down stairs
Getting out of a deep seat
Treatment of Hip Bursitis
Initially a period of deloading/resting the aggravated structures is implemented with possible inclusion of anti inflammatories. This can be combined with soft tissue mobilisation and dry needling of the gluteus medius and minimus. It is extremely important that aggravating factors are identified and modified in such a way that they don't cause further aggravation of the bursa.
Once the symptoms have settled, an exercise rehabilitation program is implemented to correct any underlying strength, endurance and/or technique issues that affect the lateral hip muscles. For long term recovery of this condition this needs to happen, otherwise it is likely that the problem will reoccur . This is why the use of corticosteroid injections can be useful for short term pain relief, however strength/technique correction are still required to correct the underlying problem. It is the role of your physiotherapist to provide you with a structured program that achieves this outcome.