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Author: Dr Jessica Bowman (Osteopath)

Experiencing recurrent pain down the outside of your hip? You could be suffering from Trochanteric Bursitis. We asked Dr Jessica Bowman if she could tell us a little about this condition- it’s more common than you would think!

Bursae are sack-like cavities located between bony or muscular surfaces in the body where friction may occur. They act to minimise this friction, as well as absorb shock. Trochanteric Bursitis occurs when either of the bursae overlying the greater trochanter of the femur (the bony part you can feel at the widest point of your upper thigh) becomes inflamed.

Trochanteric Bursitis is relatively common, accounting for approximately 1.8 patients per 1000 in primary care. It occurs most frequently in females, as well as those with weakness of the hip abductors (such as the Gluteus Medius and Minimus), inflammatory conditions of the hip (such as osteo- or rheumatoid- arthritis), and those who have recently suffered a trauma or direct impact to the outside of the hip.

Trochanteric Bursitis usually presents as pain and pinpoint tenderness behind or over the outside of the greater trochanter. Pain may radiate down the lateral thigh to the knee, and is aggravated by:

  • Lying on the affected side;
  • Standing following a prolonged period of sitting;
  • Climbing stairs, walking, or cycling.

If your osteopath suspects you may have Trochanteric Bursits, they may refer you for imaging such as Ultrasound or X-ray to assess the severity of the condition and rule out any factors which may complicate recovery, such as a tear of the underlying gluteal muscles.

Once diagnosis is confirmed, osteopathic treatment of this condition involves:

  • Restoration of biomechanical balance to the lower extremity, pelvis and lumbar spine;
  • Taping of the hip to support the underlying musculature;
  • A prescribed strengthening regime for the pelvic bowl and lower extremity to restore function to the hip and prevent symptom recurrence. Some simple, commonly prescribed exercises include:
  1. Gluteus Medius + Minimus activation using wall:
  • Find a wall and position your feet as close to it as you can comfortably without toppling over.
  • Raise your inside leg such that the thigh is parallel to the floor, forming a 90⁰ angle both with your torso and your lower leg.
  • Contract your core by sucking your belly button in your towards spine and stand tall. Breathe as naturally as you can throughout this exercise.
  • Gently push your inside knee into the wall. You should feel your outside Gluteus muscles contract.
  • Hold this contraction for a count of 5-10.
  1. Clamshells:
  • Lying on your side, bend your knees up in front of you so that your thighs are perpendicular to your hips and shoulders, which should be in a straight line.
  • Rest your head on your bottom arm, or you may wish to rest your head on a pillow for neck support. Place your top arm on the floor in front of your chest for stability.
  • Contract your core by sucking your belly button in your towards spine.
  • Raise the top knee towards the ceiling, allowing your hip to rotate in its socket. Keep the heels together, and only open the knees as far as you can go without allowing the pelvis to tilt forward or backward.
  • Slowly bring your knee back to the start position.
  1. Theraband Bridges:
  • Laying on your back, support your head with a pillow.
  • Bend the knees up such that the heels are in line with the hips.
  • Push the knees out into the band. Your knees should now be in line with your heels and hips.
  • Breathe in and contract your core by sucking your belly button in your towards spine.
  • As you breathe out, peel your sacrum and spine up off the floor towards the ceiling, vertebrae by vertebrae.
  • Breathe in, and again, vertebrae by vertebrae, lower the spine back down to rest on the floor. Remember to keep the core activated and the knees pushed out into the band (try to keep them equidistance apart) throughout this movement.

 

Your osteopath will also discuss simple management strategies with you, such as:

  • Avoidance of aggravating activities;
  • Avoidance of massage or foam rolling directly over the affected area, as well as certain stretches;
  • The use of a simple anti-inflammatory for the management of pain, if required;
  • And in severe cases, the possible referral for an ultrasound-guided corticosteroid injection into the bursa.

Most patients with Trochanteric Bursitis experience restored hip function within 6-12 weeks, though naturally this depends on the severity of the complaint and the overall health of the patient.

If you think you might be suffering with symptoms of Trochanteric Bursits or some type of hip pain, perhaps you should book an appointment with one of our friendly practitioners. Don’t hesitate to call and speak with one of our lovely receptionists to secure a time! 03 9431 5773

Please note whilst this article includes some general information, hip pain can be quite complex and its causes numerous. A thorough diagnosis is always necessary before determining the exercises that are the best course of action.  If you have hip pain and are seeking information, the best thing to do is book with one of our Osteopaths for a more tailored treatment and exercise regime.

Author: Dr Jessica Bowman (Osteopath)