What is Trochanteric Bursitis?
The muscles that surround the hips have a complicated role to play. They work to keep the pelvis level and control one of the most flexible joints of the body. They are organized in layers, and the deeper muscles are separated from the outer muscles by sheets of connective tissue, to allow easy gliding, as they interact with each other.
With all the layers of muscles working together, some points in the body are more prone to experiencing tension and friction during movement. Small sacs called bursa release a natural lubricant to allow gliding and sliding of different muscular layers and are scattered around the body at points of increased stress.
They are found all over the body and usually are quite inconspicuous, which is why most people have never heard of them. However, occasionally something goes wrong, and they become irritated and painful. This will usually happen in a few typical places in the body and one of them this over the greater trochanter, the bony part of the outer hip.
What Are The Symptoms?
The most common symptom of trochanteric bursitis is pain on the outside of your hip, which may radiate down to the knee. You can experience pain with a number of activities such as walking, jogging, climbing stairs and cycling or simply lying on the affected side.
How Does It Happen?
The most common cause for this is a combination poor biomechanics and overuse. When you have poor biomechanics, the structures around the bursa become tighter and can begin to irritate the bursa.
Some things that contribute to poor biomechanics around the hip are weak, uncontrolled muscles, tight muscles, flat feet with unsupportive footwear, a difference in leg length, incorrect exercise equipment and scoliosis. These can all lead to irritation of the bursa around the hip.
How Can Physiotherapy Help?
As there are many other conditions that can cause pain at the outer hip, correct diagnosis is essential. Once diagnosis is confirmed, the first phase of treatment is to reduce pain and irritation.
This can be done with muscle release techniques, ice or heat (depending on the case), rest, fitting you with orthotics and advice for modification to your lifestyle. Your physiotherapist will also evaluate the causes of the irritation and prescribe a suitable rehabilitation program to change your biomechanics.
Serious cases can be treated with corticosteroid injection or even surgery, but with thorough physiotherapy treatment, these are rarely needed.
What is it?
Bursae are small sacs of fluid found throughout the body. These bursae produce synovial fluid and act to reduce friction between muscles, tendons, ligaments and bones as they move over each other. Bursae are located at strategic points, typically where there are higher points of stress. If a bursa is injured or irritated, it can become inflamed, painful, red and swollen. This condition is referred to as bursitis.
One bursa that is commonly affected is the olecranon bursa, which sits just over the hard bony process at the back of the elbow. Olecranon bursitis refers to inflammation of the bursa at this point and is a common condition, particularly in men between the ages of 30-60.
What causes it?
Olecranon bursitis has a few different causes including trauma, overuse and infection. A sharp blow to the elbow, through a fall or hit, might damage the bursa leading to bursitis. In other cases, the bursa can be infected by bacteria, which enter the body through a small skin tear.
Bursitis can also develop slowly through friction of the nearby muscles that cause the bursa to become irritated and inflamed.
What are the symptoms?
The hallmark of this condition is a painful, red, swollen elbow. Typically pain is worst when resting on the tip of the elbow and/or with elbow movements, particularly when bending or straightening the elbow fully. The pain often lasts a few months and may not go away on its own. The pain may build up gradually, or come on suddenly, depending on the cause. Bursitis caused by infection (septic bursitis) may also be associated with general feelings of illness such as fatigue, fever and body aches.
What is the treatment?
As there are many different causes of this condition, accurate diagnosis is essential. Your physiotherapist is able to distinguish between olecranon bursitis and similar conditions such as rheumatoid arthritis or fibromyalgia. Septic bursitis will need to be treated by a medical professional who will determine the best course of action.
All types of bursitis can be managed initially with a RICE protocol to reduce pain and swelling (Rest, ice, compression and elevation). Mechanical causes of bursitis can require more in-depth identification of the factors that may have led to the development of this condition.
Common contributing factors are throwing technique, muscle tightness and/or weakness and training frequency. Your physiotherapist is able to address these factors and possibly provide taping support to unload the bursa, along with manual therapy and an exercise program.
In most cases, conservative or non-surgical treatment is attempted as the first line of treatment. If this is unsuccessful, corticosteroid injections can be used to reduce pain and inflammation. In severe cases where the pain persists despite all other attempts at treatment, the bursa can be surgically removed in a procedure called a bursectomy. Once the pain has subsided your physiotherapist is also able to help prevent any further recurrence.