Bursitis – what is it and how is it treated?

Most frequently trochanteric bursitis, these odd-looking words will make far more sense after we’ve started with just a little bit of anatomy. As can be seen from the the picture below, the hip joint is a ball and socket joint made up of the head of the femur (the ball) and the acetabulum (the socket). Working down from the ball there is the neck of the femur, which is much thinner than the ball and can be seen in the picture below.

Running over, and inserting into, the greater trochanter runs the gluteus medius tendon.

In between the tendon of the gluteus medius and the greater trochanter sits a bursa, which is sort of like a small water balloon. Bursae are numerous around your body and basically sit between layers of tissue (tendon and bone in this case) to prevent too much friction. However, if these are subjected to excessive and repeated friction and/or sustained compression over time, they can get inflamed – this is called bursitis. As the bursa we are going to be focusing on is the trochanteric bursa, that is why the condition is called trochanteric bursitis.

So why do they get flared up

Most frequently they would flare up as result of repeated compression but they can also result from a sustained compression. A good example is if there is some muscle weakness in the aforementioned gluteus medius.

This muscle would therefore be unable to provide adequate stability when walking or running, the net effect being the knee would fall inwards thereby stretching the gluteus medius tendon over the bursa and causing compression. This would happen repeatedly when running, leading to repeated compression. There may also be an associated tendinopathy, which is essentially a structural change in the tendon often including a thickening, increasing the likelihood of further increasing the bursal compression.

So what can be done about it?

The best form of treatment is to address the predisposing cause i.e. why did it happen in the first place? So in the example already mentioned, strengthening the gluteus medius and minimus. 1-2 minutes every other day doing the following exercise should be adequate to notice an improvement in the symptoms after just a week or two. Be sure to stick with the same speed as in the video.

Progressing this load further and working on some functional control issues may also be worthwhile, but this is a good place to start and see how you go. Depending on the severity of the problem and extent of the underlying causes, you may even get a full resolution of the symptoms in 6-8 weeks of just doing this one exercise.

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