“Trochanteric bursitis” is quite a mouthful, but the condition itself is relatively common, especially in older adults. Simply put, it is inflammation on the outer part of the hip joint that causes pain and difficulty moving in the hip area.
To start with, “bursitis” is inflammation in a structure called the bursa. A bursa is a thick, fluid-filled sac that provides cushioning between a tendon and a bone where they move against each other, preventing frictional damage. In your hip joint, where your femur (thigh bone) connects to your pelvis, the tendon connecting the gluteus maximus muscle to your femur passes over a hard bulge at the end of the bone called the greater trochanter. The bursa protecting this area, known as the trochanter bursa, can become inflamed when it is injured or endures excessive friction or stress, such as with an uneven gait or when the tendon has become tight. Both the pain and swelling can make flexing the hip difficult.
Initial treatment of trochanteric bursitis involves reducing the symptoms of pain and swelling by taking an anti-inflammatory medication, heating and icing, or receiving a corticosteroid shot. Following that, strengthening and stretching the muscles around the hip joint will enable them to provide better support and flexibility to the area, reducing the stress on the bursa. Physical therapy at Blue Hills Sports & Spine Rehabilitation can provide a directed course of treatment for relieving hip pain and developing hip flexibility and muscle strength. Full recovery can take around six weeks.
The following is a list of some of the exercises that can help to relieve stress and pain in the trochanteric bursa:
One of the reasons the trochanteric bursa may have become inflamed is due to tightening of the tendons that overlie it. Stretching the hip will lengthen the tendons and reduce the pressure they exert on the bursa. One good example is the outer hip stretch: cross one leg behind the other, then push your hips out in the opposite direction from the stretching leg. A good hip flexor stretch is to stretch one leg behind you with your knee on the ground, then place your other leg in front of you, foot on the ground, at an angle of 90° or greater (known as crescent moon in some yoga practices).
The main tendon running over the trochanter bursa attaches the gluteus maximus muscle to the upper area of the femur. Keeping the glut muscles limber will likewise keep the tendon from rubbing too hard on the bursa. You can stretch the glute by laying on the floor and bending your leg up and under your stomach (think pigeon pose for you yogis).
There are many different ways to stretch your hamstrings. One is from a seated position, where you hold your legs straight in front of you, then lean forward and grasp your shins as close to your feet as you can. This also can relieve tension on your trochanteric bursa.
This stretch strengthens your glutes, hamstrings (back of the thigh), and quadriceps (front of the thigh) while engaging your hip flexors. Lay on your back with your feet flat on the floor and your knees bent. Then tighten your abs and glutes and lift your hips until they are in a straight line with your back and knees. Hold for 15-30 seconds, then slowly lower back down.
(Lateral Leg Raises; Source: Physical Therapy First)
(Prone Leg Lift; Source: Physical Therapy First)
(Straight Leg Lift; Source: Physical Therapy First)
Strengthening your outer hip muscles, or hip adductors, will improve movement of your leg within the hip socket, which can be accomplished by exercises that repeatedly lift the leg straight out from the body. These can either be done laterally (lying on your side) or standing up, in which case a resistance band can be used for extra strengthening. Your hip extensors can be worked by lying on your stomach (prone) and raising one leg at a time 8 inches off the floor and holding for 15-20 seconds, lowering, and repeating.
This exercise is similar to lateral leg raises, but you begin on your side with your knees bent. Here you keep your feet together while repeatedly raising your knee, helping to flex your hip joint.
This is a great core exercise in addition to working on your fine neuromuscular control of the hip joint. Start by laying on your back with your legs extended in front of you. Raise one leg 8 inches off the ground and make small circles with it. Switch legs after 5 rotations for a total of 30 reps on each side.
We hope these are helpful in treating your trochanteric bursitis pain. If you would like a professional opinion on the cause and treatment of your pain, feel free to come visit us at any of our four locations in Braintree, Plymouth, Weymouth or Boston.