Do you suffer from pain on the outside of the hip?
If so, you could be suffering from Trochanteric Bursitis. The condition can affect your walking and even stop your sleeping!
It can occur after falling onto the hip, after surgery, or overuse from activities such as running. More women experience the condition, with pain on movement or when lying on the affected hip.
Read on as our physios explain what it is, why you get it, and what you can do to help yourself.
What is it?
Trochanteric bursitis is related to inflammation of a large bursa (a fluid-filled sac that helps reduce friction between body parts) which sits directly above the hip bone and socket. Its function is to reduce the friction between structures above and hips such as muscles and a connective tissue called the Tensor Fascia Lata (TFL).
Symptoms can present after a fall, or develop over time with tightness associated with muscles around the hip, weakness around the hip, or excessive and poorly controlled movement (rotation) of the leg which is commonly seen in runners or after surgery. People with this condition rarely have back pain or pins and needles/altered sensation at the same time.
A common symptom is a deep ache which can be noted when resting. The pain is very local to the outside of the hip, sometimes it can refer down the side of the thigh but never refers up into the back.
More advanced conditions will be noted on movements that load the hips such as walking or going up and downstairs. Equally, the pain will be noted when lying on the side of the hip at night time.
Early Advice
In our experience, initially people ignore this pain as it comes on after activity or is only mildly affecting the individual. As the pain progresses, the condition worsens with movement, and people can have difficulty walking and sleeping on the affected hip. The longer the symptoms persist, the longer it takes to settle.
Firstly look to reduce any activities that make the pain and symptoms worse.
Secondly, start some early-stage flexibility and mobility exercises to help break the cycle of pain and inflammation
Technique: Lying on your front, bend the leg and grab hold of your ankle. Draw your knees together and push your thigh into the floor.
Top tip: Avoid lifting up and arching your back. Keep the knees together and focus on pushing the hips forwards.
Technique: Lying on your back, lift the leg up and take this over to the other side of your body. Use your hand to gently rotate and stretch the side of the leg.
Top Tip: Try and keep your shoulders and top half down on the floor to get the stretch from your lower back too. Hold 10-15 seconds. Slowly increase the time to 30-40 seconds
Technique: Draw the thigh towards yourself, hold below the knee joint and bring it towards your body. Hold for 30-40 seconds.
Top Tip: If you feel a pinch into the hip after 90 degrees, try and take the knee/leg slightly away from the body and see if you can draw the hip closer to the chest.
Place one leg on the opposite knee. Draw the leg in and place your hands between the legs to draw the leg closer in. Aim to keep the knee outwards whilst drawing the knee towards the chest. A stretch deep into the buttock should be felt.
Top tip- If particularly tight, you can cross the leg over the other and draw the leg up along the floor. Having the foot on the ground allows the position to be held for longer.
Using a foam roller can be very effective as the compression to the muscles and soft tissue increases and improves the circulation to the tissue.
Start slowly and begin at the top of the hip. Avoid the painful area on the hip and slowly move down the thigh. Aim to hold your body weight on tender spots for 10-15 seconds before moving onto the next tender spot.
Avoid making small rolling movements up and down but aim to do longer, slower, and more sustained holds to the tissue.
Top tip Foam rolling on the ITB can be very uncomfortable for some people. If easier, start with a small softball and work the tissue up and down the outside of the thigh.
A copy of all the exercises can be downloaded here.
Trochanteric Bursitis Early Mobility & Flexibility Exercise Sheet
Strength-based exercises are important after the mobility and flexibility exercises to ensure that stability to the hip and pelvis is restored.
In many situations, this condition is linked to how the leg, hip, pelvis, and lower back move, and therefore other types of techniques and treatments can be effective in helping to speed up the recovery period. These include:
If you are unsure about your signs and symptoms then we advise you to speak to suitable healthcare professionals or a member of the Urban Therapy team.