Our hips are freaking awesome marvels of flexibility. They give us power and stability. And they absorb impact. The hip joint is one of the largest and strongest joints in the human body. Sometimes it can become inflamed, causing trochanteric bursitis.
Anatomy of the hip
Understanding trochanteric bursitis requires a quick anatomy lesson of the hip.
The Arthritis Foundation lays it out like this:
“The hip is where the thigh bone meets the pelvis to form a ball-and-socket joint. The hip joint consists of two main parts:
- Femoral head – a ball-shaped piece of bone located at the top of your thigh bone, or femur
- Acetabulum – a socket in your pelvis into which the femoral head fits
Ligaments, connect the ball to the socket. This stabilizes the hip, forming the joint capsule. The joint capsule is lined with a thin membrane called synovium. This produces a viscous fluid to lubricate the joint. Fluid-filled sacs called bursae provide cushioning. This lowers friction between muscles, tendons, and bones.
The hip is surrounded by large muscles that support the joint and enable movement. They include:
- Gluteals – muscles of the buttocks, located on the back of the hip
- Adductor muscles – muscles of the inner thigh, which pull the leg inward toward the opposite leg
- Iliopsoas muscle – a muscle that begins in the lower back and connects to the upper femur
- Quadriceps – four muscles on the front of the thigh that run from the hip to the knee
- Hamstrings – muscles on the back of the thigh, which run from the hip to just below the knee
There are many major nerves and blood vessels that run through the hip. The sciatic nerve at the back of the hip. The femoral nerve at the front of the hip. And the femoral artery begins in the pelvis and passes by the front of the hip and down the thigh.”
What is a bursa?
Your body is filled with bursa. You’ll find bursa sacs at many of the body’s major joints. This includes the elbow, shoulder, and knee. These small pouches are filled with a thick fluid. It is designed to lubricate joints and protect body parts from friction.
Each hip has two major bursae. The outer point of the hip, or “greater trochanter,” has a bursa called the trochanteric bursa. And the other bursa that’s on the inside of the hip area, is called the iliopsoas bursa.
Causes of trochanteric bursitis
One of the main causes of hip pain is bursitis, which is an inflammation of the bursa. The trochanteric bursa may become inflamed if the hip is overused, overextended, or injured. This typically occurs in middle-aged or older people.
Active chubby runners are susceptible to trochanteric bursitis. If the iliotibial band (ITB) is tight after a long run, it may rub against the trochanteric bursa. This irritation could lead to bursitis.
Other causes of trochanteric bursitis
- Muscle tears
- Hip injuries
- Hip surgery complications
- Poor posture
Trochanteric bursitis symptoms
Trochanteric bursitis symptoms may include:
- Sharp pain
- Dull ache
- Sensitive to the touch
In most extreme cases, your hip joint may become red and swollen. It could even lead to a fever.
Your doctor may prescribe one of these:
- Physical exam
- Ultrasound test
Treatments are typically nonsurgical and easy to do at home. They may include:
- Apply ice. Apply ice packs every 4 hours for 20 – 30 minutes at a time.
- Take anti-inflammatory medications.
- Over-the-counter medications like ibuprofen (Advil, Motrin) and naproxen (Aleve).
- Prescription drugs like Celebrex can reduce pain and swelling. Check with your doctor.
- Rest. Stay off your hip, you can give it time to heal.
- Physical therapy. Do exercises to improve flexibility and strengthen your muscles.
Other treatments require a trip to the doctor’s office. They might include:
- Cortisone shots
- Low-energy shock wave therapy
Prevention of trochanteric bursitis
You can prevent trochanteric bursitis by taking care of your hips properly. Here are things you can do:
- Do exercise, including stretching, warm-up, and cool down
- Wear orthotics or inserts
- Lose weight (Extra pounds put additional pressure on your hips)
According to The Cleveland Clinic, “most cases of bursitis are caused by overuse. The best treatment is prevention. It is important to avoid or modify the activities that cause the problem. Underlying conditions like leg length differences, improper posture, or poor technique in sports or work must be corrected.”
Follow these rules:
- Take it slow at first
- Use limited force and limited repetitions
- Stop if unusual pain occurs
- Avoid repetitive activities that put stress on the hips.
- Lose weight if you need to.
- Get a properly fitting shoe insert for leg length differences.
- Maintain strength and flexibility of the hip muscles.
Potential complications of trochanteric bursitis
According to the National Center For Biotechnology Information
“Complications of trochanteric bursitis are rare. Complications are more closely associated with NSAID use and infrequently corticosteroid injection.
NSAIDs can cause gastric ulceration and subsequent bleeding in those that are high risk or are taking anticoagulants. Gastrointestinal (GI) bleeding can be occult, and patients should be counseled regarding signs or symptoms of anemia. Complications associated with corticosteroid injections include:
- elevated for blood glucose levels
- injection site irritation
- injected site bleeding
National Center For Biotechnology Information gives more information:
“Proper stretching, form, and training technique can help prevent trochanteric bursitis in the young athletes.
It is important for you to understand the prognosis and success of non-operative management. Starting anti-inflammatories and/or corticosteroid injections may lead to resolution of symptoms.”
Exercises for Trochanteric Bursitis
Doing exercises to strengthen your thighs can help stabilize your hip joint and protect it from injury. Here are a few exercises you might try for trochanteric bursitis:
- Lie on your back with your feet flat on the ground and your knees bent.
- Raise your hips until they line up with your shoulders and knees.
- Slowly lower your hips to the ground.
- Perform 5 sets of 20 repetitions.
Lying lateral leg raises
- Lie on your right side.
- Extend your right arm out for balance.
- Lift your left leg as far as you can, and then bring it down.
- Do 4 sets of 15 repetitions on each leg.
Lying leg circles
- Lie flat on your back with your legs extended.
- Raise your left leg about 3 inches off the ground and make small circles with it.
- Perform 3 sets of 5 rotations on each leg.