A bursa is a small sack of fluid between tendon and bone which prevents friction. The bursa can become inflamed causing pain in the hip. We explain the symptoms, causes and treatment of hip bursitis.
Symptoms of Trochanteric Bursitis
Symptoms of hip bursitis include pain on the outside of the hip which is worse during activities such as running, climbing stairs or getting out of a car. The pain will gradually get worse and the area on the outside of the hip is tender when pressing in. Pain may also radiate down the outside of the thigh.
What is Hip Bursitis?
A bursa is a small sack of fluid which is usually positioned in between a bone and a muscle or tendon. The function of a bursa is to prevent friction between the bone and overlying soft tissue. There are several bursas around the hip joint, including:
- Trochanteric bursa - on the outside of the hip between the greater trochanter and the attachments of the gluteal muscles.
- Gluteus medius bursa - a smaller bursa, between the gluteus medius muscle and the greater trochanter, just medial to the trochanteric bursa.
- Iliopsoas bursa - between the iliopsoas muscle at the front of the hip joint and the underlying bone (bursitis in this area is also known as Iliopectineal bursitis).
- Ischial bursa - Between the hamstring tendons and the base of the pelvis.
By far, the most commonly injured bursa is the trochanteric bursa. This can be injured in one of two ways, through a direct impact to the bursa, such as a fall onto the outer hip, which is known as traumatic bursitis, or through repetitive friction from the overlying muscles and tendons, usually during running. This repeated friction results in the bursa becoming inflamed and swollen. Every time the tendons then rub over the bursa, this causes pain.
Causes of Hip Bursitis
- A fall onto the side of the hip can cause traumatic bursitis.
- Most cases of bursitis are overuse injuries due to biomechanical abnormalities.
- If you overpronate then you are more susceptible to this injury as the knee falls inwards which increases the angle at the hip.
- Weakness in the hip abductors, especially gluteus medius has the same effect.
- Tight structures surrounding the hip such as the ITB, hip flexors and hamstrings.
- A bone spur - a small excess growth of bone which can aggravate the bursa.
Treatment of Hip Bursitis
What can the athlete do?
- Rest until there is no pain.
- Apply ice to the area.
- Run only on flat, even surfaces.
- See a sports injury professional.
What can a sports injury specialist do?
- Prescribe anti-inflammatory medication e.g. ibuprofen.
- Send you for an X-ray or MRI to confirm the injury is not as a result of a bone spur.
- Refer you for physical therapy to correct muscle imbalances.
- Use Ultrasound to help reduce pain and inflammation.
- Prescribe orthotics to correct foot biomechanics.
- Stick a needle in the bursa and drain off the fluid (aspirate it).
- Give a steroid injection followed by rest.
- Operate if it is a long term injury.