Hip bursitis is an inflammatory condition, whereby a bursa
of the hip becomes inflamed, either due
to chronic rubbing, causing friction and therefore inflammation; or
inflammation as a result of a traumatic injury to the area. There are three bursae
of the hip that can be affected, namely the greater trochanteric bursa, the
iliopsoas bursa and the ischial bursa. Hip bursitis is a common running injury.
Greater trochanteric bursitis
This bursitis is commonly seen in female runners (because females
have anatomically wider hips), road runners (the camber of the road affects
running angles), cross-country skiers and ballet dancers. A burning or aching
sensation is experienced deep in the hip joint and is exacerbated by walking
and exercise. Pain may also refer down the outside of the thigh.
Iliopsoas bursitis
Repeated compression of the iliopsoas bursa causes this type
of bursitis. It can also occur when there is osteoarthritis present at the hip.
Pain is also experienced deep in the hip joint, slightly inside and to the
front of the joint itself.
Ischial bursitis
This less common type of bursitis is caused either by a
direct blow to the hip, such as a fall, or from prolonged sitting on hard
surfaces. Pain is felt at the back of the hip and is exacerbated by prolonged
sitting, uphill running, and any pressure applied to the back of the hip joint.
Management of hip bursitis
Initial treatment includes rest, ice, deep massage and
anti-inflammatory drugs. Stretching exercises are given for the involved
muscles. In more severe cases, a cortisone injection into the site may be
necessary. Once the initial pain has been treated, running technique, posture
and walking pattern should be assessed by a biokineticist to assess whether
there are biomechanical factors contributing to the condition. From this
assessment, appropriate exercises are then prescribed by the biokineticist to
stretch and/or strengthen the involved muscles and improve running or walking
abnormalities to prevent the condition from recurring.
References
Foundations of Athletic Training: Prevention, Assessment and
Management