Friday, 24 June 2016

Bursitis at the Hip

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

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