Trochanteric Bursitis

WHAT IS TROCHANTERIC BURSITIS?

Trochanteric bursitis is defined as pain over the bony prominence of the upper lateral thigh due to inflammation of the bursa. The bursa lies between the greater trochanter and the overlying musculature.

WHAT IS A BURSA?

A bursa is a small fibrous sac lined with synovial membrane and containing synovial fluid. A bursa acts as a cushion between the tendon and the bone in order to reduce friction during joint movement, especially in running.

COMMON SIGNS AND SYMPTOMS

Common symptoms of trochanteric bursitis include;

  • Pain over the lateral aspect of the hip with pain radiating down the lateral aspect of the thigh

  • Pain +/- giving way walking up and down stairs

  • Unable to lie on painful hip

  • Pain with running

  • Pain with sit to stand/squatting/kneeling

  • Trendelenburg sign (weakness in gluteals)

  • Lumbo-pelvic musculature imbalances

  • Abnormal running gait

HOW DO YOU GET TROCHANTERIC BURSITIS?

Trochanteric bursitis usually results from poor muscular control causing compression from the associated muscles, bands and fascia on to the bursa. This is commonly experienced in overuse activities such as running, which most people display an abnormality in their running gait. Other causes of trochanteric bursitis include;

  • Trauma directly to the bursa

  • Post hip surgery

  • Post hip joint replacement

PREVALENCE

Trochanteric bursitis is relatively common in both the physically active and sedentary population. Women are 80% more likely to develop trochanteric bursitis than Men with a prevalence of 15% compared to 8.5%.

PREDISPOSING FACTORS

In overuse trochanteric bursitis, there are a number of predisposing factors. These factors include;

  • Larger ‘Q’ angles

  • Weak gluteal muscles

  • Lumbo-pelvic muscular imbalances

  • Running gait

  • Bike Set up

  • Leg length discrepancy

  • Unilateral sports

TREATMENT

Treatment initially includes reducing inflammation with Physiotherapy, ice, analgesics, NSAID’s and possibly corticosteroid injections. Physiotherapy involves identifying and removing the predisposing factors in which the pain was first triggered by.

DIFFERENTIAL DIAGNOSES

Other differential diagnoses around the lateral hip can include;

  • Gluteus medius tendinopathy

  • Hip impingement

  • Gluteal bursitis

  • Gluteal tendon strains

Although these conditions may look the same and feel the same from the outside, the management and cause of injury can differ.