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A diagnosis of greater trochanteric bursitis is often associated with compression anomalies of the tendons that insert into the hip. Tendons are the junction between bones and muscles; they are a tough band of connective tissue which are capable of withstanding large amounts of tension.
Bursitis is a common complaint and can be very frustrating. These problems can persist for a lengthy period of time and cause a significant amount of pain.
Gluteus medius and minimus tendons insert into the greater trochanter which is the bony part on the outside of your hip. Bursitis is commonly associated with irritation of these points. This is a common site to experience pain and can also refer down the outside of the leg, into the buttock and into the groin. Bursitis will commonly occur due to an increase in the compression of the tendon from the illiotibial band (a long band of tissue that runs down the side of your leg). Estrogen has an effect on tendons and therefore your bursa so bursitis is more prevalent in post-menopausal women..
The first step in treating bursitis is to reduce your pain by reducing this compression. The ways we do this are to restrict hip flexion (bringing your hip forward) past 90 degrees and abduction (putting your leg across your body) past the midline. Some methods that can help you do this are;
Try not to hang on one hip when you’re standing
When sitting, avoid crossing your legs
Try to avoid siting with your knees above your hips (eg. in low seats). You can use a wedge cushion to prop you up if this is a problem for you.
Use an eggshell overlay on your mattress to sleep on
Sleep on your good side with a pillow or wedge cushion between your knees
Avoid running or walking on the camber of a road
Avoid walking/running up too many stairs until your physiotherapist tells you it’s ok
Avoid power walking and over striding when you are going for walks
Do not stretch the muscle; instead try self-trigger point relief massage. Massage balls and heat packs are excellent for this.
Do the exercises your physiotherapist gives you!
Getting your pain under control is the first step, after this it's important to address the factors that have caused it in the first place so it's important to follow the advice your physio gives you. If you'd like to learn more about integrative physiotherapy for long term resolution of symptoms, click here.