Whether you're experiencing hip pain from repetitive activity, an injury, or a pre-existing condition, you don't need to accept it as your new normal. Many of us tend to wait out our pain, thinking that it will go away on its own. Some of us even accept our pain, thinking that it will never go away at all. However, doing nothing about an injury or chronic pain can make the condition worse. If you're experiencing lateral hip pain (pain on the outside of the hip), it could be trochanteric bursitis, so let's talk about it!
What is Trochanteric Bursitis?
Trochanteric bursitis is a common condition and frequent cause of lateral hip pain affecting roughly 15% of women and 8% of men. Middle-aged women and young female athletes are most commonly affected by this condition. The trochanter bursa is a fluid-filled sac located on the lateral aspect of the hip that helps to reduce friction between the tendons and bones. This bursa can become inflamed due to increased stress on these structures and can create sharp pain on the outside of the hip. This pain can limit your ability to perform regular daily activities if it is not treated properly.
What Causes Trochanteric Bursitis?
As stated earlier, trochanteric bursitis is most commonly seen in middle-aged women and young female athletes; however, this condition can affect anyone. Here are some common causes associated with this condition:
1. Overuse of surrounding musculature that attaches to the greater trochanter
Various muscles attach to the greater trochanter that are responsible for helping control movement when walking and standing. Every single time we take a step, these muscles have to contract to stabilize the leg that is on the ground. If these muscles are not properly strengthened, it can cause overuse and microtrauma to the tendons attaching to the bursa sac.
2. Previous surgery
Surgery located around the hip, such as labral repair and hip replacement, can irritate the bursa.
3. Hip arthritis
Hip osteoarthritis creates limited capsular mobility within the hip. If the hip is unable to properly move in all three planes of motion, this can create increased stress on the muscles that attach to the bursa sac.
4. Improper foot mechanics
Patients that tend to have a collapsed arch when walking can create biomechanical disadvantages at the hip. Increased midfoot pronation when walking can cause the leg to rotate inward and the hip to become misaligned, putting stress on the hip and the leg.
5. Traumatic injury to the lateral hip
Occasionally, this can occur if you trip and fall or play a sport where you land on the lateral aspect of your hip.
Trochanteric Bursitis Symptoms
Trochanteric bursitis usually consists of the following symptoms:
Pain located on the lateral aspect of the hip
Pain when laying on the affected side
Pain with crossing one leg over the other when sitting
Difficulty and pain with going upstairs
Difficulty and pain with walking and running
Tenderness and swelling located over the lateral aspect of the hip
How to Prevent Trochanteric Bursitis
Trochanteric bursitis is best prevented by warming up properly before activity and gradually building up your activity level, especially when it comes to running, walking, and jumping. Other prevention methods include proper strength and mobility training of the hips, maintaining a proper weight, and evaluating your foot mechanics to see if custom orthotics may reduce stress.
Treatment Approaches
There is not one specific approach that is going to help everyone with trochanteric bursitis; however, these are the general guidelines for reducing pain and improving function. Please reach out to a physical therapist to help identify the true problem of your hip pain.
1. Initial phase (3-7 days): reduce inflammation
Decrease laying on that side, reduce crossing legs
Ice the affected area
Decrease activity levels such as running, jumping, and stair climbing
2. Mid phase: pain and inflammation have improved
Focus on improving hip mobility
Light strengthening of the lateral hip
3. Late phase:
Single-leg activities to help increase strength
Reduce re-injury
Sport-specific activities
Interested in Physical Therapy for Lateral Hip Pain?
Physical therapy can be one effective tool to help improve trochanteric bursitis. At Rehab United, we take a biomechanical and individual approach to treating lateral hip pain in order to help you return back to the activities you enjoy doing.
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Isabel Jones, PT, DPT, ATC is a physical therapist and a Certified Athletic Trainer with a passion for physical activity and functional movement. She received her Doctorate of Physical Therapy in 2021 from the University of St. Augustine in San Marcos, CA, joining Rehab United quickly after.