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health & fitness

Hip Bursitis

by Paula Allia - PT, DHSc, MTC, OCS

he hip has multiple bursae around the Tight or weak gluteal muscles, hip abductor muscles, and internal and
joint. These bursae are sacs of fluid external rotators as well as iliotibial band (ITB) limitations can lead to
Tthat are between two surfaces, usually this diagnosis.
soft tissue structures and bone. Decreasing Muscles need to be flexible but not overly extensible. A tight
friction between these surfaces allows for muscle rubbing repeatedly over a bursa can cause irritation. If
fluid motion without irritating the tendon the muscle or tendon gets irritated as well, tendinopathy can also
or muscle in order to participate in various occur. If too much laxity is present, other muscles or ligaments
movements like walking, running, tennis or have to kick in more which can be over working the area. Too
golf. All of these activities use varying degrees of strength and much tightness certainly restricts proper excursion and can cause
flexibility and all get help from the bursa to perform. compressive forces to the hip with increased friction. These
Proper alignment and recruitment of the anatomical structures movement dysfunctions indeed may lead to irritation of the bursa.
in a timely manner allow for appropriate movement patterns to The Iliopsoas bursa is on the anterior and just inferior and
occur with the execution of an activity. If proper recruitment does medial to the hip just under the iliopsoas muscular attachment.
not occur, abnormal rubbing of surfaces can aggravate the bursa The iliopsoas is comprised of more than one muscle. The iliacus
and cause inflammation. Rheumatoid arthritis and an infectious arises from the inside portion of the pelvis while the psoas comes
bursa may also cause the bursae to swell. down to the femur (thigh bone) from the spine. These muscles
Two common bursal problems of the hip are the trochanteric and join together and attach down on the proximal femur with the
iliopsoas bursae. Initially, the pain can feel sharp in a localized area bursa attempting to decrease friction when these muscles are
but then chronically if undiagnosed can become achy and more diffuse active. If these muscles are tight and rubbing on the bursa,
and can actually refer pain into the leg. irritation may also occur.
Finding a bursa that is inflamed is a challenge in itself. Once Treating bursitis by applying ice or medications by physicians
found doctors may prescribe non- steroidal anti-inflammatories may start to reduce inflammation. Cold laser may also be used.
and ice. Also important is finding what the cause of this If gone untreated, pain may ensue enough to warrant an assistive
inflammation is and then treating this cause. Paying attention device while weight bearing to decrease the load and lessen the
to the symptoms in the hip are essential for getting the right friction on this already irritated structure. Once under control,
diagnosis. Once diagnosed, finding the cause and altering the appropriate stretching of tight muscles and strengthening of the
abnormalities can allow the healing of the bursa. If the cause muscles can begin. Correcting imbalances will help return to a
is not figured out, the inflamed bursa may return and become a normal functioning hip so that activities can be restarted without
chronic issue thus making the right changes are pertinent. discomfort.
The trochanteric bursa sits on the lateral or outside portion of What does one do if they suspect bursitis? Seek out the
the hip. It can be injured by directly bumping the hip especially if physical therapist that can identify the cause and provide therapy
hitting it repeatedly. Sleeping on one side always can also create to return to normalcy.
a vulnerability to this bursal irritation from the constant pressure Here’s To Your Health!
on it. It also can be irritated by repeated activities that cause the
bursa to be rubbed between the muscle and bone. If this area
Find that professional that understands the body fully and help to
goes untreated adhesions can occur which actually worsens the
guide you to your longevity in activities. Exercise smart and undo
problem.
excessive strains. For further information, please call
Proper length tension of associated muscles and tendons is an
Fitness Together in downtown Naples at (239) 263-9348.
important component of good physiological movement so that
tissues can glide without excessive friction over this area.

Fitness Together 335 14 Ave South, Naples, FL 34102 - 239.263.9348 www.fitnesstogether.com/naples
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74 Life in Naples | April 2022