TROCHANTERIC BURSITIS

 The Injury

A bursa is a small sac of fluid, and bursae are present wherever moving parts occur, helping to reduce friction. They are normally found around joints and where tendons, muscles, or ligaments, pass over bony prominences.

• The trochanteric bursa lies over a part of the femur (thigh bone) called the greater trochanter (a bony lump at the top of the outside of the thigh bone). Its job is to prevent friction between the greater trochanter and tissue called the iliotibial band.
• The condition known as trochanteric bursitis refers to a situation where the bursa has become irritated and inflamed. This can be caused either by a direct blow to the area or by repetitive friction of the iliotibial band on the bursa, as occurs in long-distance running.

 Signs and Symptoms

• Pain over the area of the bursa, but in severe cases it may radiate down the leg.
• The pain will usually be brought on by hip movements such as walking, running, and climbing stairs.
• The physiotherapist should be able to diagnose the condition through manual tests, but it can be confirmed by an ultrasound scan.

 Treatment

• Rest is very important in the treatment of trochanteric bursitis in order to allow the condition to settle down.
• Physiotherapy will include ice, electrotherapy and stretching of the iliotibial band, and may be successful in curing the condition.
• However, in a number of cases, particularly chronic (long-term) cases, a corticosteroid injection may be necessary (a corticosteroid is a naturally occurring substance which can settle down inflammation). 
• Once the condition has settled down, strengthening and stabilizing exercises can begin, followed by a carefully graduated return to full activity.

 Prevention

• As with all overuse injuries, trochanteric bursitis can be caused by doing too much, too soon. When beginning or stepping up a running program, gradual progress must be made. For example, it is impossible to increase from running 2 miles per day one week to running 10 miles per day the next week, without the body being put at risk of various problems.