What you can do to feel better again!
People often fear that there is not much that can be done for hip pain, and sadly, it simply isn’t true. Like anything in life, the more you understand a problem, the more you are aware of the solutions that are available and this resource has been put together to empower people to understand how to get back to doing the things they want to do again!
Hip pain can have a real impact on your life and it doesn’t have to be that way forever. Learn more about Hip Bursitis and the available treatment options to get over hip pain for good.
What is Hip Bursitis?
Hip bursitis is a condition where there is irritation and swelling of the bursa (a fluid filled sack that sits between tendon and bone to reduce friction). There are many bursae around the hip that act as a cushion or shock absorber between the tendons of the hip and the leg bone (femur).
Note: There are over 140 bursae in the entire body.
What are the symptoms of Hip Bursitis?
People that have hip bursitis will experience a feeling of soreness on the outside of the hip/ thigh. The feeling of pain will slowly increase over time and once the injury is established, the pain will remain ongoing.
People who have hip bursitis will experience pain within the initial period of activity (for example, within the first few steps after rising from sitting or lying down) or with prolonged activity like longer periods of walking.
People who have hip bursitis will report that pain will improve with rest and this is the primary reason that people become less active and disengage from activities that they once enjoyed.
In established cases, people with hip bursitis will limp as a means to prevent forces of the body travelling through the surrounding tendons and eventually the bursa to reduce pain. This can lead to behaviour change, loss of strength and over time people that experience hip bursitis may find themselves walking with a limp or what’s known as a “Trendellenberg gait” or “waddling gait”.
Hip bursitis can affect either one or both hips at the same time and people who experience hip bursitis will often report associated:
– Back pain,
– Leg pain,
– Knee pain,
– Ankle pain,
– Foot pain
As hip bursitis is associated with limping and disordered movement, it is the reason that many people can also experience other injuries and painful conditions at the same time.
How is Hip Bursitis diagnosed?
Most people are diagnosed with hip bursitis after visiting their doctor and after imaging such as MRI or ultrasound are completed. Following this, the doctor will often refer to a movement focussed therapist such as a physiotherapist or podiatrist for treatment.
It is helpful to know that imaging, such as MRI and ultrasound is not required to diagnose and begin treatment. A good therapist who has experience working with hip bursitis can apply a wide range of physical tests within a consultation to diagnose, understand more about the causes of the bursitis and begin treatment within the first session, without the need for further imaging.
What causes Hip Bursitis?
The purpose of a bursa in the body is to reduce friction from tendons over bony prominences, however when too much friction occurs, the bursa itself becomes irritated and this is what leads to bursitis.
What causes this increased friction?
No two cases of bursitis are the same and there are multiple influencing factors that may contribute to a person developing an injury such as hip bursitis. These may include:
– Gait (walking pattern)
– Low hip muscle strength
– Repetitive movements
– Repetitive occupational tasks (For example, bending and lifting or kneeling and rising)
– Repetitive habits (such as standing with the hip “cocked out to the side” or crossing the legs when sitting)
– Other pre-existing injury (For example, an unaddressed foot injury that has had an effect on gait)
– Surgery/ Joint replacement (such as a foot operation, knee or hip replacement on the same or opposite side that has had an effect on gait)
Who gets Hip Bursitis?
People of any age can experience hip bursitis, although it is most common in the 30-60 year old age group.
What are the treatment options for Hip Bursitis?
It is common for people in Australia to receive Cortisone injection for hip bursitis, contrary to clinical evidence for best outcomes.
Although Cortisone injection can, in some cases, relieve pain it does not address the cause of the bursitis. For this reason, sadly people can have injection, after injection, after injection without a long term resolution to the problem.
Because people are different and because no two cases of hip bursitis are the same, it is important that a person experiencing hip bursitis have a thorough assessment with a practitioner experienced in helping people with hip bursitis.
Successful long term management of hip bursitis must begin with a thorough assessment and understanding of the influencing factors that have caused the problem (see causes above).
As every case of hip bursitis has multiple influencing factors, a successful management plan will usually involve addressing multiple factors such as:
– Load/ activity management
– Footwear advice/ consideration
– Orthotic therapy to gait (see above)
– Strength and conditioning exercises
People with different physical requirements and different levels of ability should always be offered an individualised treatment.
If you are experiencing hip bursitis, the most important thing to consider is what you want to be able to do again (whether it be walking, running, dancing or playing competitive sport) because it’s the things that we want to do in life, that make us unique and what can bring us joy.
Helpful links
Please feel welcome to book an appointment here, or call us on (03) 52981147
Understand and learn more with the following resources:
https://www.proactivehm.com.au/how-do-orthotics-work/
https://www.proactivehm.com.au/do-i-need-a-gait-analysis/
Written by:
Ryan Michell,
Physiotherapist
Proactive Health & Movement
Daniel Monteleone
Podiatrist, Strength & Conditioning Coach
Proactive Health & Movement
