Trochanteric Bursitis

Michelle GrantNichole Frederickson

What is Trochanteric Bursitis

Trochanteric Bursitis is defined as painful inflammation of the bursa located just superficial to the greater trochanter of the femur.

Pathophysiolgy

Standing Asymmetrically for long periods of time with the effected hip elevated and adducted, while dropping the pelvis on the opposite side.

Excessive walking or running Falls or repetitive trauma by impact Climbing stairs Leg length discrepancy or hip

surgery complications

Pathophysiology Continued Increased repetitive

friction against the bursa causes irritation and inflammation which in turn causes pain.

Pain symptoms occur when the involved muscle contracts, when it is stretched, or when the provoking activity is repeated.

Signs or Symptoms

Pain is experienced over the lateral hip and down the lateral thigh to the knee

Faulty posturePainful gaitDecreased

muscle flexibility

Signs and Symptoms

Decreased muscular endurance

Weak gluteus medius and minimus

Shortened lateral rotatorsDominance of the hamstrings

Preferred Practice Patterns

Pattern 4E- Impaired joint mobility, motor function, muscle performance and range of motion, associated with localized inflammation

Modalities

Inflammation Control Cold packs or ice massage Hydrotherapy Laser Ultrasound Electronic Stimulation Compression or taping Continuous Passive Motion

Treatment

Restricted activity to avoid pain Use an Assistive Device to decrease

weight bearing Massage Manual Traction Joint Mobilization

Therapeutic Exercise

Stretch any muscles that are restricting motion in clinic and home exercise

Train the involved muscles to contract and control alignment of the femur

Strengthening the weakened muscles

Control and strengthen the trunk

Therapeutic Exercise

Perform each exercise 1 to 3 minutes before progression

Perform exercises that do not worsen symptoms Modify intensity Position Time performed

Weight-bearing exercises or partial weight-bearing exercise Biking Weight shifting exercises on parallel bars

ADL Functional Training

Progress close chain exercises to functional activities

Increase eccentric resistance and demand for controlled speed to return-to-work activities

Progress to patterns of movement consistent with the desired day-to-day activities

Practice timing and sequencing of events

References

APTA.Guide to Physical Therapist Practice. 2nd ed.Alexandria, VA:APTA;2001.

Kisner C, Colby LA.Therapeutic Exercise: Foundations and Techniques. 5th ed.Phillidelphia, PA:F.A. Davis Company;2007.

Foye PM, Stitik TP.Trochanteric Bursitis.http://emedicine.medscape.com/article/309286-overview.Updated Oct 1, 2009.Accessed Nov 20, 2010.