Trochanteric bursitis refers to inflammation of the fluid-filled capsule that cushions the bony knobs on the upper region of the femur or thigh bone. The problem may arise from muscle infections or irritations originating in the buttock area, in connective tissue. Leg length discrepancies between legs can also pose a problem. Other factors include repetitive movements or obesity. Symptoms include continual pain, pain with movement of the affected leg, general muscle weakness, loss of normal hip movement and site swelling. Following a thorough physical examination, physical therapists recommend individualized treatment.
Pain and Swelling
Ice and OTC non-steroidal anti-inflammatory drugs or NSAIDS are commonly the first recommendations for treating pain, inflammation and swelling. Ice is typically applied to the affected area for up to 20 minutes at a time. However, care must be taken to ensure that the frozen gel or ice pack does not directly contact and burn the skin. NSAIDS and ice interrupt pain signals that travel along the neural pathways to the brain. The substances also act to calm the other biological and chemical processes that cause excess fluid accumulation and subsequent swelling.
Transcutaneous Electrical Nerve Stimulation or TENS units are treatments that therapists use during clinic sessions or in the comfort of a patient's home. Patients attach one or more pads containing electrodes to the designated area of the leg. When turned on, the TENS unit emits an electrical impulse that interferes with nerve tissue communication. The impulse intensity and frequency are adjustable in order to provide effective treatment without discomfort.
Trochanteric bursitis often develops after repetitive athletic activities. Habitually running up and down hilly terrain, walking or running on uneven surfaces are common causes. By stopping the suspected contributing activity, the affected leg has a chance to rest and heal. Consulting with a therapist can also help athletes develop different training schedules that put less stress on the body.
When a therapist assesses a patient having trochanteric bursitis, they evaluate muscular endurance and strength. In this case, therapy often includes specific exercises. While standing or lying on the unaffected side, the patients merely raises the top leg up and away from the body for the number of recommended repetitions. The “clam-shell” is an alternative exercise that is also performed when lying on the unaffected side with knees bent. The patient lifts and lowers the top leg, which looks similar to a clam opening and closing its shell. Other exercises are prescribed based on the specific muscle groups causing or involved in the condition.
Range of Motion
The ball-and-socket hip joint normally enables people to move their legs in complete 360-degree rotations. Tight muscles and pain diminish adequate movement. The lunge exercise performed by runners before a race is often recommended to stretch the quadriceps and hip flexor muscles. Tightening of the connective IT band is remedied by performing the crossed leg stretch or by using a foam roller.