The Anatomy
The hip joint is made up of two boney structures, which are the head of the femur and the acetabulum, which is made up of three different bones. The acetabulum is a concave surface that is horseshoe shaped and lined with cartilage, except for the inferior aspect which is lined by the transverse acetabular ligament. This joint is deepened by a fibrocartilage ring, referred to as a labrum, which runs along the rim of the acetabulum. The femoral head is also covered with cartilage that acts like a cushion against forces and adds some lubrication to the joint. This whole complex is then encased in a fibrous joint capsule that is essentially made up of 3 different thickened ligaments. Hip bursitis typically involves either the trochanteric bursa or the iliopsoas bursa. A bursa is a fluid filled sac that helps cushion and prevent friction that occurs between boney structures and overlying soft tissues. The most commonly affected is the trochanteric bursa which is located between the greater trochanter of the femur and the iliotibial band, which is the tissue that runs along the outside of the thigh. The other commonly injured bursa is the iliopsoas bursa, which is located between the lesser trochanter of the femur and the iliopsoas muscle.
What Will You Experience?
The most common symptom that people experience with trochanteric bursitis is lateral hip pain, which will occasionally radiate down the outside of the thigh. The person may also experience severe point tenderness over the greater trochanter. Iliopsoas bursitis typically produces pain in the groin region of the affected side, which may travel down the front of the thigh. With both cases of hip bursitis, the initial pain will most likely be sharp and intense, but eventually will become achier and more spread out. Pain is sometimes worse at night, when lying on the affected side. Prolonged periods of walking, climbing, or squatting typically increase the pain.
What Is It?
Bursitis is an inflammation of the bursa. This inflammation may acutely be caused by contusions to the bursa, either from a fall or by direct contact from an object or other person. More commonly, this inflammation or irritation is caused by a repetitive stress to the affected bursa, such as climbing, biking, or running. These repetitive activities only become irritants when there are muscular imbalances within the hip joint. Typically there will be certain muscles that become tight and certain muscles that become weak, which alters the way that the joint moves, and thus alters the amount of force that the bursa has to cushion against.
Predisposing Factors
A couple of common factors that predispose people to hip bursitis are a leg-length difference or previous surgery to the affected hip. Loss of flexibility or strength in the hip musculature may also predispose you to developing bursitis. In addition, runners who run on an uneven surface, such as a banked surface, will more likely develop this condition due to the unequal force distributions. Also, if a person has a greater width between their greater trochanters, than there iliac crests, they may have an increased chance of developing this condition.
What Will Lake Marion Do for You?
Like any condition that we approach in our office, you will receive an in depth physical examination to help properly diagnosis your condition. This examination will also include functional movement screens that help us determine exactly which tissues are affected with your specific situation. As sports chiropractors, we have a slightly different approach to the treatment of this condition. We will address inflexibility in tissues with a combination of advanced soft tissue techniques, such as the Graston Technique, and stretching exercises. Weaknesses that may be present will be addressed with specific corrective exercises that are designed to target the exact muscles that aren’t “firing” properly. Different Kinesio taping techniques may also be employed to help with the underlying muscular imbalances. Any joint or capsular restrictions will be addressed with specific chiropractic extremity adjustments. The key to success in relieving this condition effectively and efficiently is developing and implementing a treatment plan that is specific to your situation.