Hip Labral Tear | Anatomy and Symptoms
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Bursitis is the inflammation of these bursae caused by excessive friction, compression or infection. The most common bursitis of the hip is that of the greater trochanteric bursa. There are more than 150 bursae in the human body. A bursa is a fluid-filled sack, a bit like a balloon. They act like a sliding sheet by offering a smooth cushion that can glide as the body moves. Bursae are located over points of potential friction to prevent injury. There are several bursae at the hip, the most important being the greater trochanteric bursa, iliopsoas bursa and ischiogluteal bursa.
So, what does bursitis in the hip feel like? Most patients will describe hip bursitis as an ache on the side of their hip. That is if the affected bursa is the greater trochanteric bursa, the most common bursa to get inflamed. Hip bursitis pain can also be sharp if it is aggravated or in specific positions that cause aggravation, by pinching or compressing the bursa.
The location of pain with hip bursitis will depend on the specific bursa that is inflamed. Greater trochanteric bursitis will be painful on the lateral side of the hip. That is because the bursa is located at the side of the hip between the greater trochanter of the femur and the gluteus maximus muscles. The iliopsoas bursa is between the iliopsoas musculotendinous junction and the capsule of the hip joint, and pain will be felt a the front of the hip. The ischiogluteal bursa is between the ischial tuberosity of the pelvis and the gluteus maximus muscle, pain will be felt on and around the seat bone.
bursitis hip pain location diagram
hip bursitis picture
Hip bursitis is most commonly caused over a period of time by chronic excessive force, compression or friction of the bursa. This can be for a range of reasons. Repetitive movements or postures are the most common causes of bursitis. And there are biomechanical factors that can increase the risk of this injury developing. For example, weakness of the muscles around the hip and pelvis can increase the risk of greater trochanteric bursitis. This weakness can cause greater adduction of the hip joint with actions such as walking and running, which can put more pressure on the bursa. Combine this with an increase in walking or running, and greater trochanteric bursitis may develop.
Trauma can also cause bursitis. A sudden high overload of pressure, such as from a fall onto the bursa can cause acute inflammation. Falling on the outside of the hip or the seat bone can cause, greater trochanteric bursitis and ischiogluteal bursitis, respectively.
The final cause of bursitis is infection. This is most common with bursae that sit just below the skin, as a break in the skin can introduce bacteria to the bursa. Busae of the knee and elbow are more likely to develop infectious bursitis than around the hip. However, a deeper wound or a systemic infection can cause infections bursitis at the hip.
As with most musculoskeletal injuries, there is no single conclusive hip bursitis test. Diagnosis of hip bursitis is through a series of assessments during a medical examination. Indicators that the diagnosis is hip bursitis are the location of pain, and pain that is reproduced with pressure over the specific bursa, with activation of the muscles over the bursa and different postures or positions that compress the bursa. This, in combination with assessments that rule out other pathologies, can diagnose hip bursitis.
Further confirmation of a hip bursitis diagnosis can be through diagnostic imaging: x-ray, MRI and ultrasound. Of these, MRI and ultrasound are the most accurate. MRI of hip bursitis can provide a clear image of a cross-section through the body, so the specific hip bursa that is affected can be identified, and the size can be easily measured. However, MRI is expensive and takes a still image in one position. The benefit of ultrasound is that it is cost-effective and can be done with movement. This is beneficial when the bursitis is mild and may only be seen in specific positions of compression.
– Crossing your legs
– Pelvis drop when walking or running
– Sitting in a low chair
– Lying on your side
– Walking upstairs
– Prolonged standing
– Bringing your knees to your chest
– Walking upstairs
– Standing up from sitting
– Running and jogging
– Lifting your leg when into bed or a car
– Exercises such as deep squats
– Prolonged sitting
– Sitting on a hard chair
– Walking uphill
– Bending forwards
– Exercises such as straight-leg deadlifts or deep squats
Hip bursitis can last from a few days to weeks, and even months. The duration of symptoms will depend on the cause of bursitis, the extent of the inflammation, and the treatment followed. In an acute case, a few days of rest may settle symptoms completely, whereas if it is caused by chronic overload, and if initial symptoms are ignored, it may take a lot longer to reduce the symptoms and inflammation, and more treatment may be needed to address the cause and contributing factors.
This is not medical advice. We recommend a consultation with a medical professional such as James McCormack. He offers Online Physiotherapy Appointments.