Why is it important to strengthen and stretch the muscles around the hips and pelvis if you have bursitis of the hip?
What is bursitis?
A bursa is a small fluid filled, jelly like sac, which lies between a bone and a tendon. Bursae are found all over the body. Their function is to enable tendons to glide smoothly over the bone or joint. Sometimes however, the bursa may become swollen, inflamed and painful – this is called bursitis. There are two main bursae which may become painful in the hip. The trochanteric bursa on the side of the hip, and the iliopsas bursa in front of the hip. You can read much more about bursitis of the hip in this informative article.
Treatment options for bursitis of the hip
In addition to medical treatments for bursitis of the hip, all sufferers will benefit from the correct stretching and strengthening exercises.
- NSAIDS – doctors often prescribe non-steroidal anti-inflammatory medications, which help to reduce the inflammation symptoms. Your doctor will advise you on their use, and possible side effects
- Activity modification – you may need to modify your activities for a period of time, to allow the inflammation in the bursa to settle down. For example not sitting for too long; walking with a crutch if it is really severe; sleeping with a pillow between your knees and with the affected side on top. You may need to do an activity such as swimming or water aerobics, rather than running or walking. Speak to a physical therapist for advise as to what exercise would be better for you, if your current activities are aggravating your condition.
- Gentle stretching – it is important to stretch the tight muscles, which aggravate the bursitis. Check out this great exercise video, which has physio approved stretches and exercises appropriate for hip bursitis. You may also want to start a gentle Yoga class, but be sure to discuss your condition with your instructor, and avoid any movements or stretches, which cause too much discomfort or pain
- Physical therapy, massage and foam rolling – there are often severe trigger points in the muscles around the inflamed bursa. A physiotherapist, or qualified massage therapist can help to relieve these tender points in the muscles through trigger point therapy, dry needling, acupuncture, and electrotherapy. A physiotherapist can show you how to stretch, strengthen, and use a foam roller or small ball in order to do self-massage to help loosen up the tight muscles and fascia around the hip.
- Strengthen the stabilising muscles of your core and pelvis – this is critically important. If your deep tummy muscles, and the muscles around the hip area are not working properly, any activities – and even your walking and movement patterns – may constantly aggravate the sensitive bursa. You can do these physio-approved exercises, which will help to strengthen all the right muscles.
- Pilates is also a wonderful way to strengthen these deep tummy and gluteal muscles.
- Correct leg length difference – if you have one leg shorter than the other, it may be necessary to see someone who can make an insert for your shoe in order to correct the leg length difference and improve the way your hips and pelvis move
- Cortisone injections – sometimes a doctor may inject the bursa with a corticosteroid and some other medications such as local anaesthetic. This may help to reduce the inflammation in the bursa. Sometimes repeated injections may be necessary, but unfortunately sometimes the injection does not work. It is still important to address the underlying muscle weakness and tightness, to hopefully prevent it re-occurring
- Weight loss – losing weight means less pressure in all the structures around the hip joint. Weight loss also then improves how you walk. A better gait pattern (way of walking) means less irritation of the bursa.
- Surgery – occasionally if all other options have been tried and have failed, an orthopaedic surgeon may perform surgery to remove the bursa. This can also be done arthroscopically.
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You can get started with these gentle physio-approved exercises. There is also a downloadable PDF for easy reference. Remember to always be kind to your joints.
The Joint Gurus