Apex Sports Clinic

Hip Bursitis

Let’s understand Hip Bursitis

What’s the Condition?

Hip bursitis is a common inflammatory condition affecting the bursae, small fluid-filled sacs that cushion the bones, tendons, and muscles near the hip joint. These bursae can become inflamed due to repetitive stress, trauma, or overuse, leading to pain and discomfort around the hip area. Athletes, particularly those engaged in high-impact sports, are susceptible to hip bursitis due to the repetitive motions and strain placed on the hip joint during training and competition.

Femoroacetabular Impingement (FAI)

A labral tear is an injury to the labrum, a crucial ring of fibrocartilage that surrounds the hip joint's socket, known as the acetabulum

Let's’ explore the causes:

Repetitive Movements:

Athletes involved in sports that require repetitive hip movements, such as running, cycling, or kicking, are at risk of developing hip bursitis. The constant friction and pressure on the bursae can lead to irritation and inflammation over time.

Trauma or Injury:

Direct trauma to the hip area, such as a fall or collision during sports activities, can cause acute bursitis. The impact can compress or injure the bursae, leading to inflammation and pain.

Muscle Imbalances:

Muscle imbalances around the hip joint, often resulting from inadequate strength or flexibility training, can contribute to hip bursitis. Weak hip muscles or tight hip flexors can alter joint mechanics and increase stress on the bursae, leading to irritation and inflammation.

Overuse or Overtraining:

Athletes who overtrain or increase their training intensity too quickly without adequate rest are at risk of developing hip bursitis. Overuse of the hip joint can lead to repetitive stress injuries and inflammation of the bursae.

What are the Symptoms?

Athletes with hip bursitis typically experience pain on the outside of the hip or in the buttock area. The pain may worsen with activity, especially movements that involve hip flexion or prolonged periods of standing, walking, or running. The affected area may feel tender to the touch, and swelling or inflammation may be present around the hip joint. Hip bursitis can lead to stiffness and decreased flexibility in the hip joint, making it difficult for athletes to perform certain movements comfortably. Pressing on the affected area or lying on the affected side may exacerbate the pain and discomfort associated with hip bursitis.

What are the treatments you can explore ?

Temporary cessation or modification of activities that aggravate symptoms can help alleviate pain and inflammation. Athletes may need to adjust their training routines or incorporate cross-training activities that place less stress on the hip joint.

Applying ice packs to the affected area can help reduce inflammation and alleviate pain. Ice therapy should be applied for 15-20 minutes several times a day, especially after physical activity.
Physical therapy focuses on improving flexibility and strength in the hip and surrounding muscles to alleviate strain on the bursae. Stretching exercises target tight muscles, while strengthening exercises aim to stabilise the hip joint and improve biomechanics.

Surgical Treatments:

1. Bursectomy:

Procedure:

Bursectomy involves the surgical removal of the inflamed bursa (bursa sac) around the hip joint. This procedure is typically performed arthroscopically, using small incisions and a camera (arthroscope) to visualise the hip joint and surrounding structures. Bursectomy may be recommended when conservative treatments have failed to provide relief, and the inflamed bursa is causing persistent pain and functional limitations. By removing the inflamed bursa, the procedure aims to eliminate the source of pain and allow for improved hip mobility and function.

Recovery:

Recovery from bursectomy is generally quicker compared to more extensive hip surgeries. Physical therapy may be prescribed to help restore strength and flexibility in the hip joint post-operatively.

2. Trochanteric Bursa Debridement:

Procedure:

Trochanteric bursa debridement involves removing the inflamed tissue and debris from the trochanteric bursa, a common site of hip bursitis. This procedure can be performed arthroscopically or through an open surgical approach. Trochanteric bursa debridement is indicated when conservative treatments have been ineffective, and there is evidence of significant inflammation and damage within the bursa. By clearing out the damaged tissue and debris from the bursa, the procedure aims to reduce pain and inflammation and promote healing of the affected area.

Recovery:

Recovery from trochanteric bursa debridement varies depending on the extent of the procedure and individual factors. Physical therapy may be prescribed to aid in recovery and optimise hip function post-surgery.

It’s important for athletes considering surgical treatment for hip bursitis to consult with an orthopaedic surgeon specialising in hip conditions.

Post-Surgical Management

Rehabilitation:

Following surgical intervention for hip bursitis, athletes undergo a structured rehabilitation program to gradually reintroduce physical activity and sports participation.

Physical therapists guide athletes through exercises aimed at restoring hip strength, flexibility, and functional movement patterns. Rehabilitation may include progressive resistance training, proprioceptive exercises, and sport-specific drills to prepare athletes for a safe return to play.
Regular follow-up appointments with healthcare providers are essential to monitor progress, address any postoperative complications, and adjust the rehabilitation plan as needed.

Athletes may need to modify their training routines or incorporate preventive strategies to reduce the risk of recurrent hip bursitis. This may involve cross-training, proper warm-up and cool-down techniques, and maintaining optimal hip joint mechanics during sports activities.

Athletes should pay attention to their body’s signals and avoid pushing through pain or discomfort.
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Dr.Foo Gen Lin_Apex Sports Clinic