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Hip Bursitis

Originally posted on Jun 24, 2010

What Is It?
A common area for runners to develop bursitis is on the side of the hip. A large tendon (the IT Band) passes over the boney prominence of the hip bone.  The bursa normally protects the bone from the friction of the tendon gliding over it during the normal running stride.  Hip Bursitis results when the friction becomes too great and the bursa starts to take on fluid.  The swelling (the itis part of bursitis) is normally accompanied by pain that you can touch right over the top and back of the bony part of your hip.

What Causes It?
The bursa can become inflamed because of friction from over use which is aggravated by muscular imbalance, tightness around the hip, or misalignment in your back or legs.  A direct trauma to the bursa can also result from a fall or even from sleeping in a funny position.  Following is a list of predisposing factors:

  • Weak gluteals and hip rotators resulting in faulty leg alignment
  • Poor Core Strength results in inefficiency in your running stride
  • Referred pain from the low back and/or sciatic nerve
  • Excessive foot pronation changes the alignment of the leg during running
  • Repetitively running on the same side of an uneven/cambered road
  • Trigger Points in low back and hip muscles can affect their performance
  • Sitting with legs crossed – you likely do it more than you realize
  • Crossing over with each stride or excessively wide hips and pelvis
  • Inflexibility in the hips, hamstrings, gluteals and IT Band
  • Asymmetry/Dysfunction in your spine/pelvis or stiffness in your hip joint

How Can I Fix It?
Hip Bursitis can occur from a combination of factors. A proper diagnosis and training approach is the key to resolving the pain.  This will allow you to treat the cause of the problem rather than just the symptoms.

  • Strengthening hip muscles to correct pelvic and leg alignment
  • Improving Core Strength to improve running efficiency
  • Addressing Foot mechanics with the proper shoes or orthotics
  • Consider a physical therapy evaluation for spine and pelvis dysfunction
  • Have your running biomechanics and footwear evaluated using video
  • Appropriate stretching of your hips, hamstrings, gluteals and IT band
  • Trigger point dry needling to your hip muscles to release tension
  • Modify your training routine – consider frequency, duration, and terrain
  • Direct anti-inflammatory medications early (Iontophoresis, Ice) and heat later
  • Sleep with a pillow between your legs if you sleep on your side
  • Use a foam roll to massage your IT Band, quads, hamstrings, and gluteals
  • Make an effort to completely stop crossing your legs
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