Trochanteric bursitis

1. Trochanteric Bursitis Michelle Grant Nichole Frederickson

2. What is Trochanteric Bursitis Trochanteric Bursitis is defined as painful inflammation of the bursa located just superficial to the greater trochanter of the femur.

3. Pathophysiolgy Standing Asymmetrically for long periods of time with the effected hip elevated and adducted, while dropping the pelvis on the opposite side. Excessive walking or running Falls or repetitive trauma by impact Climbing stairs Leg length discrepancy or hip surgery complications

4. Pathophysiology Continued Increased repetitive friction against the bursa causes irritation and inflammation which in turn causes pain. Pain symptoms occur when the involved muscle contracts, when it is stretched, or when the provoking activity is repeated.

5. Signs or Symptoms Pain is experienced over the lateral hip and down the lateral thigh to the knee Faulty posture Painful gait Decreased muscle flexibility

6. Signs and Symptoms Decreased muscular endurance Weak gluteus medius and minimus Shortened lateral rotators Dominance of the hamstrings

7. Preferred Practice Patterns Pattern 4E- Impaired joint mobility, motor function, muscle performance and range of motion, associated with localized inflammation

8. Modalities Inflammation Control Cold packs or ice massage Hydrotherapy Laser Ultrasound Electronic Stimulation Compression or taping Continuous Passive Motion

9. Treatment Restricted activity to avoid pain Use an Assistive Device to decrease weight bearing Massage Manual Traction Joint Mobilization

10. Therapeutic Exercise Stretch any muscles that are restricting motion in clinic and home exercise Train the involved muscles to contract and control alignment of the femur Strengthening the weakened muscles Control and strengthen the trunk

11. Therapeutic Exercise Perform each exercise 1 to 3 minutes before progression Perform exercises that do not worsen symptoms Modify intensity Position Time performed Weight-bearing exercises or partial weight-bearing exercise Biking Weight shifting exercises on parallel bars

12. ADL Functional Training Progress close chain exercises to functional activities Increase eccentric resistance and demand for controlled speed to return-to-work activities Progress to patterns of movement consistent with the desired day-to-day activities Practice timing and sequencing of events

13. References APTA. Guide to Physical Therapist Practice . 2 nd ed.Alexandria , VA:APTA;2001. Kisner C, Colby LA. Therapeutic Exercise: Foundations and Techniques . 5 th ed.Phillidelphia , PA:F.A. Davis Company;2007. Foye PM, Stitik TP. Trochanteric Bursitis .http :// emedicine.medscape.com /article/309286-overview.Updated Oct 1, 2009.Accessed Nov 20, 2010.