A bursa is a small fluid filled sack that sits between and cushions movement of muscles and ligaments over bony areas, usually around a joint. If a bursa becomes irritated it results in pain each time the tissues moves over the top of it. In the case of the hip, this can be with every step.
What Is It
The bursa may become irritated for a number of reasons. When the muscles around the hip are weak, control of the hip with weight bearing is poor, causing the hip to move poorly. This can lead to excessive pulling and rubbing on the bursa leading to irritation. If the muscles that run over the top of the bursa are too tight then this causes an increase in friction each time the muscle moves over the bursa resulting in irritation.
- Pain and tenderness, generally experienced on the outside of the hip, occasionally radiating into the groin.
- Pain with weight bearing activity such as walking and running.
- Typically the pain is worse at night when laying on the affected hip or when getting up after a period of sitting.
- Pain will generally settle with rest.
The initial stages of management of the condition involve rest from activities which aggravate the hip. In this phase ice and anti-inflammatory medication may be useful to reduce pain and swelling.
An assessment of the hips and of your running or walking biomechanics by your physio, will allow them to provide you with a program of stretching to tight muscles and tissue as well as strength and control exercises to improve the way your hip moves. Your physio will likely also do some stretching and tissue release around the hip to restore normal mechanics.
In severe cases which have failed to respond to conservative measures, a steroid injection under ultrasound guidance may be considered to calm the irritated tissue.