Trochanteric (hip) bursitis help?

[RemarkableOwl21]

I’m struggling a lot with trochanteric bursitis and was wonderingif anyone had advice for getting over it. My doctor diagnosed me about 6 weeks ago and gave me a cortisone shot, plus assigned physical therapy. The shot only gave me relief for 9 days. I was doing the physical therapy exercises daily for 3 weeks but stopped when i felt my pain was getting worse and some of the exercises were becoming very painful.

I’ve given up running, but not riding yet. I suspect I will need to take a break from it because riding seems to aggravate it. The odd thing is that sitting at my desk and driving also aggravate it so I feel like I’m still going to be in pain even if I stop riding. Has anyone else found that even sitting caused pain? I’m trying to understand why sitting is aggravating and how to sit to avoid issues because I have a desk job.

Other things I’ve tried are a week of 2 advil, 3 times per day for inflammation, various stretches…

[Simkie]

Have you had any diagnostics? Greater troch bursitis is often a gluteal tendonopathy or tear.

Alison Grimaldi has some great info:

Blog

Poke around there & see if that sounds familiar!

[RemarkableOwl21]

Thank you for this! Very informative. Sounds like only a small percent of people have bursitis without gluteal tendonopathy.

[FitToBeTied]

Ice.

[Kyrabee]

What Simkie says. It is most likely tendonitis. I suffered with what I thought and was told was bursitis. I had a couple steroid shots that helped for about a month then boom, pain back with a vengeance. I did one round of (poorly done) PRP with this doctor and it maybe helped 10%. This doctor finally ordered an MRI and I had a high grade tear of the gluteus minimus and a smaller tear of the gluteus medius. All he offered me was open surgery…Yikes…no.

I had Regenexx PRP done to both tendons in November and 2 weeks later started PT. I worked for 3 months with a PT and have continued my exercises. I am currently about 80-90% better. It is still dicey to lay on my left (affected) side for long but it is no longer painful with weight bearing and I can walk up hills and stairs. I am checking back in with that doctor later in the summer and may have her do a Tenex procedure on them to finish ‘cleaning’ those tendons up if I am still having symptoms. I have to drive 280 miles to that doctor .

My recommendation…get your hip ultrasounded or get an MRI. I dinked around for months with the first MD until he finally ordered an MRI. Be assertive and find out what is wrong…sooner than later. I had the same issue with PT. The first session pre-MRI just did not give me any relief. After the PRP it was quite painful and took about 4 weeks to settle down then I made good progress with PT.

Good luck.
Susan

[PaddockWood]

I have hip pain off and on and it will wake me up at night if I’m laying on that side. Years ago I went to a Sports Meds clinic that takes care of our local pro hockey team. They pulled out Kelly Starrett’s book The Supple Leopard.

My hip was so bad I’d get out of my car after a 30 min drive and could barely walk for a number of steps.

You take a rubber ball and get down and find where it hurts and roll around on it and it does not feel good. But you do it as long as you can stand - maybe one minute (I’m a wimp) and voila. Relief. There were also stretching exercises.

All I can say is that was 10 years ago and when I have flare ups - maybe every 2 months - I’ll get my rubber ball and get on the floor and look for what is bothered. Roll it out and it goes away.

Watch starting at 4:35.

Your Inside Pelvis Bits, World Record? | Feat. Kelly Starrett | Ep. 75 |...

Because of Kelly I now use a ball around my knee when it gets pissy. It’s amazing how it releases whatever is wrong. I also use it on my scapula in the back. Another area that comes and goes.

Using the rubber ball and rolling and releasing has kept me from ever needing anything. Cheap, do at home, and I feel darn good most of the time.

[Simkie]

@Kyrabee

I am currently about 80-90% better

Yay, that’s great to hear! What excellent progress! Congrats, I know that’s been such a tough journey.

[Rosewatt]

Yes, I dealt with this post-fall. Recovered alright after lots of rest, anti-inflammatories etc and rode for 3 years afterwards, initially. However, it would flare up and cause me to limp while walking in the winter.

Somewhere around 2019, it flared up quite badly. Now, I believe this was partially due to the muscle waste during isolation, but it was triggered by me overstretching my hip inwards. The main issue was a sharp pain in the groin area that limited my mobility and felt like I had torn a ligament or tendon. After several periods of trying to ride and having flare ups, I finally went in to see a specialist and was diagnosed with trochanter bursitis and his explanation for the groin pain was residual ligament inflammation. Prior to diagnosis, I had x-rays and MRI; however, nothing showed up. I honestly really wasn’t sure I’d get back to riding again, as I was having troubles walking; however, I decided I was just causing re-occurring injury by continuing to ride. Ultimately, I decided to lay riding down for a rest, as my horse was also simultaneously being retired. I took about 3 years off.

I started back this September. Took on one heck of a project (unintentionally), but a well-minded green horse, who started out just needing walking/turning training. I did use voltaren and advil from time-time, when I first started back as a preventative measure to keep me going. We probably did that for 2 months before we started to ask for itty bitty trot steps. So far, so good! Now we are doing wtc and I can feel that my hip is stronger (muscle built a curve too!).

I do think taking a significant amount of time off did me well and I’d do it again. It really depends where your bursitis stems from, but where mine was from injury, it was definitely something that needed to fully heal prior to any kind of riding was done.

Side note is that I am extra careful not to stretch that hip internally or laterally, as that seems to be a trigger. I can still feel this is the weaker hip, but the pain hasn’t shown up this winter.

[RemarkableOwl21]

Thank you all for your suggestions. I went back to my doctor this morning and asked about gluteal tendinopathy. He agreed that it might be that, especially since the cortisone shot did not resolve the problem. He ordered an MRI for Friday and mentioned the possibility of PRP to treat.

[Simkie]

Fab!

I’ll toss in my soapbox about regenerative therapies here. It’s a very new field, and while there are a LOT of orthopedists doing PRP out of the office with a tabletop machine, seeing a specialist who’s using a true laboratory process will maximize your chance of success. Purity and concentration vary really widely–not all PRP is the same.

So if you do get to the point of considering PRP, pursue an opinion or two from a specialist in this field. Regenexx is a great place to start, as they have offices across the US, and their process gives you 20X PRP. That is, 20 times platelet concentration as baseline.

Good luck!

[Kyrabee]

I have to give a shout out to Regenexx…thanks to Simkie. It was night and day difference between the crap job the ortho doc did (drew insufficient blood, very small volume to inject, no imaging for the injection) and Regenexx.

I had to drive 280 miles to Idaho Falls but was very happy I did. Pre-appointment I was sent a treatment protocol (which included no NSAIDs for 2 weeks prior and 3 months after ) and exercises to do immediately post-procedure. Let’s say I was actually given instructions.
With the doctor’s initial treatment they sent me out the door and said let us know how that works. No pre or post instructions whatsoever.

So if it gets to that be sure to check with your doctor that they have a protocol and imaging. Otherwise it is a total waste of money. I paid exactly $50 more for far more services…and success with Regenexx.

Susan

[Bristol_Bay]

Two things helped me with this. Well, three.

I switched from dressage to a close contact saddle. The long, straight leg put too much pressure on my hips. Once I tried my friend’s Antares, I never looked back.

I bought two pairs of bicycle shorts and sewed them together at the hem, creating a pocket for my ice packs. Having the ice so close to my hips (and using a TENS unit at the same time) was a game changer.

Lastly, I bought a new car, realizing that sitting in my Honda sedan, my knees were higher than my hips. Getting an SUV resolved that.

Eventually, my hips improved to where I could hike and jog again. I stretch every day and use a foam roller on my IT bands. I still ice at night whether I need to or not.

Good luck. It will get better.

[RemarkableOwl21]

Thanks for the advice. I also feel in more pain after driving and I agree it is the bucket-type seat.

I get the results from my mri tomorrow and will report back on this post.

[2tempe]

I had hip bursitis a long time ago; went to some basic and useless pt that did nothing, then went to sports dr. I was about to move out of state, so he gave me some behavioral suggestions:

1. Use a mounting block (my left hip was worse and this was back in the day of everyone mounting from ground)
2. When sitting at desk (all day at work) and in car, hips knees lower than hips and sit like a man! ie knees as far apart as you can.
3. If sleeping on side, get a pillow to hold between knees so your upper leg is more level, not angled down from hip. He said women are prone to this because of the angle of hip/pelvis.
4. Do not sit indian style - something I would often do when sitting on floor.
   Much to my surprise, these helped me so much that I never went to another dr. after moving. I was 40ish at the time so YMMV.
   Fast forward roughly 30 years I have lumbar issues that were made worse by having a bucket seat, low sitting sedan. Traded that car in 2 yrs ago for a smaller SUV type. Huge difference there too.

[RemarkableOwl21]

Thanks for these tips. Sitting Indian-style is so painful right now. I’ve started driving our truck and can angle the seat so my hips are higher than knees. It seems to help versus how I was sitting in our other car.

[RemarkableOwl21]

I’ve had an MRI of my hip and gluteal area, and the results were normal. An xray of low back was normal too. Doctor said I could get an mri of low back but we decided to hold off for now. I’m feeling a little less pain as a result of some of the things I’ve learned from you guys so thank you.

I’m trying to sit with hips higher than knees while working and driving. No more crossing legs when sitting. I’m sleeping with a pillow between legs when on my side. I’m doing a few PT exercises including standing on one leg while holding up/hitching up the affected hip for 45 seconds. These are just some of the things ive found helpful. I haven’t stopped riding yet but will do if the trajectory worsens. For now, I feel like there has been an improvement in my pain level versus 2 weeks ago.

[Annie10]

This is a great thread with lots of good information!

[Jackie_Cochran]

Lately I have been “treating” my hip pain very successfully using layers of different Far Infra-red fabric stuff.

Now when I suspect that my hips will start hurting or if I feel the first twinges of pain I layer my Incrediwear “shorts”, my Fenwick “shorts” and if that does not take care of it (rarely) I put my BOT women’s boxer shorts over them.

My pain from my hip bursitis does not last long after I put this stuff on.

The horses first showed me this, the Far Infra-red Radiation stuff works best in layers of different types of the F.I.R. stuff, I use BOT, Fenwick and Incrediwear.

If I was not so allergic to Neoprene there are other brands that I am sure would also help me like the Benefab and Copper Compression gear but the Neoprene gets my skin like I rolled in poison ivy. I envy people who are not allergic to Neoprene.

Both the Incrediwear and the Copper Compression people have special gear for hips, but so far I have had success just with the shorts.