If your physician or physical therapist has recently given you a diagnosis of IT Band Friction Syndrome and Greater Trochanteric Bursitis, the lengthy title of your diagnosis probably doesn’t mean much to you. All you know is that you are experiencing a myriad of symptoms that most likely include hip and leg pain, perhaps even extending to pain in the buttocks region, and even down to the knee as well. Read on to learn more about what these conditions actually are and more importantly how to resolve them.
IT Bands and the Greater Trochanter
The IT bands are a group of thick fibers that extend from the outside of the hip area, down each thigh, gliding past the fluid-filled bursa in the knee area, eventually connecting to the shinbone found in the calf. The gluteus (butt) muscles insert into the top portion of this IT band. The greater trochanter refers to an area at the top of the femur (thigh) bone. This region makes up part of the hip joint and makes use of fluid-filled sacs, or bursae, that lubricates the hip joint. During repetitive movements, the IT fibers continually rub against the bony prominences found in both the hip and knee areas. In some cases, this can lead to the bursa around the greater trochanter becoming irritated and inflamed. If the IT band of fibers becomes too tight it can lead to pain and swelling in the bursae around the knee area as well.
Signs and Symptoms
People who are having issues with band friction and trochanteric bursitis typically report feeling a sharp hip pain that is particularly noticeable when walking down a flight of stairs. Over time, the pain can turn into a chronic dull ache. Some patients report a “sore butt” as the top portion of their IT band adjacent to their gluteus muscle becomes irritated. If left untreated, the pain can begin to travel and a patient might experience leg pain and/or leg weakness, as well as knee pain. In severe cases, the hip area can become swollen and red, with some patients reporting a fever as well.
Contributing Factors
The repetitive motions found in running, especially those who participate in marathons, often contribute to the creation of these conditions, as well as other repetitive hip and leg activities such as bicycling. These repetitive motion issues typically show up in the middle-aged, although it is possible for a person of any age to experience these issues. Other contributing factors include glute weakness, which prevents the gluteus muscle from providing the proper support to the hip area, along with poor posture, hip surgery complications, and in some cases even gout, a form of arthritis. Older individuals may find themselves dealing with tight IT bands when they don’t properly stretch out simply before going for a walk.
Testing
A doctor or physical therapist will conduct a physical examination of their patient’s hip region, in addition to having the patient perform some specific movements to see if the pain worsens. Some doctors might perform an X-ray to rule out other conditions and they may request an ultrasound or perhaps an MRI if a patient doesn’t respond to treatment. If a doctor injects an anesthetic into the hip bursa and the patient’s pain is eliminated, they most likely have trochanteric bursitis.
Treatment
Physicians typically recommend conservative measures first, including ice packs, anti-inflammatory meds, and rest. If a patient continues to have issues, doctors often will write a prescription for a series of treatments with a physical therapist. PT specialists will evaluate a patient for mechanical issues such as overpronation as well as specific muscle weakness(es), and recommend treatments such as shoe orthotics and/or Flexibility-ROM-Strengthening exercises designed to stretch and strengthen key muscles. They may also make use of treatments like ultrasound to reduce pain as well as iontophoresis, another procedure that delivers anti-inflammatory medications directly through the skin of the inflamed region.
Prevention
Wearing good quality athletic shoes that help address any issues such as overpronation is a must, as well as properly stretching muscles before engaging in any athletic activity. Beginners especially, need to follow a plan for a measured increase in activity to gradually increase their strength and endurance, rather than overtaxing out-of-shape muscles.
If you have pain in the hip, buttocks, legs, or knee area and would like to know more about IT Band Friction Syndrome and Greater Trochanteric Bursitis, please contact us at 570-208-2787 or email us at: cawleyptfrank@gmail.com.
Written by Dr. Jeff Frail DPT
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