What is Osteitis Pubis?

Osteitis Pubis is a common cause of chronic groin pain in the football codes. It is an overuse injury. That is, it is caused by repeated trauma rather than a specific incident. However, it is not uncommon for a specific incident to trigger the symptoms.

Diagnosis is usually made in the advanced stages when the pubis bones have began to erode at the pubic symphysis. Early diagnosis can prevent the condition progressing beyond the stage of "bone stress".

What Causes Osteitis Pubis?

The main cause is instability of the pelvic bones and in particular the pubic symphysis. 

The instability is aggravated when asymmetrical loads are placed through the pelvis such as when running or kicking. These activities are normally well accommodated in the normal "stable" athlete but with poor lumbopelvic control the additional forces are uncontrollable and will cause injury.

Due to the instability in the region it is not uncommon for the athlete to have experienced a previous history of groin strains, a "sportsman's" hernia or low back pain.

How to Diagnose Osteitis Pubis

Pain is usually experienced over the pubic symphysis with referred pain into the inguinal region and the groin. Palpation of the pubic symphysis and the pubic ramus is acutely tender. Resisted muscle contraction of the hip adductors and flexors will elicit pain. Likewise stretching into abduction and extension can elicit pain in the acute stage. Coughing, sneezing and performing a sit up will reproduce pain. This athlete is often unable to lie flat on their back or prone.

Treatment for Osteitis Pubis

Read full article: Osteitis Pubis

What is Trochanteric Bursitis?

Trochanteric bursitis is the most common bursitis of the hip. Trochanteric bursitis is inflammation of the bursa (a small, cushioning sac located where tendons pass over areas of bone around the joints), which lies over the prominent bone on the side of your hip (femur). The superficial trochanteric bursa is located over the greater trochanter. This is the most commonly inflamed bursa. A deep trochanteric bursa lies deeper and can become inflamed in more severe cases. Read full article: Trochanteric Bursitis What is a Bursitis? What are Trochanteric Bursitis Symptoms? One or more of the following symptoms may be experienced: Pain and swelling occurring over the side of the hip Referred pain that travels down the outside thigh and may continue down to the knee Pain when sleeping on your side; especially the affected hip Pain upon getting up from a deep chair or after prolonged sitting (eg. in a car) Pain when climbing stairs Pain in sitting with the legs crossed Increased pain when walking, cycling or standing for long periods of time What Causes Trochanteric Bursitis? The trochanteric bursa may be inflamed by a group of muscles or tendons rubbing over the bursa and causing friction against the thigh bone. This injury can occur traumatically from a fall or a sport-related impact contusion. It can also be a case of gradual onset via a repetitive trauma to the bursa from such activities as running (with poor muscles control or technique), walking into fatigue, or cycling, especially when the bicycle seat is too high. It is also a secondary injury associated with chronic conditions such as: Scoliosis - curvature of the spine Unequal leg length Weak hip muscles Osteoarthritis (degenerative joint disease) of the hips or lower back Calcium deposition in the gluteal tendons that run over the bursa Rheumatoid arthritis. How is Trochanteric Bursitis Diagnosed? Your physiotherapist will provide you with an assessment of your medical history and a physical examination of your hip, pelvis and back. A hallmark sign is if you feel tenderness over the bursa or greater trochanter (hip bone) when pressure is applied. Diagnosis can also be confirmed by medical imaging techniques that include ultrasound scan & MRI.  What is Trochanteric Bursitis Treatment? Read full article: Trochanteric Bursitis Contact PhysioWorks or Book Online Helpful Products for Trochanteric Bursitis Related Injuries Bursitis Shoulder Femoroacetabular Impingement (FAI) Fibromyalgia Gluteal Tendinopathy Hip Labral Tear Muscle Pain: Strains or Tears Piriformis Syndrome Poor Hip Core Sacroiliac Joint - SIJ Pain Sciatica Trochanteric Bursitis (Bursitis Hip)

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Hip or Groin Pain? Maybe it's Femoracetabular Impingement or FAI?

What is Femoroacetabular Impingement? Femoroacetabular Impingement (FAI) is a hip condition which describes a mechanical mismatch between the hip “ball” and the “socket”. There are three described types of femoroacetabular impingement: Cam Type FAI ‘Cam’ type femoroacetabular impingement describes a ‘bump’ on the surface of the femoral head (ball) which jams on the rim of the (acetabulum) socket. This typically affects young athletic men. Pincer Type FAI ‘Pincer’ type femoroacetabular impingement describes an increased coverage by the acetabulum over the anterior femoral head. This typically affects middle aged women and is less common. Mixed Type FAI Often there can be a combination of both cam and pincer types, which is termed “ What Causes Femoroacetabular Impingement? Read full article here: http://bit.ly/198U5ew What are the Symptoms of Femoroacetabular Impingement? FAI often presents as hip and groin pain with restricted range of hip motion. Symptom onset can be acute, following injury, or insidious after prolonged exertion.  Pain is often provoked with prolonged sitting, walking, crossing the legs as well as during and after sport and exercise.  There will typically be a restriction in hip flexion and internal rotation range of motion.  Pain is primarily felt deep in the groin at the front of the hip, more rarely it can be on the side of the hip or the buttock. How is Femoroacetabular Impingement Diagnosed? Read full article here: http://bit.ly/198U5ew How is Femoroacetabular Impingement Treated? An initial trial of non-operative treatment is advocated for most patients, as the pain is relatively self-limiting.  Read full article here: http://bit.ly/198U5ew FAQ's about Femoroacebular Impingement Read full article here: http://bit.ly/198U5ew Article by John Miller Contact PhysioWorks or Book Online Helpful Products for Femoroacebular Impingement Related Injuries ACL Tear Adductor Tendinopathy Corked Thigh (Bruised Quadriceps) Femoroacetabular Impingement (FAI) Gluteal Tendinopathy Groin Strain Hamstring Strain Hip Arthritis (Osteoarthritis) Hip Labral Tear Iliotibial Band Friction Syndrome Muscle Pain: Strains or Tears Osteitis Pubis Poor Hip Core Sacroiliac Joint - SIJ Pain Stress Fracture Thigh Strain Trochanteric Bursitis (Hip Bursitis)

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Suffering Hip Pain? Maybe it's Trochanteric Bursitis?

What is Trochanteric Bursitis? The most common form of hip bursitis is trochanteric bursitis.  Trochanteric bursitis is inflammation of the bursa (a small, cushioning sac located where tendons pass over areas of bone around the joints), which lies over the prominent bone on the side of your hip (femur). The superficial trochanteric bursa is located over the greater trochanter. This is the most commonly inflamed bursa. A deep trochanteric bursa lies deeper and can become inflamed in more severe cases. What is a Bursitis? What are Trochanteric Bursitis Symptoms? One or more of the following symptoms may be experienced: Pain and swelling occurring over the side of the hip Referred pain that travels down the outside thigh and may continue down to the knee Pain when sleeping on your side; especially the affected hip Pain upon getting up from a deep chair or after prolonged sitting (eg. in a car) Pain when climbing stairs Pain in sitting with the legs crossed Increased pain when walking, cycling or standing for long periods of time What Causes Trochanteric Bursitis? The trochanteric bursa may be inflamed by a group of muscles or tendons rubbing over the bursa and causing friction against the thigh bone. This injury can occur traumatically from a fall or a sport-related impact contusion. It can also be a case of gradual onset via a repetitive trauma to the bursa from such activities as running (with poor muscles control or technique), walking into fatigue, or cycling, especially when the bicycle seat is too high. It is also a secondary injury associated with chronic conditions such as: Scoliosis - curvature of the spine Unequal leg length Weak hip muscles Osteoarthritis (degenerative joint disease) of the hips or lower back Calcium deposition in the gluteal tendons that run over the bursa Rheumatoid arthritis. How is Trochanteric Bursitis Diagnosed? Your physiotherapist will provide you with an assessment of your medical history and a physical examination of your hip, pelvis and back. A hallmark sign is if you feel tenderness over the bursa or greater trochanter (hip bone) when pressure is applied. Diagnosis can also be confirmed by medical imaging techniques that include ultrasound scan & MRI.  Contact Physio Works or Book Online What is Trochanteric Bursitis Treatment? Ice Bursitis is an inflammed bursa. Daily application of ice packs is highly recommended to reduce your pain and swelling. Medications NSAIDs or anti-inflammatory drugs (i.e. ibuprofen). Use of these medications should be discussed with your doctor.  Corticosteroid Injections Single injection of a corticosteroid with a local anaesthetic into the bursa may be required to stimulate your healing response. It is preferable to have this injection using ultrasound guidance.  Physiotherapy Hip Bursitis Treatment PHASE I - Pain Relief & Protection Managing your pain. Pain is the main reason that you seek treatment for trochanteric bursitis. In truth, it was actually the final symptom that you developed and should be the first symptom to improve. Managing your inflammation. Bursa inflammation it best eased via ice therapy and techniques or exercises that deload the inflammed structures. Your physiotherapist will use an array of treatment tools to reduce your pain and inflammation. These include: ice, electrotherapy, acupuncture, deloading taping techniques, soft tissue massage and temporary use of a mobility aid (eg cane or crutch) to off-load the affected side. PHASE II - Restoring Normal ROM, Strength As your pain and inflammation settles, your physiotherapist will turn their attention to restoring your normal hip joint range of motion, muscle length and resting tension, muscle strength and endurance, proprioception, balance and gait (walking pattern). Hip researchers have discovered the importance of your hip muscle recruitment patterns with a normal order of: deep, then intermediate and finally superficial muscle firing patterns in normal pain-free hips. Your physiotherapist will assess your muscle recruitment pattern and prescribe the best exercises for you specific to your needs. PhysioWorks has developed a “Hip Core Stabilisation Program” to assist their patients to regain normal hip muscle control. Please ask your physio for their advice. PHASE III - Restoring Full Function The final stage of your rehabilitation is aimed at returning you to your desired activities. Everyone has different demands for their hips that will determine what specific treatment goals you need to achieve. For some it be simply to walk around the block. Others may wish to run a marathon. Your physiotherapist will tailor your hip rehabilitation to help you achieve your own functional goals. PHASE IV - Preventing a Recurrence Trochanteric bursitis does have a tendency to return. The main reason it is thought to recur is due to insufficient rehabilitation. In addition to your muscle control, your physiotherapist will assess you hip biomechanics and start correcting any defects. It may be as simple as providing your will core abdominal exercises or some foot orthotics to address any biomechanical faults in the legs or feet. Your physiotherapist will guide you. Fine tuning your hip stability and function by addressing any deficits in core strength and balance, learning self-management techniques and achieving the ultimate goal of safely returning to your previous sporting or leisure activities! Bursitis Surgery Surgery is not a common path. However, in persistent cases, arthroscopic removal of the bursa; a bursectomy, can be performed. Contact Physio Works or Book Online How Can You Prevent Trochanteric Bursitis? Muscle weakness or fatigue is a major cause of trochanteric bursitis. So addressing your strength and endurance is necessary to avoid a recurrence. Wearing adequate footwear which supports any biomechanical imbalances in your feet is a key preventative measure. Successful weight management, minimises excess stress on the hip joints which can alleviate pressure on the bursa. If you need advice regarding your weight-loss please discuss with your doctor or dietitian. What Results Can You Expect for Trochanteric Bursitis? While some people can respond quickly to physiotherapy treatment within a few weeks, more chronic cases where a tendinopathy exists in the gluteal muscle group under the bursa can require a few months to achieve recovery. Trochanteric bursitis is successfully managed in the vast majority over a period of approximately six week. It is important to not stop your rehabilitation exercises as soon as you pain abates. Excellent hip muscle control is your best rehabilitation and prevention strategy. Please follow the advice of your physiotherapist or doctor. Physiotherapists at Physio Works can get your started on the right track to recovery! If you have any specific questions, please ask them. Contact Physio Works or Book Online Common Trochanteric & Hip Bursitis Treatments Immediate Injury Treatment Avoid the HARM Factors What are the Healing Phases for a Soft Tissue Injury? Acupuncture and Dry Needling Core Stability Exercises Biomechanical Analysis Balance Enhancement Exercises Proprioception & Balance Exercises Agility & Sport-Specific Exercises Medications? Soft Tissue Massage Bursitis Treatment Electrotherapy & Local Modalities Kinesiology Taping Prehabilitation Strengthening Exercises Stretching Exercises Support Brace Supportive Taping & Strapping TENS Machines Contact PhysioWorks or Book Online FAQs about Trochanteric & Hip Bursitis What is Pain? Physiotherapy & Exercise When Should Diagnostic Tests Be Performed? How Does Kinesiology Tape Reduce Swelling? How Can You Prevent a Future Leg Injury? How Much Treatment Will You Need? How to Stretch? Sports Injury? What to do? When? What are the Common Massage Therapy Techniques? What are the Early Warning Signs of an Injury? What is Chronic Pain? What is Sports Physiotherapy? What is the Correct Posture Standing? What Pillow Do Physiotherapists Recommend? When Can You Return to Sport or Work? Contact PhysioWorks or Book Online Helpful Products for Trochanteric Bursitis Related Injuries Femoroacetabular Impingement (FAI) Fibromyalgia Gluteal Tendinopathy Hip Labral Tear Muscle Pain: Strains or Tears Piriformis Syndrome Poor Hip Core Sacroiliac Joint - SIJ Pain Sciatica Shoulder Bursitis Trochanteric Bursitis (Hip Bursitis)

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Trochanteric Bursitis... What is it? How is it Diagnosed? What's the best treatment?

The most common form of hip bursitis is trochanteric bursitis.  Trochanteric bursitis is inflammation of the bursa (a small, cushioning sac located where tendons pass over areas of bone around the joints), which lies over the prominent bone on the side of your hip (femur). The superficial trochanteric bursa is located over the greater trochanter. This is the most commonly inflamed bursa. A deep trochanteric bursa lies deeper and can become inflamed in more severe cases. What is a Bursitis? What are Trochanteric Bursitis Symptoms? One or more of the following symptoms may be experienced: Pain and swelling occurring over the side of the hip Referred pain that travels down the outside thigh and may continue down to the knee Pain when sleeping on your side; especially the affected hip Pain upon getting up from a deep chair or after prolonged sitting (eg. in a car) Pain when climbing stairs Pain in sitting with the legs crossed Increased pain when walking, cycling or standing for long periods of time What Causes Trochanteric Bursitis? The trochanteric bursa may be inflamed by a group of muscles or tendons rubbing over the bursa and causing friction against the thigh bone. This injury can occur traumatically from a fall or a sport-related impact contusion. It can also be a case of gradual onset via a repetitive trauma to the bursa from such activities as running (with poor muscles control or technique), walking into fatigue, or cycling, especially when the bicycle seat is too high. It is also a secondary injury associated with chronic conditions such as: Scoliosis - curvature of the spine Unequal leg length Weak hip muscles Osteoarthritis (degenerative joint disease) of the hips or lower back Calcium deposition in the gluteal tendons that run over the bursa Rheumatoid arthritis. How is Trochanteric Bursitis Diagnosed? Your physiotherapist will provide you with an assessment of your medical history and a physical examination of your hip, pelvis and back. A hallmark sign is if you feel tenderness over the bursa or greater trochanter (hip bone) when pressure is applied. Diagnosis can also be confirmed by medical imaging techniques that include ultrasound scan & MRI.  Contact Physio Works or Book Online What is Trochanteric Bursitis Treatment? Ice Bursitis is an inflammed bursa. Daily application of ice packs is highly recommended to reduce your pain and swelling. Medications NSAIDs or anti-inflammatory drugs (i.e. ibuprofen). Use of these medications should be discussed with your doctor.  Corticosteroid Injections Single injection of a corticosteroid with a local anaesthetic into the bursa may be required to stimulate your healing response. It is preferable to have this injection using ultrasound guidance.  Trochanteric Bursitis Treatment PHASE I - Pain Relief & Protection Managing your pain. Pain is the main reason that you seek treatment for trochanteric bursitis. In truth, it was actually the final symptom that you developed and should be the first symptom to improve. Managing your inflammation. Bursa inflammation it best eased via ice therapy and techniques or exercises that deload the inflammed structures. Your physiotherapist will use an array of treatment tools to reduce your pain and inflammation. These include: ice, electrotherapy, acupuncture, deloading taping techniques, soft tissue massage and temporary use of a mobility aid (eg cane or crutch) to off-load the affected side. PHASE II - Restoring Normal ROM, Strength As your pain and inflammation settles, your physiotherapist will turn their attention to restoring your normal hip joint range of motion, muscle length and resting tension, muscle strength and endurance, proprioception, balance and gait (walking pattern). Hip researchers have discovered the importance of your hip muscle recruitment patterns with a normal order of: deep, then intermediate and finally superficial muscle firing patterns in normal pain-free hips. Your physiotherapist will assess your muscle recruitment pattern and prescribe the best exercises for you specific to your needs. PhysioWorks has developed a “Hip Core Stabilisation Program” to assist their patients to regain normal hip muscle control. Please ask your physio for their advice. PHASE III - Restoring Full Function The final stage of your rehabilitation is aimed at returning you to your desired activities. Everyone has different demands for their hips that will determine what specific treatment goals you need to achieve. For some it be simply to walk around the block. Others may wish to run a marathon. Your physiotherapist will tailor your hip rehabilitation to help you achieve your own functional goals. PHASE IV - Preventing a Recurrence Trochanteric bursitis does have a tendency to return. The main reason it is thought to recur is due to insufficient rehabilitation. In addition to your muscle control, your physiotherapist will assess you hip biomechanics and start correcting any defects. It may be as simple as providing your will core abdominal exercises or some foot orthotics to address any biomechanical faults in the legs or feet. Your physiotherapist will guide you. Fine tuning your hip stability and function by addressing any deficits in core strength and balance, learning self-management techniques and achieving the ultimate goal of safely returning to your previous sporting or leisure activities! Bursitis Surgery Surgery is not a common path. However, in persistent cases, arthroscopic removal of the bursa; a bursectomy, can be performed. Contact Physio Works or Book Online How Can You Prevent Trochanteric Bursitis? Muscle weakness or fatigue is a major cause of trochanteric bursitis. So addressing your strength and endurance is necessary to avoid a recurrence. Wearing adequate footwear which supports any biomechanical imbalances in your feet is a key preventative measure. Successful weight management, minimises excess stress on the hip joints which can alleviate pressure on the bursa. If you need advice regarding your weight-loss please discuss with your doctor or dietitian. What Results Can You Expect for Trochanteric Bursitis? While some people can respond quickly to physiotherapy treatment within a few weeks, more chronic cases where a tendinopathy exists in the gluteal muscle group under the bursa can require a few months to achieve recovery. Trochanteric bursitis is successfully managed in the vast majority over a period of approximately six week. It is important to not stop your rehabilitation exercises as soon as you pain abates. Excellent hip muscle control is your best rehabilitation and prevention strategy. Please follow the advice of your physiotherapist or doctor. Physiotherapists at Physio Works can get your started on the right track to recovery! If you have any specific questions, please ask them. Contact Physio Works or Book Online Common Trochanteric & Hip Bursitis Treatments Immediate Injury Treatment Avoid the HARM Factors What are the Healing Phases for a Soft Tissue Injury? Acupuncture and Dry Needling Core Stability Exercises Biomechanical Analysis Balance Enhancement Exercises Proprioception & Balance Exercises Agility & Sport-Specific Exercises Medications? Soft Tissue Massage Bursitis Treatment Electrotherapy & Local Modalities Kinesiology Taping Prehabilitation Strengthening Exercises Stretching Exercises Support Brace Supportive Taping & Strapping TENS Machines Contact PhysioWorks or Book Online FAQs about Trochanteric & Hip Bursitis What is Pain? Physiotherapy & Exercise When Should Diagnostic Tests Be Performed? How Does Kinesiology Tape Reduce Swelling? How Can You Prevent a Future Leg Injury? How Much Treatment Will You Need? How to Stretch? Sports Injury? What to do? When? What are the Common Massage Therapy Techniques? What are the Early Warning Signs of an Injury? What is Chronic Pain? What is Sports Physiotherapy? What is the Correct Posture Standing? What Pillow Do Physiotherapists Recommend? When Can You Return to Sport or Work? Contact PhysioWorks or Book Online Helpful Products for Trochanteric Bursitis Related Injuries Femoroacetabular Impingement (FAI) Gluteal Tendinopathy Hip Labral Tear Muscle Pain: Strains or Tears Piriformis Syndrome Poor Hip Core Sacroiliac Joint - SIJ Pain Sciatica Shoulder Bursitis Trochanteric Bursitis (Hip Bursitis)

Contact PhysioWorks or Book Online