trochanteric bursitis
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Trochanteric Bursitis
Michelle GrantNichole Frederickson
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What is Trochanteric Bursitis
Trochanteric Bursitis is defined as painful inflammation of the bursa located just superficial to the greater trochanter of the femur.
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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
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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.
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Signs or Symptoms
Pain is experienced over the lateral hip and down the lateral thigh to the knee
Faulty posturePainful gaitDecreased
muscle flexibility
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Signs and Symptoms
Decreased muscular endurance
Weak gluteus medius and minimus
Shortened lateral rotatorsDominance of the hamstrings
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Preferred Practice Patterns
Pattern 4E- Impaired joint mobility, motor function, muscle performance and range of motion, associated with localized inflammation
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Modalities
Inflammation Control Cold packs or ice massage Hydrotherapy Laser Ultrasound Electronic Stimulation Compression or taping Continuous Passive Motion
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Treatment
Restricted activity to avoid pain Use an Assistive Device to decrease
weight bearing Massage Manual Traction Joint Mobilization
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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
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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
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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
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References
APTA.Guide to Physical Therapist Practice. 2nd ed.Alexandria, VA:APTA;2001.
Kisner C, Colby LA.Therapeutic Exercise: Foundations and Techniques. 5th 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.