A diagnoses of trochanter bursitis is popular these days. But is it bursitis or trigger points? And, what is causing it? What are the perpetuating factors?
To simply calm down the bursa (treat the symptom) is helpful but if the underlying causes are not addressed for the issue, it will be a lengthy course of treatment at best, and at worst, a repeating problem that can effect gait and therefore impart imbalanced forces on the entire lower extremity. A cascade of orthopedic and musculoskeletal issues can then lead to a chronic pain syndrome. A cortisone shot is good for calming it down but that’s not the whole enchilada.
Usually the easiest way to check if it’s bursitis is to gently (and I mean no more than a nickel’s worth of pressure) press on the greater trochanter (GT). If that gentle pressure eleicits pain then it’s probably bursitis.
If not, search for trigger points in G-minimus, G-Medius, TFL, piriformis or any of the other deep six rotators since they all attach at the GT. It’s a hotbed of activity there and any or all of those muscles can cause pain.
Here is a good strategy to begin treating the tissue. In either supine or prone press on a tender point at the GT and slowly abduct the leg until tenderness is at least 70% reduced. Hold for about 90 seconds then slowly place the clients leg back in neutral. Shortening the tissue while you gently press on a tender point is using positional release/strain counterstrain. It’s a good technique to calm the tissue and elicit a parasympathetic response. In my Muscle Swimming approach, positional release is a staple. If you’ve taken any of my courses you’ve heard me emphasize: “Always start your work with the tissue in a shortened state.”
Looking at causes:
Core misalignments are most likely contributing to issues in these tissues. Common culprits are:
high iliac crest
In addition to treating the tissue, core misalignments should be addressed.
Stretching the tissue can be introduced on subsequent sessions provided that the symptoms are way down,
Below is a stretch that gets the abductors of the hip; quadratus lumborum and latissimus dorsi/teres major.
Assess don’t guess! Stabilize and restore the core and SI joint with osteopathic-derived muscle energy techniques and neuromuscular therapy using Peggy Lamb’s innovative Muscle Swimming techniques. Properly find the root causes of the pain with precise assessment tools and return function and mobility to your clients.