I have been told by my GP that the hip pain I have been getting regularly over the last few months is something called ‘trochanteric bursitis’. He has advised on rest but I am keen to go skiing in the New Year. How can I help get rid of this problem before January and is skiing likely to do any damage?
Claire Powell, Horder Healthcare Chartered Physiotherapist, answers the question:
Lateral hip pain (LHP) has traditionally been referred to as trochanteric bursitis which means an inflammation of the fluid filled sac on the outside of the hip. Over the last 10 years however, evidence has demonstrated that the bursa is, in fact, an inconsistent feature of lateral hip pain. Furthermore, studies of lateral hip pain have found no signs of inflammation in the area of the bursa. Researchers have shown that the primary problem is actually with the tendons of the buttock muscles known as Glutus Medius and Minimus and the condition is therefore now known as a Tendinopathy.
Tendinopathy usually occurs from a sudden increase in activity or load to these tendons. Rest does not cure tendinopathy but the GP is correct to advise caution as exercising to the point or beyond pain is also not helpful. Keeping activities to no or low levels of discomfort are recommended.
It would be advisable to see a physiotherapist who could help identify the underlying cause. Often it is the case that certain muscles that provide stability to the hip joint are not doing their job as well as they could and if these are retrained, this helps to prevent the poor movement pattern.
In terms of whether skiing would cause any damage, this is difficult to say. Skiing will place extra demand on the hip and these glutes muscles that are not working to their normal capacity. If these have not been fully retrained to cope with the demands of the twisting, turning and weight bearing components of skiing, the condition could flare up again which would limit your abilities (and enjoyment!) with skiing.
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