Friday, April 04, 2014

A diagnosis ......... but is it?

Trochanteric Bursitis and Tendinopathy in the Glute Medius.

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 trochanteric bursa may be inflamed by a group of muscles or tendons rubbing over the bursa and causing friction against the thigh bone and 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.

So to fix this........... well strengthen the hip/core/glutes and correct any bio mechanical faults.

So I am now to get a Corticosteroid Injection into the Bursa... then starts the strength exercises for the hip which MUST be done. I can still train but only to what doesn't hurt.  I may be faced with a very expensive out lay for some orthotics but for now... I will try the injection and exercises.

Now for the Tendionopathy in the Glute....GT for short ...

GT typically presents as pain over the greater trochanter (the bony lump felt at the side of your hip). symptoms may spread into the outside of the thigh and knee. It is commonly misdiagnosed as hip joint pathology,ITBS, sciatica or as being referred from the lumbar spine.   This tendon is compressed by the Iliotibial Band (ITB) when the hip is adducted (which happens when the leg moves in towards the other leg). This compression can be increased if combined with flexion or external rotation of the hip.

So If you have GT it's likely that your symptoms will include pain with crossing your legs and with climbing stairs or hills, even just with single leg balance if your pelvic control is poor. Each case is different though and in milder cases these may be fairly pain free. For runners it's likely to painful during the impact phase of running when your foot strikes the floor and your body weight moves over the foot.

One other key characteristic with GMT is pain in sidelying. Unfortunately it can be painful on either side making sleep very difficult. The issue is if you lie on your painful side there is likely to be some direct compression of the gluteal tendons. If you lie on your good side the bad leg is upper most and often falls into adduction and flexion. Considering we spend some hours sleeping this can be a significant source of aggravation for the tendon.

So fingers crossed...once we get the injection in the bursa this too will settle...I will need to find some very soft topper pad to put on my side of the bed to try and add more cushion so that if I lay on that side in my sleep it wont compress the muscle/tendon as much.

So thats it in a simple nutshell.  The dr said that I con continue to train but to be guided by pain.  I need to figure out a series of exercises to do so that I can strengthn the hip and glute.  If I can do this I may not need the orthotics.  This injury keeps on reoccuring so I also need to figure out why it keeps coming it when my training becomes more intense...extra speed work or longer distance???  this does seem to be the pattern and while I could manage that a couple of years ago....I cant now.

NO CROSSING LEGS while sitting.  I need this to be written everywhere!!!!!!

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