Hip Bursitis

[MuttNut]

I used to be a regular runner, with biking thrown in the mix every now and again. Then a few months ago I started having severe pain in one hip. I was diagnosed with hip bursitis and have been going to physical therapy for several months. The hip pain is gone, but I find myself reluctant to start jogging again for fear it'll cause the bursitis to come back. I was thinking of making biking my regular exercise.

My question is this: does biking aggravate hip bursitis? Does anyone here have hip pain and bike without problems?

[kermit]

I have it, resulting from a broken hip and wearing a 20 lb. gun belt to work every day. I actually think cycling has helped it, and alot of stretching.

[Aquila]

I used to always have hip pain when I ran, even back in high school. But I finally asked a doctor a year or so ago (I'm in my late 40s) and was diagnosed with bursitis. She sent me to a physical therapist, who helped me with exercises to stretch a tendon or something, and it helped a LOT.

Biking doesn't bother it at all (I started biking now after physical therapy, but I biked as a kid, too), and now I can run without it seeming to be bothered, but I haven't run much.

I love the way the physical therapist could help me! Maybe ask your physical therapist for advice for your specific problem?

[rocknrollgirl]

I have it. I did pt, and then started see a massage therapist for trigger point stuff and it is gone. I went every other week last year for 30 mins, stretched, strengthened and viola.

[lo123]

I get bursitis frequently and have damage to both my hip joints from arthritis. Cycling is one of the few things I can do pain free (so long as I don't grind too much going up hills).

[KnottedYet]

Bursitis is always a symptom of something else. Always, always, always.

Bursae don't spontaneously inflame.

You can treat the bursa all you like, and they will feel better. But if you don't address the cause of your bursitis it will always come back. Always, always, always.

Sometimes the cause is chronic, and you just have to look at it as a regular chore like brushing your teeth. "I must always stretch and strengthen these things."

Sometimes it's transient, and you just have to work on it once. "I learned how to support my pelvis and hips properly, and it's been gone ever since."

And sometimes it's some funky structural thing that requires funky structural adaptations like orthotics or shoe lifts.

And for some really lucky folks, it's all of the above! :rolleyes:

But everyone I've worked with has found cycling to be a good thing, and sometimes even a very helpful thing.

(including me)

[MuttNut]

Thank you for all the replies. You are right KnottedYet- my physical therapist said the same thing: that bursitis is a symptom, not an ailment in itself. It looks like mine is more of a chronic thing, so I've got the stretches down and know how to stay on top of things.

I'm glad to hear that biking sounds like it'll be a safe alternative to running. Thank you for sharing your experiences!

[GumbyGirl]

Hey MuttNut!

I feel your pain. I had hip and gluteal bursitis all at the same time in BOTH hips and butt cheeks! It was awful, and also having been a runner I understand how frustrating it can be. But just like KnottedYet said it is a symptom of something else. Your PT should be able to help heaps, but it's not just about stretching.

I'm an exercise physiologist so have experience in treating chronic injuries/conditions and very commonly in women we don't use our butt muscles properly. We often don't have a good connection to activate correctly to work our lower limbs. Worse still in hip bursitis the butt commonly switches off more to protect from pain.

I was also a cyclist (casually at the time) and cycling was really important for my recovery. Your PT should be able to check if your gluteal (butt) muscles activate when you extend through the hip (ie, in the down stroke of a pedal stroke or when planting the foot and toe off in running). You can then practice and ensure these muscles are firing right by putting your bike on an indoor trainer or riding a stationary bike and training with pedal stroke and muscle activation in controlled conditions.

This will all help with hip stabiity and get your pelvis supported so that the hip bursitis is less likely to come back!

Hope you feel better soon
GG :)

[nscrbug]

Hey MuttNut!

I feel your pain. I had hip and gluteal bursitis all at the same time in BOTH hips and butt cheeks! It was awful, and also having been a runner I understand how frustrating it can be. But just like KnottedYet said it is a symptom of something else. Your PT should be able to help heaps, but it's not just about stretching.

I'm an exercise physiologist so have experience in treating chronic injuries/conditions and very commonly in women we don't use our butt muscles properly. We often don't have a good connection to activate correctly to work our lower limbs. Worse still in hip bursitis the butt commonly switches off more to protect from pain.

I was also a cyclist (casually at the time) and cycling was really important for my recovery. Your PT should be able to check if your gluteal (butt) muscles activate when you extend through the hip (ie, in the down stroke of a pedal stroke or when planting the foot and toe off in running). You can then practice and ensure these muscles are firing right by putting your bike on an indoor trainer or riding a stationary bike and training with pedal stroke and muscle activation in controlled conditions.

This will all help with hip stabiity and get your pelvis supported so that the hip bursitis is less likely to come back!

Hope you feel better soon
GG :)

Hey GumbyGirl...I've got a question for ya. I've had gluteal pain (left side) for about 3 months now. It is definitely a limiter when it comes to running...but biking doesn't seem to aggravate it at all. Whenever I do anything that requires a strong gluteal or hamstring contraction, it is pain city! At first I thought this might be piriformis syndrome. Then I started reading up a bit on ischiogluteal bursitis, and am now wondering if this might be my problem. How can I tell if it's a piriformis issue or gluteal bursitis? Would the symptoms be similar? I've tried stretching (which hurts) and foam rolling on a regular basis...but the pain still persists. Any ideas? Thanks!

Linda

ETA - Sorry for the thread hijack!

[OakLeaf]

Linda, to indirectly address your question, I've had some glute issues as well, and the foam roller is just the wrong shape to get into them. Recently I got a 6" foam ball (http://www.power-systems.com/p-2951-myo-release-ball.aspx) that I can sit on and get right to the problem area. It's nice for travel and for getting into a lot of different areas.

[nscrbug]

Linda, to indirectly address your question, I've had some glute issues as well, and the foam roller is just the wrong shape to get into them. Recently I got a 6" foam ball (http://www.power-systems.com/p-2951-myo-release-ball.aspx) that I can sit on and get right to the problem area. It's nice for travel and for getting into a lot of different areas.

Ahh...thanks! I will look into that foam ball. I've tried a tennis ball, but it feels way too firm. This is another therapy ball that I came across -

http://www.julstro.com/about_pink_ball.html

[Wahine]

Bursitis is always a symptom of something else. Always, always, always.

Bursae don't spontaneously inflame.

You can treat the bursa all you like, and they will feel better. But if you don't address the cause of your bursitis it will always come back. Always, always, always.

Sometimes the cause is chronic, and you just have to look at it as a regular chore like brushing your teeth. "I must always stretch and strengthen these things."

Sometimes it's transient, and you just have to work on it once. "I learned how to support my pelvis and hips properly, and it's been gone ever since."

And sometimes it's some funky structural thing that requires funky structural adaptations like orthotics or shoe lifts.

And for some really lucky folks, it's all of the above! :rolleyes:

But everyone I've worked with has found cycling to be a good thing, and sometimes even a very helpful thing.

(including me)

+1 and I'd like to add that in a lot of women the problem is not stabilizing in the frontal plane (think motion side to side relative to the body) during weight bearing while running. So side planks are often helpful and if you're not recruiting your glute max at push off during your gait cycle you'll have problems with stabilizing as well. One of the sneaky factors that affect this is how far back your big toe can bend. Ideal is 90 degrees... less than that negatively affects your running form.

[GumbyGirl]

Okay Linda

Keep in mind I'm not a physician, I usually work with chronic injuries once they are diagnosed by a physician... soooo with that in mind, I am cautious with my advice. But here is some general info... :)

Piriformis syndrome often presents as more like sciatica type pain as it is generally nerve related as well. This means radiating pain in the buttocks, back of the thigh and sometimes the lower leg. Stretching the piriformis often aggravates it.

Ischiogluteal bursitis will usually present as pain very low in the buttocks close to or located on the ischial tuberosities (sitbones), often more achey... but only a physician that goes through a thorough assessment would be able to distinguish this for you. Sorry!!:(

One thing though, bursitis will not generally respond to massage and may become worse following treatment. So if that foam roller/ball is making things worse then maybe take a break, especially whilst in the acute stage! This may be your clue...

Not sure if this helps - best person to do a differential diagnosis is your PT or physician - but don't be afraid to ask about alternate diagnoses as they don't always look outside the box.

GG

[Wahine]

One thing though, bursitis will not generally respond to massage and may become worse following treatment. So if that foam roller/ball is making things worse then maybe take a break, especially whilst in the acute stage! This may be your clue...

GG

Just a little clarification here. Bursitis does not respond well to massage directly in the area and is in fact contraindicated. But, if the bursitis you have is a greater trochanteric bursitis (on the outside of the hip area) massage can be helpful when it targets the muscles that attach into the iliotibial band, that is, the glute max and tensor fascia lata. Massage of the glute med muscle belly can also be helpful in some cases. But again... no massage directly at the site of the bursitis.

[GumbyGirl]

Thanks Wahine - totally agree, the clarification is appreciated! :D

[tangentgirl]

So glad I found this thread. At what point should one see a doctor or PT about something that seems like bursitis?

For example, my hip has been hurting since Saturday, when I decided riding up the Hill of Doom would be a good idea, even though I hadn't tackled the Hill of Weariness, the Hill of Evil or the Hill of Malcontent in a long time. Everyone knows you start with those hills and build up to the HoD.

Anyhoo, it's Thursday now, and it still hurts. Kind of a lot. I'm stretching and Adviling and maybe I'll grab some ice. Is this the kind of thing that will mellow out on its own?

[GumbyGirl]

Oh definitely yesterday! I agree, better safe than sorry. I had a hell of a long journey back from hip bursitis, partly because I thought it'd just go away and settle down. Oh, I was wrong :( And at least you can get it checked out and find out what it is. Good luck with it! :)

[tangentgirl]

Can I whine for just a second? Went to the doc, got good stretches, exercises & whatnot, but damnitt...it still hurts. Ouch. Grr. Going back. Ouch ouch ouch.

Done whining. Please commence with your regularly scheduled forums.

[GumbyGirl]

Hang in there tangentgirl! It can take a little while to ease up, but the work now will be worth it! :)

[isconniethere]

I too have this problem! Last year I decided to take up running, and everything was going well and then, Hip pain. The doctor decided it was bursitis and gave me a shot in the hip (wouldn't refer me to PT!). It wasn't very helpful and I just had to stop. I have finally decided to try again and now hip pain right away in the other hip. I guess running will not be for me. It was very frustrating but I don't want to end up with permanent hip pain. On the other hand I have never had any problem with hip pain while biking!

[Catrin]

I too have this problem! Last year I decided to take up running, and everything was going well and then, Hip pain. The doctor decided it was bursitis and gave me a shot in the hip (wouldn't refer me to PT!). It wasn't very helpful and I just had to stop. I have finally decided to try again and now hip pain right away in the other hip. I guess running will not be for me. It was very frustrating but I don't want to end up with permanent hip pain. On the other hand I have never had any problem with hip pain while biking!


Have you considered getting a second opinion or doctor? There are many things that can cause hip pain - it would be a pity for you to stop running permanently if you do not need to do so. Why wouldn't he refer you to a PT?

[tangentgirl]

Wouldn't refer you to a PT? Bogus. I'd get a new doc.

I've been working with a chiropractor, an endurance sports-specific guy, who's given me some good exercises and stretches. It is starting to get better, slowly. I did have to cut back on training, and that's a drag, but if I get better in the long run, I'm not worried.

It doesn't hurt during cycling at all, luckily. Afterwards, well...I have decided to lay off the big hills for a week or two. Strangely enough, walking a 5k really *$#@ed it up.