inflammation of the bursa

[mwelliott65]

I am 5 weeks post op on my left hip and feel like everything is very good i.e. joint and muscles.  The only thing holding me back is the pain in the area below my incision on the outside of my hip.  I have been told by my doctor that it is inflammation of the bursa which is right beneath the muscle that goes over the outside hip area.  This has hindered my recovery (especially with flexibility) and doesn't seem like it is getting much better.  I still have a little swelling in that area and if I didn't have this pain I feel I could do a lot more for rehab.  I take two alleve in the morning and again at night and ice it as often as I can.  This helps a little.  My doctor says it is common and if it persists after 3 months he will give me a cortisone shot.  Does anyone have experience with this and is there anything else I can do to reduce the inflammation? 

thanks.

[John C]

That bursa over the greater trochanter has been my main issue off and on over the three years since my surgery. I felt it during my first steps down the hospital hallway, and it was the hindering factor during the next month as I tried to get away from the crutches. Somewhere between 5 and 6 weeks, it stopped being a problem, and I thought that it was over. It is fine 90% of the time now, but a few times a year it will flair up; usually when I am switching to different sports at the change of seasons.
I spoke to Dr. Gross about it (he was kind enough to call me at home). He said that it was not uncommon, agreed that it often occurred with an increase or change in activities, and usually got better over time. He also mentioned the cortisone shot if it did not get better in a few weeks. His main suggestion was to do repetitive exercises with minimal resistance, in order to get movement and circulation to the area, without putting a lot of stress on it. This has usually worked well for me, especially in a pool. I have never resorted to the cortisone shot.
The other important thing that I have discovered is the connection between the bursa being irritated, and any tightness in the IT band that runs across it. During the last bursa flair up that I had a couple of months ago, I used a foam roller to release the tension in the IT band, and the bursa got better in about two days.
I have a theory as to why mine was sore right after surgery. According to the surgeons measurements, my leg came out about 4mm (roughly .16") longer after surgery. This is not much, but it effectively makes the IT band slightly short, so it puts more pressure where it runs across the bursa, until the IT band eventually stretches out to accommodate the longer span.
Anyway, I would offer you encouragement from someone who had serious bursa pain and issues for the first five weeks, and after six weeks, has had only occasional flair ups that can be controlled with exercises and rolling the IT band.

[mwelliott65]

That is very helpful information.  My IT band has been sore every since the surgery and much like your situation my leg is a bit longer.  My physical therapist spends a lot of time working on the IT band and it feels much better after but that is only 2 times a week.  I will look into getting a "foam roller".  Do you think a physical therapist would have this?  Thanks again for the encouragement.   Take care.

[maxx6789]

you can get a "foam roller" at virtually any sporting goods store (dick's, sports authority, etc) ... they are not expensive.

[mwelliott65]

Thanks and I am hoping it works.  One thing I forgot to ask is how often does one use the foam roller?

[ScubaDuck]

I have dealt with a tight IT band for most of my life.  When I was running lots of miles had to make sure I stretched it often.  The last eight years after I could no longer run the IT band became even worse.  Although stretches and massage helped some it was still troublesome.

Te foam roller was the first device that I really felt gave me the ability to work the IT band.  The IT band itself doesn't stretch but the ends where it attaches does.  Also using a ball to sit on and work the psoas helps alot.

Dan

[John C]

I would defer to the professional therapists and trainers, but personally I use the roller for a few minutes, two to three times a day, when it flares up.

[mwelliott65]

Thanks again for the help and information.  Very much appreciated.  I have a foam roller coming in the mail (I live in a very rural area) and heading off to PT this morning.  We will see how it goes. 

[ZAP]

That is very helpful information.  My IT band has been sore every since the surgery and much like your situation my leg is a bit longer.  My physical therapist spends a lot of time working on the IT band and it feels much better after but that is only 2 times a week.  I will look into getting a "foam roller".  Do you think a physical therapist would have this?  Thanks again for the encouragement.   Take care.

I started with a foam roller and my IT band got use to it or the knots got deeper. I've upgraded to a $10 rolling pin from walmart.  It works very well. Try to get the rubber one, but the wood and plastic ones work just as well. Fits nicely in my gym bag.