From the Guidelines
Trochanteric bursitis is commonly caused by several risk factors, including repetitive trauma or overuse activities, age, anatomical variations, previous hip surgery or injury, obesity, inflammatory conditions, and weakness in hip abductor muscles, particularly the gluteus medius, as noted in recent studies 1. The most recent and highest quality study, published in 2023, highlights the importance of assessing peritrochanteric structures, including the gluteus minimus and medius muscles, abductor tendons, and the trochanteric bursa, using MRI 1. Some key risk factors for trochanteric bursitis include:
- Repetitive trauma or overuse activities, such as running, cycling, or climbing stairs
- Age, with middle-aged and elderly individuals being more susceptible
- Anatomical variations, such as leg length discrepancy, spine disease, or improper gait mechanics, which can alter biomechanical forces across the hip
- Previous hip surgery or injury, which can lead to inflammation of the bursa
- Obesity, which places additional stress on the hip joint
- Inflammatory conditions, such as rheumatoid arthritis or gout, which can trigger bursitis
- Weakness in hip abductor muscles, particularly the gluteus medius, which fails to properly stabilize the pelvis during walking, increasing pressure on the greater trochanter
- Poor footwear choices and rapid increases in exercise intensity without proper conditioning, which can also contribute to developing this painful condition Understanding these risk factors is crucial for prevention through appropriate exercise modification, weight management, and proper biomechanics, as emphasized in the American Heart Association's scientific statement on the use of nonsteroidal anti-inflammatory drugs 1.
From the Research
Risk Factors for Trochanteric Bursitis
- Lower limb length discrepancy is often mentioned as a potential predisposing factor for trochanteric bursitis, although it has not been proven 2
- Iliotibial band contracture is also mentioned as a possible predisposing factor, but lacks concrete evidence 2
- Hip osteoarthritis and lumbar spondylosis are additional factors that may contribute to the development of trochanteric bursitis, however, their role is not well established 2
- Abductor tendon pathology, including issues with the gluteus medius or minimus muscles, is believed to be a primary cause of symptoms in trochanteric bursitis, rather than bursa pathology itself 2, 3
- External coxa saltans, a condition where the iliotibial band snaps over the greater trochanter, can also be a contributing factor to greater trochanteric pain syndrome, which encompasses trochanteric bursitis 3