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Bursitis : pelvic region

  • Bursitis types
  1. Trochanteric Bursitis
    1. Location : between gluteus maximus tendon and the tranchaner, between gluteus medius tendon and the trochanter
    2. Cause
      1. overuse
      2. leg length discrepancy, IT band contracture, etc
    1. Symptoms
      1. Pain on lateral hip
      2. pain is worse on climning stairs and getting out of a car
  2. Iliopectineal bursitis
    1. location : between the iliopsoa and the iliofemoral ligament
    2. Cause
      1. Overuse
      2. hip flexor tightness, etc
    3. Symptoms
      1. Pain on the anterior hip and may radiate down the anterior leg
  3. Ischial bursitis = bench warmer’s bursitis
    1. location : between gluteus maximus and the ischial tuberosity
    2. Cause
      1. sitting for long time on hard surface(ex, hoarseback riding)
      2. excessive sprinting (hamsting contracture)
    3. Symptoms
      1. Pain on the ischial tuberosity and may radiate down the posterior leg
  • Assessment
  1. Testing
    1. ROM
      1. AF / PR
        1. Acute stage : rom is reduced in most diretions due to pain
        2. Chronic stage : Pain is in a single position
      2. AR ROM = Bursitis differentiation test
        1. Pain(+) while the bursa is compressed
  • Treatment
  1. Acute
    • Contraindication : on site techniques
    • Hydrotherapy : Cold
    • MLD : proximal to the edema
    • Trigger point
    • GTO release / O an I technique
    • Segmental petrissage : towards the bursa, not away from it. but no on-site work
    • Grade 1,2 joint play
    • Pain free passive ROM
    • Remedial exercise : pain free AR ROM and submaximal isometric exercise
  2. Chronic
    • Hydrotherapy : deep moist heat
    • Fascial techniques
    • Trigger points
    • Friction
    • Petrissage is applied towards the bursa
    • Pain free passive ROM
    • Remedial exercise : stretch, pain free isometrics to isotonic exercise

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