Trochanteric Bursitis and Gluteus Medius Tears

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At the side of the hip in the upper thigh, there is a bony prominence called the greater trochanter. Three important structures come together at this point: the trochanteric bursa, the gluteus medius muscle and the iliotibial band.

The trochanteric bursa is a small, fluid-filled sac that pads the prominent bone over the greater trochanter.

At times, this bursa can become inflamed, leading to significant pain over the side of the hip. Trochanteric bursitis can occur from direct pressure, after injury or with overuse, but is also linked to tears of the gluteus medius.

The gluteus medius is one of the key muscles surrounding the hip. This muscle starts in the buttock and attaches at the greater trochanter, on the side of the hip. Activation of the gluteus medius allows us to lift our leg to the side (abduct).

Tendonitis or tears of the gluteus medius can occur after injury or with long-term wear and tear. These tears generally cause pain and weakness on the side of the hip (not the groin).

The iliotibial band is a stiff band of tissue that runs along the outside or lateral part of the leg from hip to knee. It extends over the prominence of the greater trochanter and can become tight in this area.

What are the symptoms of trochanteric bursitis and gluteus medius tears?

Trochanteric bursitis causes pain and irritation over the greater trochanter, the bony prominence on the outside of the hip. This is unlike pain from the hip joint, which generally occurs in the groin area or front of the hip. Most people with pain on the side of the hip simply have irritation of the trochanteric bursa and iliotibial band, but in severe cases, tendonitis or a tear of the gluteus medius may also be present. Gluteus medius tears cause pain at the side of the hip which can extend up to the buttock and result in weakness when lifting the leg to the side.

How are trochanteric bursitis and gluteus medius tears diagnosed?

Your sports medicine physician can often diagnose trochanteric bursitis based on your symptoms and with an examination of the hip muscles. In severe cases, an MRI may be helpful to check for a tear of the gluteus medius muscle or tendon.

How are trochanteric bursitis and gluteus medius tears treated?

Trochanteric bursitis generally responds well to nonsurgical treatment, which focuses on stretching the iliotibial band and decreasing inflammation. Anti-inflammatories or a cortisone injection into the bursa may also be very effective in reducing pain and resolving symptoms. If a significant tear of the gluteus medius is present (this is not common), surgical repair may be required. Your sports medicine physician can help you develop an individualized program based on your specific symptoms.

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