Tag Archives: hip pain

Bursitis: what is it and how can massage help?

What is bursitis?
Bursitis is the inflammation of the bursae. Bursae are small sacs of synovial fluid throughout the body. The bursae primarily rest where muscles and tendons slide across bones, to allow smooth movement of the joint.
When inflammation in the bursae occurs the tracking of joints, muscles and tendons becomes difficult and painful. This can result in stiffened muscle.

Hips, shoulders, elbows and knees are the most commonly affected.

What causes bursitis?
A number of things can cause bursitis. Most commonly repetitive movement and excessive pressure on the joint. Other causes include trauma to the joint like a knock or fall, autoimmune disorders, infection and medication.

Who gets bursitis?
Anyone that has had a joint trauma is at risk of developing bursitis. Also those in professions that require repetitive motions or pressure on the joint, such as cleaners, students, trade 2102_LayCarpet_25workers, and athletes particularly in impact sports such as football, rugby and roller derby are all at risk.
Those with other inflammatory conditions such as arthritis, diabetes and systemic lupus can also be at risk.

How is bursitis treated?
Your GP may refer you for an ultrasound scan to diagnose the inflammation. They are also likely to prescribe a course of NSAIDs. Once the inflammation has subsided physiotherapy and soft tissue therapy is recommended.

Your GP may recommend a cortisone injection into the sight of the bursae for persistent inflammation.

Qualified therapist doing pressure point massage on a womans hip

Qualified therapist doing pressure point massage on a womans hip

How can massage help?
Although massage cannot cure bursitis, it can help alleviate the muscle pain and tension that is either a result of the inflammation or the cause. A massage therapist will work to release taught bands and trigger points in the agonist and antagonist muscles; above, below and opposite the site of the bursitis.

What can I do to help alleviate bursitis?
In the 72 hours following the trauma or onset of pain use the RICE (rest, ice, compression, elevation) first aid for the injury. The less you can use the joint, the better. This will help stop inflammation from getting worse. Ice will also help reduce the inflammation and pain.

Once inflammation has eased, massage, gentle stretching and heat to the surrounding muscles will help ease soft tissue pain.

The once soft tissue pain has eased strengthening exercises can be used to help rehabilitate the joint and the muscles around it.

Muscle in Review: Psoas Major

Psoas major (pronounced ‘so-az’), is located in the deep abdominals. It originates at the at the lower vertebrae (T12-L5) and attaches to the front of the femur. Its main function is to flex the hip when the spine is in a fixed position, but it also aids in curving the lower spine.

Psoas is the often forgotten hip flexor that can cause pain in the front of the leg, abdominals, groin and lower back.

Iliopsoas

Psoas Major trigger points

Pain from trigger points in psoas can cause pain down into the groin and scrotal areas, mimic appendicitis or period pain, and cause a ‘band’ of pain across the lower back.

When treating psoas I generally use deep tissue and manual myofascial release. It is very difficult muscle to dry needle due to it’s deep location and proximity to other major organs. Some cupping to the insertion point on the upper femur can help but massage to the abdominals is often the best method.

Other techniques like pin and shift, where the therapist puts pressure on the muscle and has the client activate their hip can work, simple compression to the muscle, or counter strain technique where the muscle is passively held in position for up to 90 seconds is also effective if the client is relaxed enough.

Taking care of psoas can mean a lot of relief from groin and lower back pain.

What can cause tension in psoas? Long periods with the hip flexors active, such as long drives with the foot on the accelerator. Cycling can cause a lot of tension in the hip flexors, psoas in particular, as the back is often in the the foreshortened position.

Bridge Pose

Stretches to psoas can be effective if done correctly. A deep lunge position, dipping into the groin, and sometimes stretching the arm of the same side up and laterally over the head can help.

Warrior I

One-Legged King Pigeon Pose

Yoga poses effective for psoas and hip flexors include warrior poses, either kneeling or on toes, pigeon pose and bridge pose.

 

 

Be sure to counter balance any prolonged hip flexor foreshortening, like fixed seated positions with stretches in the opposite position.