# Bursitis - Position changes to minimize hip stress



## SpokaneSteve

Hello all:

I have battled some low-grade bursitis in my hips all season. I went to a Dr., PT, sports medicine Dr. (who gave me a cortisone shot) and then another PT.

The second PT looked at my bike fit and thinks that I need to move my saddle forward to reduce the stress on my bursa and hips. We made a small adjustment which seems to help but I would like to understand the physiology more before I make another adjustment.

Does moving a saddle forward reduce the pressure on my hips? Can anyone explain how? The PT said that my position was far back and "glute-intensive" rather than engaging my quads.

Any help to understand these position issues and/or hip bursitis advice would be appreciated.

Thanks, Steve.


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## choppedsled

Hello Steve,

I'm from Spokane as well. I can't answer your question, but am looking for a good PT in the area that knows cycling and bike fitting. It sounds like your unsure of the PT your seeing? My wife has IT band issues and needs some help with it.

Thanks,

Jesse


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## Rollo Tommassi

*Forward and up*

I'm assuming you have an inflammation of the bursa on the trochanter (outer hip)

The PT is trying to reduce the amount of muscles and muscle attachments from flexing around the area of the trochanter, and cause additional inflammation. Gluteus Maximus, Tensor Latia Fascia, etc Also the iliotibial band tract crosses there - it's a 'busy intersection' so to speak. 

By limiting the amount of closure in the hip angle - ie, how tightly curled you are in the riding position - there is less muscle action from the the large mass of the glutes . 

BUT, I'd also add you should make these changes incrementally. If the recommendation is to adjust more that 6mm to achieve a more relaxed position you should come to this point 2-3mm at a time. Too sudden of changes can cause adaptive issues in other muscles or joints, so adjust the saddle height as well.

Also consider easing back on mileage and higher gearing, give it a chance to heal.


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## stoked

I have been suffering from left hip bursitis in the trochanteric area for 5 years now. My injury is from a direct hit to the area by a van while doing my weekend ride. I had the usual PT 3 times a week for 4 months right after. I jumped on the bike 4 months later and then things started to go downhill. 
I had a local cortisone injection a year after the accident which helped for a month or two but after starting to ride again same pain started. It was worse during the winter. I have a desk job so sitting long hours only made things worse. In the mean time I was still riding. The second winter pain became so bad that I started to feel it while walking. Off the bike and another shot, more PT and things felt a little better. This time I took much longer time off the bike 5-6 months to give my body time to heal because I was able to feel the muscle damage from the shots. I had few months of acupuncture which helped. I was lucky enough to work on a project for 18 months from home. I spent 6 months standing up working on a laptop. I think sitting down all day was blocking the circulation in the area. I was doing my stretches and using supplements. I saw a sports MD who was a cyclist and she recommended foam rollers to stretch my IT band. I did those for a bit which helped. I started to ride again but this time short distances 20-25 miles or so. I also started to listen to my body more. Slowly I built up my strength and I was able to do my usual 50-60 mile rides. However I noticed that if I pushed hard(over 24mph+ for 30 min longer) and kept my speed up the pain was coming back so I backed off. I am happy to say that I've done 5 centuries with 8000ft climbing each ride this year w/o pain. 

Take away from my experience for anyone suffering from hip bursitis is to stay off the bike and continue with PT especially if you had a cortisone injection. I know each one's injury is different but listen to your body and don't push so hard. Do not jump on the bike too soon. In this case idea of no pain no gain has extreme opposite effect. Another tip is to ice the area after a ride right away for 20 min and if you have some pain take IB profen /advil etc. so that area does not get inflammated. I no longer take pills but still ice my hip and knees after a ride. Get a chair at work that does not put pressure on the area. I also made a habit of taking quick breaks at work from constant sitting. Drinking lots of water also helps. Do not sleep on that side(I have not slept on my left side for 5 years now) .Only change I made on my bike during the recovery was to lower the seat few mm which helped a bit. Now I ride in my original seat height.


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## ClydesdaleChris

Thanks stoked, that was a great overview. I have just been diagnosed after being hit by a car a few months ago, now I can hardly walk. Hopefully a jab will help.


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