Bicycling Hip Pain
As with any sport, there's a degree of risk for injury involved with cycling. Endurance sports, such as cycling and running, require repetitive motions over a long period. This can lead to overuse injuries if body alignment or movement is even slightly off.
Bicycling is a sport that individuals of all ages can enjoy, but also comes with risks. According to the journal "American Family Physician," bicycle injuries account for more than 1.2 million doctor visits a year in the United States. The repetitive motion in biking can lead to several types of overuse injuries or strains, including hip bursitis.
If you experience hip pain that worsens or doesn't go away, see your doctor for treatment.
Cycling for 60 minutes, five days or more a week, is unnatural. Your body was not meant to withstand so much stress from the constant motion in your hip. Vary your exercise and your timing to spread the stress to other parts of your body instead of letting your hips take the entire load. Alternate days of cycling with days of walking, running or stair climbing. Alternatively, limit your cycling to 20 minutes and spend 20 minutes on the elliptical machine and 20 minutes on the treadmill.
The American Council on Exercise notes that cycling too fast poses a danger to your hips as well as your knees and ankles. Try adding resistance instead of revolutions to get your heart rate up. Avoid unusual maneuvers in your cycling classes that put additional stress on your hip joints, such as freezing your upper body while standing or pedaling with one leg only.
Hip Joint Bursitis
Hip bursitis is inflammation of bursa, which lies between tendon and one of the hip joint bones. Most common hip joint bursitis is ischeal bursitis or trochanteric bursitis. Other bursa around hip joint, which may get inflamed are iliopsoas bursa and gluteus medius bursa.
Symptoms of hip bursitis typically include pain at the hip and may get worse with prolonged exercise or walking.
Cycling and Bursitis
According to the AAOS, hip bursitis can occur from overuse, especially with repetitive movements used in cycling or running. The "American Family Physician" states that hip bursitis occurs in cyclists due to the repeated sliding of the fascia lata over the greater trochanter. Riding a bicycle not fitted to you can also cause your body to work harder, putting more stress on the body and increasing the risk of overuse injuries.
Treatment For Hip Joint Bursitis
Conservative Treatment of Hip Bursitis
Exercise- As tolerated.
Heat- Heated bag is applied over hip joint. Prevent overheating the skin.
Cold- Ice bag is applied over hip joint, avoid frost bite.
Specific Treatment of Hip Bursitis
Pain- NSAIDs, avoid opioids if pain is secondary to inflammation.
Anti-Inflammatory Medications for Hip Bursitis
Avoid corticosteroid tablets or injection.
Antibiotics for Hip Bursitis
Inflammation not responding to NSAIDs is treated with antibiotics.
Blood examination and joint fluid study suggests- Infection.
Physical Therapy for Hip Bursitis
Initial- As tolerated until inflammation and pain is active.
Later- Aggressive physical therapy to prevent post inflammatory scarring and stiffness of the joint.
Returning to Cycling
If you return to bicycling too early, before your hip has had a chance to heal, you may be at risk for another injury, or you could worsen your injury and possibly cause permanent damage. Your physician or physical therapist will have you do certain exercises and help determine when it is safe for you to start cycling again. When you do return to cycling, you may need to lower your seat. Warming up thoroughly prior to a ride and stretching your hip and upper thigh muscles can also help reduce the risk of developing hip bursitis.
Causes and Prevention
Your diagnoses may vary, but the causes of cycling hip injuries are usually similar and involve over-training and muscular imbalances. For example, piriformis syndrome is caused by overuse of the glutes, which results in a weak, tight piriformis muscle that causes sciatica.
To avoid such problems, warm up and stretch your hip flexors, piriformis and glutes when you ride. Also, engage in resistance training exercises regularly to prevent muscle imbalances that can result from the repetitive pedal motion.
And have your bike professionally fitted to make sure there aren't any issues with your posture or pedal stroke -- such as rocking of the hips -- which can cause hip pain and injury.
My physical therapist would have me ride a stationary bicycle for 10 minutes as part of my 1 hour bursitis therapy. After having a therapy session my pain would feel worse than before the therapy. Based on this article riding the stationary bicycle should not be part of my bursitis therapy. Do you agree with my assessment?
I have cancelled all future physical therapy sessions and plan on going to an acupuncturist.