Emphasis on Increasing Ankle Dorsiflexion to Minimize Dynamic Knee Valgus in a Patient With Trochanteric Bursitis: A Case Report

Background: Trochanteric Bursitis is a pathology related to swelling and inflammation of the Greater Trochanteric bursa on the lateral aspect of the hip. The etiology may be a result of one, or a combination, of the following: acute trauma, chronic abnormal movement patterns, increased muscle tone, and muscle weakness. Resolution of the stimulus eliciting the bursitis can prove to be quite difficult due to the broad spectrum of etiologies leading to its onset. Purpose Statement: The purpose of this case report is to describe the positive outcomes of a patient with trochanteric bursitis following ankle dorsiflexion (ADF) mobilizations, neuromuscular reeducation of the ankle and hip, and quadriceps hypertrophy as treatment interventions. Case Description: The patient was a 25-year-old male who came to Physical Therapy via direct access due to prolonged lateral hip pain. He had a history of bilateral high ankle sprains, a fracture of his right tibia and fibula, and a bulged L3/L4 disc. He presented with numbness on the lateral aspect of his right leg, and lateral hip pain caused by most single leg exercises. Interventions: Physical Therapy involved a broad range of active treatment methods. They focused on reducing DKV through neuromuscular reeducation of the ankle and hip, improving ADF range of motion (ROM) through joint and soft tissue mobilizations, and hypertrophy of the quadriceps on the involved side through progressive high volume resistance training. Outcomes at Discharge: The patient displayed improved dorsiflexion ROM and reduced lateral hip pain during activities. He also demonstrated reduced DKV with dynamic lower extremity testing. Discussion: This case outlines the management and outcomes of a young male patient presenting with chronic trochanteric bursitis and abnormal lower limb mechanics. Following 12 weeks of Physical Therapy interventions the patient demonstrated improved objective and subjective outcomes resulting in his successful discharge from therapy.