Trochanteric Bursitis Treated Effectively With Deep Oscillation

A Case Report with thanks to Ben Neves of Hull Sports Massage

 

 

Background

 

John is an 82-year-old veteran who has dementia and high blood pressure controlled with medication. He has suffered from trochanteric bursitis for two years, during which time he has had two steroid injections to no avail. Physiotherapy has not helped, as the hip area is too painful to move.

 

Initial Presentation

 

John first attended the clinic on 27th July 2022 with his daughter, who is there for support. John used a Zimmer frame, barely shuffling, very antalgic in gait. He was unable to sleep on the affected side. Pain was measured on the VAS of 8/10 (severe).

 

Physical Examination

 

Atrophy to affected leg, pain radiating from the trochanteric region, limiting the range of movement and power to remain stable in standing.

 

Clinical considerations/Aims

 

Initial considerations were to use shockwave therapy; however, due to poor tissue mass and frailty and discussion with John, we decided to use Deep Oscillation to calm the tissue and irritability of the bursa.

I really did want to relieve his pain from this chronic condition. Because of the previous two steroid injections, I thought it incumbent to break down stubborn fibrotic remodelling of the area. In addition, it was plain that several trigger points were situated around the Tensor fasciae latae, gluteus minimus and medius, which had some bearing on the pain down the lateral leg Ilio-tibial band causing dull lateral knee pain.

Initial aims were to reduce pain, enhance muscle relaxation to prevent spasming, to re-introduce normalisation of walking patterns to aid proper muscle firing and thus to walk better.

 

Treatment Protocol/Method

 

Trigger points specific, Deep Oscillation electrostatic lymphatic drainage therapy through gloved hands

 

• 200-250 Hz - 10 minutes
• 60 Hz  - 5 minutes
• 40 Hz - 5 minutes

 

The massage pattern was trigger point specific with the insertion and origin of muscle groups and lymphatic drainage points around the inguinal ligament and popliteal area. Effleurage strokes with finger circles around bony landmarks (greater trochanter) with slow pumping actions to aid lymphatic drainage.

 

Frequency Rationale

 

High: 200-250Hz

To reduce pain, activate the lymphatic network, and break down metabolic waste. Specifically, I wanted to break down the hardened fibrotic tissue gently.

 

Medium: 25-80 Hz

Ideally suited to aiding microcirculation, specifically between the interstitial spaces around the trochanter and surrounding supportive musculature. Helping micro-circulation in the interstitial spaces of the tissue to boost the recovery and tonification of muscles. By creating relaxation of the tissue layers, I could promote mobility, flexibility and movement, lacking in John’s usual movement.

 

Results

 

This approach had an impact on John's well-being from the outset.

On John's second visit, he was clearly encouraged as his pain had lessened, and although he was still using his Zimmer frame, he reported that he could sleep better. Several more treatments followed, and as each week passed, John's gait, strength, and pain had improved so much that he went from his trusted Zimmer frame to a walking stick, then eventually stick-free. He now enjoys good sleep and can integrate with the rest of the family as best he can.

 

Clinician's Observations

 

Deep Oscillation has shown that it “does what it says on the tin” in that it truly is a beautiful modality that can stand up against other treatments when others may not be appropriate.

Deep Oscillation is one of my “go-to” modalities as it sits well on its own and with other modalities too!

A truly versatile, safe and effective treatment.

 

Hull Sports Massage

 

ABOUT DEEP OSCILLATION®

 

The special structure of DEEP OSCILLATION® allows the creation of biologically effective oscillations in the treated tissue using electrostatic attraction and friction. In contrast to other therapies, these pleasant oscillations have a gentle and deep-acting effect on all tissue components to an 8 cm depth (through skin, connective tissue, subcutaneous fat, muscles, blood and lymph vessels).

 

 

Because of the non-invasive, non-traumatic, gentle nature of this therapy, very early possibilities of application are possible following injury and from Day One post operatively. Chronic conditions can also be worked upon with effective results.

This 8 minute video provides a good overview of the therapy and its applications

 

 

Learn more about DEEP OSCILLATION® biological and clinical effects

Click here to obtain study references

The following physiological effects of DEEP OSCILLATION® are clinically proven: 

• Highly effective in reducing pain
• Anti-inflammatory
• Effective in reabsorbing oedema (swelling)
• Encouraging wounds to heal
• Fibrosis Reduction
• Improving trophicity
• Rubor reduction (haematoma/bruising)
• Detoxification
• Improving quality of tissue