The iliac crest bursa lies between the iliotibial tract and the lateral surface of the iliac crest, reducing friction as the IT band moves over the iliac crest attachment during hip flexion-extension. It is distinct from the trochanteric bursa at the greater trochanter and develops in response to repetitive IT band motion over the crest.
Iliac crest bursa inflammation produces lateral hip pain at the iliac crest level in distance runners and cyclists, distinct from the more distal greater trochanteric bursitis (which occurs at the GT level) and lateral knee iliotibial band syndrome (at the lateral femoral condyle). The pain is reproduced by palpation at the iliac crest and by lateral trunk flexion away from the affected side. Management is the same as for IT band-related conditions: activity modification, physiotherapy, and corticosteroid injection into the bursa.
Overtraining causes iliac crest bursal inflammation from repetitive IT band friction over the crest attachment, producing lateral hip pain at the crest level in runners, managed by reducing mileage, hip abductor strengthening to reduce IT band tension, and corticosteroid injection if persistent.
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