If you’ve ever experienced hip pain, you know that it can be agitating and limiting in your daily activities. One of the more common varieties of hip pain is known as hip bursitis (or trochanteric bursitis).
In this article, we’ll explain what hip bursitis is, and we’ll explore some options for which exercises for hip bursitis will make you feel better– and also movements to avoid when hip bursitis starts to affect the way you move.
What Is Hip Bursitis?
Hip bursitis refers to the inflammation of the bursa in your hip joint.
Hip bursitis is a condition caused by the inflammation of a small fluid-filled sac called a bursa that helps to cushion your joints. Bursae can be found in your knees, elbows, hips, and heels.
Sometimes, with too much repetitive motion, trauma, or stress to the joint, these sacs can become inflamed, which can cause pain with movement.
What Are the Symptoms of Hip Bursitis?
There are two main symptoms of hip bursitis:
- Pain in your outer hip when lying directly on your side
- Pain when getting up from a chair after sitting for a long time.
Hip bursitis pain also tends to worsen after prolonged activity, such as standing or walking.
Hip bursitis pain is usually localized to only one side of the body and usually starts as a sharp, acute pain. This can evolve into a more dull, achy pain over time.
The area around the affected hip may be warm and swollen, due to the inflamed bursa under the skin. The spot on your hip where the pain is located will also be tender to deep touch or pressure. It can also be painful when getting in and out of a car or climbing stairs.
There are other causes of lateral hip pain, so it is important to see a doctor if your hip pain is worsening, interfering with your daily activities, or spreading to your leg or back.
A healthcare professional, like a physical therapist, can help you to identify the source of your painful hip bursitis so that you can get back to doing the things you love, pain-free.
What Are the Causes of Hip Bursitis?
Hip bursitis is often the result of excessive stress on the joint. Some sports and occupations can put you at greater risk due to repetitive motion, or a limited variety of range of motion required for that activity.
These may include sports that involve a lot of running or cycling, jobs that require stair climbing or prolonged walking, and other activities that require continuous, repetitive motion of the hip joints.
Other conditions can put you at greater risk of developing trochanteric bursitis as well. Trauma or direct injury to the hip joint, ground-level falls, scoliosis, and having one leg that is significantly stronger than the other can all be risk factors for developing bursitis.
Sometimes, hip bursitis can develop without a definitive cause, but typically the cause of hip bursitis can be identified by a medical professional.
Middle-aged and elderly people tend to be affected by bursitis more than others. It also tends to be more common in women than men.
What Are the Best Exercises for Hip Bursitis?
The recommended initial treatment for hip bursitis is activity limitations and anti-inflammatory medications. Once you control the inflammation, you can begin targeted strengthening exercises and stretches to target the hip and leg muscles.
Keep in mind that these exercises should not cause significant discomfort or pain. If you are having severe pain during or after performing the exercises, you should stop. Seek advice from a medical professional or physical therapist before continuing.
There are a few specific exercises for hip bursitis that research has proven effective for reducing pain and improving function. You can repeat these exercises for around three sets of ten repetitions, with short rest between sets and exercises.
Side-lying Leg Lifts
Lie on your unaffected side with your legs out straight. Lift the top leg a couple of inches off the bottom one, then slowly lower back down. Keep the motion controlled.
Clamshells
Lie on your unaffected side with your knees slightly bent up toward your chest. Keeping your feet together, lift one knee up like a clam’s shell opening. Hold that position at the top for a couple of seconds, and then release.
Seated Kicks
Sitting up with good posture in a supportive chair, kick one leg out straight. Hold that position for a couple of seconds and then lower both feet flat onto the floor. These are also sometimes referred to as seated straight-leg raises. Perform ten full repetitions on one side before switching sides.
Stretches for Hip Bursitis
There are also stretches for hip bursitis that can help to improve the flexibility of the tissues around your hip and thigh.
Figure Four Stretch
To begin this hip rotator stretch, lie on your back with your affected leg crossed over the other knee. To increase the intensity of the stretch, pull your legs toward your chest. Hold a gentle stretch for thirty seconds.
IT Band Stretch
Stand with your left side closest to the wall and your left hand against the wall with a mostly straight arm.
Cross your left leg over your right leg, so that your shins are crossed.
Reach your right arm up and overhead and side bend as if you are trying to put your right fingertips on the wall. Hold for 30 seconds.
You should feel a stretch in your outer right hip.
Don’t overdo it with this stretch- as it can exacerbate your symptoms if you push too much.
It is recommended to see a physical therapist for hip bursitis, especially if the bursitis is impacting your day-to-day life. It can be very beneficial to have an expert advising you in choosing effective exercises, proper form, exercise progression, and pain management.
Seeing a physical therapist soon after developing hip bursitis symptoms can be very helpful in limiting the impact on your daily activities.
Which Hip Bursitis Exercises Should I Avoid?
There are a few exercises that you want to steer clear of if you are someone with hip bursitis. All these exercises can cause too much repetitive movement at the hip joint and worsen the irritation of the bursa and in turn, your pain.
Squats: Lowering in and out of squatting positions can put a lot of stress on your hip joints. When inflamed, this position may be too much for you and cause more pain unnecessarily.
Running: Considered a ‘high-impact’ activity, running involves a lot of stressful compression forces on your knee, hip and ankle joints. This can exacerbate the inflammation, especially if your hip muscles are weak.
Cycling/Biking: Though lower impact than running, biking is one of the most repetitive exercises with a lot of movement coming from the hip joint and the knees.
Avoid biking until much later in the recovery process, and focus on an exercise program that allows you to exercise slowly to keep hip pain in check.
Cardio Machines Like Elliptical or Stair: Typical machines you may use at the gym to get your heart rate up can cause a lot of pain for someone with bursitis.
Walking Long Distances: Many people wonder if walking is good for hip bursitis. Walking around the house should be fine, but going on a 3-mile walk is likely going to cause worsening symptoms.
Prolonged Sitting, Lying, or Standing: Spending too much time in any position is not good. Both repetitive, prolonged movements, as well as lack of movement, can worsen symptoms. It is best to balance between moving and resting throughout the day.
How Much Recovery Time is Needed to Treat Hip Bursitis?
Some cases of trochanteric bursitis last a few weeks while others can persist for longer periods of time. Some people may develop chronic hip bursitis that can flare up, increasing pain intensity periodically over time. Following exercise guidelines provided by your physical therapist can help to manage chronic cases of hip bursitis.
If pain persists despite physical therapy, medications, and activity modifications, other treatment options are available.
Orthopedic doctors can administer cortisone steroid injections for hip bursitis pain relief. The doctor will inject cortisone and local anesthetic directly into the bursa in your hip joint, which can result in months of pain relief. (1)
After getting a hip bursitis injection, it is important to strengthen and stretch the tendons and muscles around the hip joint. These exercises can prevent the pain from returning when the effects of the shot wear off.
In very rare, severe cases, you may consider surgery. However, surgery is usually uncommon unless the bursa is also infected with bacteria. (4)
Summary
Hip bursitis can be a very painful condition, but if treated effectively and early, you can get your pain under control. Whether you’re a young athlete or a less-than-active senior, it is important to take good care of your joints to improve your quality of life to keep you moving better for longer.
References:
- The American Academy of Orthopedic Surgeons https://orthoinfo.aaos.org/en/diseases–conditions/hip-bursitis
- Clifford C, Paul L, Syme G, Millar NL. Isometric versus isotonic exercise for greater trochanteric pain syndrome: a randomised controlled pilot study. BMJ Open Sport Exerc Med. 2019 Sep 21;5(1):e000558. doi: 10.1136/bmjsem-2019-000558. PMID: 31673402; PMCID: PMC6797310. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6797310/
- Seidman AJ, Taqi M, Varacallo M. Trochanteric Bursitis. [Updated 2022 Nov 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538503/
- InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. How can bursitis be treated? 2018 Jul 26. Available from: https://www.ncbi.nlm.nih.gov/books/NBK525763/
- https://orthoinfo.aaos.org/en/diseases–conditions/hip-bursitis
