Have you ever experienced outer hip pain that aches when sitting in soft, cushy chairs or when lying on your side when you’re trying to sleep? If so, you’re probably suffering from hip bursitis (medically known as trochanteric bursitis). This pain can be super annoying and problematic, especially for women as they tend to develop this issue more often than men. Even I have struggled with hip bursitis pain on and off due to my intense hiking adventures with my wife as this condition is often caused by tightness in the soft tissue structures in the outer hip area. Although, I will admit that I too am not perfect as I do not perform my own hip bursitis exercises as often as I should. Yes, even physical therapists can sometimes be stubborn patients.
In this post, we will discuss the basics behind understanding the causes of hip bursitis, what signs and symptoms to look out for, and which hip bursitis exercises can best be used to treat and prevent this annoying hip pain.
- Convenient Access: Print or Use On-the-Go on Any Mobile Device
- Customized Healing Plans: Easy-to-Follow, Tailored Exercise Guides
- Holistic Recovery: Reduce Pain, Improve Mobility, & Increase Strength
- Comprehensive Progression: All-in-One Rehab Worksheets Include a Progressive Exercise Sequence for Optimal Results
- Expertly Designed by Dr. Tim Schuckers, PT, DPT, OCS
Convenient Access: Print or Use On-the-Go on Any Mobile Device
Customized Healing Plans: Easy-to-Follow, Tailored Exercise Guides
Holistic Recovery: Reduce Pain, Improve Mobility, & Increase Strength
Comprehensive Progression: All-in-One Rehab Worksheets Include a Progressive Exercise Sequence for Optimal Results
Expertly Designed by Dr. Tim Schuckers, PT, DPT, OCS
Table of Contents
What is a Bursa?
A bursa is a small, fluid-filled sac that usually sits between muscles or tendons and bones. It is filled with synovial fluid (think of this as the body’s natural lubricant). The purpose of the bursa is to provide padding and protection to the muscles and tendons. Without a bursa sitting in-between, the muscles/tendons would be irritated and likely damaged by constant rubbing against the bone.
The hip bursa (trochanteric bursa) sits in between the Iliotibial band (IT band) and the femur bone. Its job is to prevent excessive rubbing of the IT band as it passes back and forth over the bone.
What is Hip Bursitis?
Simply put, hip bursitis occurs when the hip bursa becomes irritated and inflammation develops within the bursa tissue causing pain. The inflammation coincides with increased swelling and tenderness in and around the bursa.
Symptoms of Hip Bursitis
The primary symptoms of hip bursitis are pain and tenderness that are localized to the outermost hip area.
The pain is reproduced when you press on the area surrounding this bone. The pain is typically described as a constant dull ache or burning sensation that can be sharp when pressure is applied to the area.
Without treatment, the symptoms will gradually worsen and the pain will begin to travel down the outside of the thigh towards the outside of the knee.
Causes of Hip Bursitis
Hip bursitis is a type of hip injury that is caused by progressive compression. Gradually, tightness begins to build up in the outer hip soft tissue (muscles/fascia). This tightness can be caused by several reasons such as increased weight gain, a general decrease in flexibility, weakness in the outer hip muscles, or a sudden change in activity levels of aggravating activities.
Luckily, with physical therapy, I can help address most of these causes with education, accountability, and teaching you the most important hip bursitis exercises that will treat and prevent this type of hip pain.
Remember that the bursa sits in between the IT Band and the femur bone? As the IT band begins to tighten up, it will start to press the bursa down against the bone. Your body will be able to tolerate this for a certain length of time, however eventually, the scale will tip and pain symptoms will begin to develop.
Other Potential Causes of Hip pain
Outer hip pain can also be caused by other medical conditions including:
Hip Osteoarthritis (Hip OA)
Gluteus Medius Muscle Tear
IT Band Syndrome
Luckily, it is fairly easy to differentiate between these and hip bursitis. If you have hip bursitis, your pain WILL BE INCREASED when you press on the bursa near the outer hip area as seen in the diagram above.
To read more about other potential causes of hip pain, check out my detailed article, “Why Does My Hip Hurt? Understanding Different Types of Hip Pain Symptoms.”
Which Activities can Aggravate Hip Bursitis?
Since bursitis is a compressive disorder, anything that causes increased compression of the bursa against the femur will cause further aggravation of the bursa. It is important to understand and identify potential causes of compression so that you can steer clear of these activities to allow the bursa to heal.
Activities to be cautious with include:
Sleeping on your painful side
- Do NOT sleep on your painful side. This will cause hours of compression on the bursa and will only delay the healing process
Sleeping on your non-painful side
- Sleeping on your non-painful side is much better than sleeping on your painful side, however, you WILL need to place a pillow in between your legs to prevent the painful leg from dropping down past mid-line. If the painful leg drops past mid-line, it will stretch the IT band down over the bone and cause compression of the bursa.
- Sleeping on your non-painful side is much better than sleeping on your painful side, however, you WILL need to place a pillow in between your legs to prevent the painful leg from dropping down past mid-line. If the painful leg drops past mid-line, it will stretch the IT band down over the bone and cause compression of the bursa.
Crossing your legs while sitting
- Do NOT cross your legs as this will cause increased IT band tension
- Do NOT cross your legs as this will cause increased IT band tension
Standing with your weight shifted onto the painful leg
- If you find yourself standing for several minutes at a checkout line, try not to shift your weight onto your painful leg. This will cause increased tension through the IT band and consequently compress the bursa. Do your best to stand with equal weight distribution on both legs.
Hip Bursitis Treatment Goals
The number one goal of treatment is to reduce the compression of the bursa and allow it to heal. Education is key to this one as mentioned before.
Using a cold pack on the outer hip for 10-15 minutes can help reduce the irritation of the bursa. This can be performed several times throughout the day depending on the severity of symptoms.
- REUSABLE, LARGE SIZE
- LONG-LASTING GEL COLD PACK
- GREAT FOR SMALL BODY AREAS SUCH AS NECK, ELBOW, ETC.
- PROFESSIONAL QUALITY
- FILLED WITH NON-TOXIC SILICA GEL
One can also consider taking oral anti-inflammatory medications (Advil, Aleve, Ibuprofen, etc.), but only if you are cleared by your medical doctor to ensure that it is safe for you to do so as these medications can have adverse effects on a select number of individuals.
Hip bursitis exercises will help in both the short term and the long term.
They do so by:
Reducing the tightness in the muscles and fascia around the bursa.
Strengthening the hip muscles to help support the hip and reduce stress on the bursa.
Hip Bursitis Exercise Precautions
When performing the following hip bursitis exercises, try to lie on a padded surface such as a carpeted floor, bed, or thick yoga mat. Additionally, you may place a pillow under the painful hip when lying on your side if it is too painful while doing the side-lying exercises. Alternate sets of each exercise by performing one set while lying on one side, then roll over to the other side and perform one set on that side. This reduces the duration spent consecutively lying on just one side.
The BEST Hip Bursitis Exercises for Hip Pain Relief!
- Convenient Access: Print or Use On-the-Go on Any Mobile Device
- Customized Healing Plans: Easy-to-Follow, Tailored Exercise Guides
- Holistic Recovery: Reduce Pain, Improve Mobility, & Increase Strength
- Comprehensive Progression: All-in-One Rehab Worksheets Include a Progressive Exercise Sequence for Optimal Results
- Expertly Designed by Dr. Tim Schuckers, PT, DPT, OCS
Convenient Access: Print or Use On-the-Go on Any Mobile Device
Customized Healing Plans: Easy-to-Follow, Tailored Exercise Guides
Holistic Recovery: Reduce Pain, Improve Mobility, & Increase Strength
Comprehensive Progression: All-in-One Rehab Worksheets Include a Progressive Exercise Sequence for Optimal Results
Expertly Designed by Dr. Tim Schuckers, PT, DPT, OCS
IT Band Stick Massage Roller
- Perform IT band massage with a roller-type stick massager. My absolute favorite is The Stick Original 24″ Roller. I own one and have used it for many years now.
- Roll the outer leg and thigh from BELOW the hip bone, down the leg stopping just before the knee.
- Anytime that you get to a tender bumpy area (I like to call “speed bumps”), spend some time trying to massage these tight areas out
- Perform: 3-5 minutes
Prone Knee Flexion Stretch with Strap
- Use this: OPTP Stretch Out Strap is my go-to as it comes with a nice, in-depth guide with pictures on several different stretches that you can use with it, and it has several loop sections on it for you to grab hold of when stretching.
- Want to feel a thigh stretch in your hip flexor muscles
- Perform: 2 reps x 1 min hold
Single Knee to Chest Stretch
- Want to feel a stretch in the glute muscles (buttock)
- Perform: 3 reps x 30 sec holds
Supine Hip External Rotator Stretch
- Use both hands to gently pull your knee towards the opposite shoulder
- You should feel a stretch in the buttock area
- Perform: 3 reps x 30 sec holds
Supine Figure 4 Piriformis Stretch
- Interlock both hands behind your thigh
- While using your elbow to block your thigh, gently pull the knee towards you until a stretch is felt in the glute muscles (buttocks)
- Perform: 3 reps x 30 sec holds
Side Lying Hip Abduction Exercise
- Squeeze your upper buttock muscle while lifting your top leg (knee straight) directly upwards
- You should feel this exercise activating and isolating your glute complex
- 3 sets x 10-15 repetitions
Side Lying Clamshell (with/without band)
- Beginner: start out by just lifting your own leg weight
- Advanced: once your hip strength builds, start using a loop resistance band around the knees
- Use these Power Systems Loop Resistance Bands – there are a lot of cheaper knock-offs bands out there, but these are quality ones that I use in my clinic.
- Perform: 3 sets x 10 reps
Bridging Exercise with Toe Raise
- Isolate the glute complex by squeezing your buttocks muscles
- If you feel your hamstring cramping, then you are overusing your hamstring and underutilizing your glute complex (buttock muscles)
- Elevate your toes, so you can press through the heels
- Perform: 3 sets x 10 reps
Chair Assisted Squats
- Beginner: start by holding onto a chair for assistance
- Advanced: perform air squat by holding arms out in front of you
- Perform: 3 sets x 10 reps
Expected Response from Hip Bursitis Exercises
With good compliance to performing these exercises daily, one should expect a gradual decrease in outer hip pain after 1-2 weeks.
The typical time frame for complete resolution of symptoms is 2-3 months, though this does fluctuate depending on how severe the condition was before you started treating it.
If you have NOT noticed a significant improvement in hip pain after a few weeks of performing these exercises, or if the hip pain has continued to increase, you should seek a medical evaluation with your doctor or physical therapist.
Alternative Treatment Options
Cryotherapy (ice/cold pack) should be used daily for 15-20 mins to help reduce the inflammation and pain in the outer hip area. NEVER PLACE the cold pack directly on the skin as this can lead to “ice burn.” Usually wrapping the cold pack in a pillowcase or other thin layer does the trick.
- REUSABLE, LARGE SIZE
- LONG-LASTING GEL COLD PACK
- GREAT FOR SMALL BODY AREAS SUCH AS NECK, ELBOW, ETC.
- PROFESSIONAL QUALITY
- FILLED WITH NON-TOXIC SILICA GEL
MRI (magnetic resonance imagining) or ultrasound imaging may provide a more accurate diagnosis of hip bursitis as the inflammation will be clearly identified through these images. However, this is rarely required when symptoms are in the mild to moderate intensity levels.
A corticosteroid injection would likely be beneficial for those suffering from severe hip pain and inflammation as the steroid acts as an anti-inflammatory. I usually save this option for those who have failed to benefit from 4 weeks of physical therapy or those who come to me already with severe symptoms. Your medical doctor will be required to give you this type of injection.
Diclofenac sodium topical gel (Voltaren Gel) is an over-the-counter anti-inflammatory gel that you can rub over the painful area several times per day. It soaks through the skin and reduces the inflamed tissue underneath. Remember to talk to your doctor or physical therapist before using any topical creams to ensure that it is safe for you to try.
- TWO 3.5oz/100g TUBES OF VOLTAREN PAIN GEL
- POWERFUL TOPICAL PAIN RELIEF
- NONSTEROIDAL ANTI-INFLAMMATORY
- NUMBER 1 DOCTOR RECOMMENDED TOPICAL PAIN RELIEF
Massage can be beneficial for hip bursitis as muscle tightness is a key contributor to the compression of the hip bursa. Request that the massage therapist NOT press on the outer hip near the bursa, but rather focus on relaxing the glute complex, hip flexors, and IT band.
How to Prevent Future Hip Bursitis Pain
Once you have successfully reduced the hip pain, shifting to a maintenance program is essential to prevent hip bursitis from recurring in the future. I highly recommend that you continue with the hip exercises 1-2x/week to ensure that you stay flexible and keep the hip muscles strong.
If you start to feel the return of similar symptoms down the road, quickly intervene by modifying potential activities that may be causing increased bursa compression, and return to performing the exercises daily until the pain decreases.
Video: Hip Bursitis Exercises for Hip Pain Relief
Frequently Asked Questions
What are some exercises that can help relieve hip bursitis pain?
There are various exercises that can help relieve hip bursitis pain, including hip stretches, strengthening exercises, and low-impact activities such as swimming or cycling. It’s essential to consult with a healthcare provider or physical therapist before starting any exercise program to ensure it’s safe and tailored to your individual needs.
Is it okay to exercise with hip bursitis?
It may be okay to exercise with hip bursitis, depending on the severity of the condition. If the symptoms are severe, consulting a doctor to discuss the potential benefits of a corticosteroid injection to the bursa should be considered.
How can I prevent hip bursitis from recurring?
You can help prevent hip bursitis from recurring by practicing good posture, performing regular stretches and exercises to strengthen the hips and surrounding muscles, and avoiding activities that aggravate your symptoms such as long-distance walking, running, or going up/down stairs regularly.
What are the best stretches to ease hip bursitis pain?
Some of the most effective stretches for hip bursitis pain include butterfly stretches, figure-four stretches, hip flexor stretches. It’s essential to perform these stretches slowly and gradually increase the intensity to avoid further aggravating the condition.
How often should I do hip bursitis exercises?
The frequency and duration of hip bursitis exercises may differ depending on the severity of the condition. It’s typically recommended to perform exercises that strengthen the hips and surrounding muscles at least 2-3x/week and to stretch daily.
