Hip Bursitis Exercises: Relieve Trochanteric Pain and Restore Function

That sharp pain on the outside of your hip. The tenderness when you lie on that side at night. The ache that flares with every step, especially on stairs. If this sounds familiar, you may be dealing with hip bursitis—one of the most common causes of lateral hip pain.

The good news: hip bursitis responds well to the right exercise approach. The key is knowing what to do and, just as importantly, what to avoid.

Understanding Hip Bursitis

Trochanteric bursitis is inflammation of the bursa—a fluid-filled sac that reduces friction—located over the bony prominence on the outside of your hip (the greater trochanter).

Common symptoms:

• Pain on the outside of the hip
• Tenderness when pressing on the area
• Pain when lying on the affected side
• Pain with walking, climbing stairs, or prolonged standing
• Pain that may radiate down the outer thigh

What causes it:

• Repetitive friction from tight IT band or gluteal tendons
• Weakness in hip muscles (especially gluteus medius)
• Poor biomechanics (leg length discrepancy, gait issues)
• Overuse from running, cycling, or excessive walking
• Direct trauma (falling on the hip)
• Prolonged pressure (lying on one side)

Important note: Recent research suggests many cases diagnosed as "bursitis" are actually gluteal tendinopathy—irritation of the tendons rather than the bursa. The treatment approach is similar, but understanding this helps explain why anti-inflammatory treatments alone often fail.

Phase 1: Reduce Irritation

Before strengthening, you need to calm things down.

Avoid Aggravating Factors

Sleeping: Don't lie on the affected side. Place a pillow between your knees when side-sleeping on the unaffected side.

Sitting: Avoid crossing your legs. Don't sit with your affected hip lower than your knee (deep chairs, bucket seats).

Standing: Avoid standing with your weight shifted to the affected side (the "hip hang" posture).

Exercise: Temporarily reduce or avoid activities that aggravate symptoms—running, excessive stair climbing, lateral movements.

Ice

Apply ice to the outside of your hip for 15-20 minutes after activity or when pain flares.

Gentle Movement

Complete rest isn't ideal. Gentle, non-aggravating movement promotes healing.

Walking: Short walks on flat ground are usually fine. Avoid hills initially.

Swimming: Excellent low-impact option. Avoid breaststroke kick if it aggravates symptoms.

Phase 2: Stretching (With Caution)

Tight muscles, particularly the IT band and hip flexors, contribute to bursitis. However, aggressive stretching can worsen symptoms. Stretch gently.

Hip Flexor Stretch

Tight hip flexors alter hip mechanics.

1. Kneel on your affected side (pad the knee)
2. Front foot flat on the floor, knee at 90 degrees
3. Tuck your tailbone under (flatten your lower back)
4. Shift forward slightly until you feel a gentle stretch
5. Hold 30 seconds, repeat 2-3 times

Key: Don't overstretch. Mild tension is enough.

Piriformis Stretch

The piriformis can contribute to lateral hip issues.

1. Lie on your back
2. Cross your affected ankle over the opposite knee
3. Gently pull the uncrossed leg toward your chest
4. Feel the stretch in your buttock
5. Hold 30 seconds, repeat 2-3 times

Gluteal Stretch

1. Lie on your back
2. Pull your affected knee toward the opposite shoulder
3. Hold 30 seconds

IT Band Considerations

Traditional IT band stretches may actually increase pressure on the bursa. Instead of aggressive stretching:

Foam rolling (careful): Roll the quadriceps and gluteals, but avoid rolling directly over the painful area on your outer hip.

Standing IT band stretch (gentle):

1. Cross your affected leg behind your other leg
2. Lean away from the affected side
3. Hold 20-30 seconds
4. Keep this gentle—don't force it

Phase 3: Strengthening

Weak hip muscles—especially the gluteus medius—are a primary cause of hip bursitis. Strengthening is essential for long-term relief.

Isometric Hip Abduction

Start here if other exercises are too painful.

1. Lie on your back with a pillow or ball between your outer thigh and a wall
2. Press your thigh into the pillow without moving
3. Hold 10 seconds
4. Repeat 10-15 times

Clamshells

Classic gluteus medius exercise.

1. Lie on your unaffected side
2. Knees bent at 45 degrees, feet together
3. Keeping feet touching, lift your top knee toward the ceiling
4. Don't let your pelvis roll backward
5. Lower slowly
6. Do 15-20 repetitions

Progression: Add a resistance band around your thighs.

Side-Lying Hip Abduction

1. Lie on your unaffected side, legs straight
2. Lift your top leg toward the ceiling (about 30-45 degrees)
3. Keep your toes pointing forward, not up
4. Lower slowly
5. Do 15-20 repetitions

Key: Quality over quantity. Don't lift too high or let your pelvis rock.

Standing Hip Abduction

1. Stand holding onto something for balance
2. Lift your affected leg out to the side
3. Keep your body upright—don't lean
4. Lower slowly
5. Do 15 repetitions

Progression: Add an ankle weight or resistance band.

Glute Bridges

Strengthens glutes and hip extensors.

1. Lie on your back, knees bent, feet flat on floor
2. Push through your heels to lift your hips
3. Squeeze your glutes at the top
4. Lower slowly
5. Do 15-20 repetitions

Single-Leg Stance

Functional hip stability.

1. Stand on your affected leg
2. Keep your pelvis level—don't let the opposite hip drop
3. Hold 30 seconds
4. Progress to 60 seconds, then add arm movements or unstable surfaces

Wall Sits

Builds quadriceps and hip strength.

1. Stand with your back against a wall
2. Slide down until knees are at 90 degrees (or less deep if painful)
3. Hold 20-30 seconds
4. Progress to longer holds

Step-Downs

Eccentric control for hip stability.

1. Stand on a low step with your affected leg
2. Slowly lower your other foot toward the ground
3. Tap lightly and return
4. Focus on keeping your pelvis level
5. Do 10-15 repetitions

Phase 4: Functional Progression

As pain decreases, progress to more challenging exercises.

Lateral Band Walks

1. Place a resistance band around your ankles or above your knees
2. Slight squat position
3. Step sideways, maintaining tension on the band
4. Take 10-15 steps each direction

Single-Leg Deadlift

1. Stand on your affected leg
2. Hinge forward at the hip, extending the other leg behind you
3. Keep your back flat
4. Return to standing
5. Do 10-12 repetitions

Side Plank (Modified)

1. Lie on your unaffected side
2. Prop yourself on your forearm, knees bent
3. Lift your hips off the ground
4. Hold 20-30 seconds
5. Progress to straight legs

Lunges (Forward and Lateral)

Once basic exercises are pain-free:

• Forward lunges
• Lateral lunges (step to the affected side)
• Start with small range of motion and progress

Sample Weekly Program

Weeks 1-2 (Acute Phase)

Daily:

• Ice after activity if needed
• Hip flexor stretch: 2 × 30 seconds
• Piriformis stretch: 2 × 30 seconds
• Isometric hip abduction: 2 × 10

Every other day:

• Gentle walking: 15-20 minutes
• Swimming or cycling (if tolerated)

Weeks 3-4 (Early Strengthening)

Daily:

• All stretches: 2 × 30 seconds each

3x per week:

• Clamshells: 3 × 15
• Side-lying hip abduction: 3 × 15
• Glute bridges: 3 × 15
• Single-leg stance: 3 × 30 seconds
• Standing hip abduction: 2 × 15

Weeks 5-8 (Progressive Strengthening)

3x per week:

• All stretches (brief maintenance)
• Clamshells with band: 3 × 15
• Side-lying abduction with ankle weight: 3 × 15
• Glute bridges: 3 × 15
• Lateral band walks: 3 × 15 steps each direction
• Step-downs: 3 × 12
• Single-leg stance: 3 × 45 seconds

Week 9+ (Return to Activity)

• Continue maintenance strengthening 2-3x per week
• Gradual return to aggravating activities
• Progress running/hiking slowly if applicable

Modifications for Daily Life

Sleeping

• Don't sleep on the affected side
• Use a body pillow or place a pillow between your knees
• Consider a mattress topper if your bed is too firm

Sitting

• Avoid crossing your legs
• Use a cushion if chairs are hard
• Keep hips level with or above knees
• Get up and move every 30-45 minutes

Standing

• Distribute weight evenly on both legs
• Avoid "hip hanging" (shifting weight to one side)
• Wear supportive shoes

Exercise Modifications

• Avoid side-lying directly on the affected hip
• Modify cycling seat height if it aggravates symptoms
• Reduce running volume; run on flat, soft surfaces
• Avoid repetitive stair climbing during acute phases

When to Seek Professional Help

See a healthcare provider if:

• Pain is severe or getting worse despite conservative treatment
• You have significant weakness
• Symptoms don't improve after 6-8 weeks of consistent exercise
• You have night pain that significantly disrupts sleep
• Pain radiates significantly down your leg
• You have symptoms in both hips

Additional treatments that may help:

• Physical therapy for hands-on treatment and personalized programming
• Corticosteroid injection (provides temporary relief; doesn't address underlying cause)
• Shockwave therapy
• PRP or other regenerative injections (for tendinopathy)

Prevention

Once recovered, maintain hip health:

Strengthen regularly: Hip abductor exercises 2-3 times per week as maintenance.

Stretch appropriately: Maintain hip flexor and piriformis flexibility.

Progress gradually: Avoid sudden increases in walking, running, or cycling volume.

Maintain healthy weight: Excess weight increases load on hip structures.

Address biomechanics: Consider gait analysis if problems recur. Orthotics may help if you have leg length discrepancy or foot issues.

Vary your activities: Don't do the same repetitive motion constantly.

The Path Forward

Hip bursitis can be frustrating—it's painful, it disrupts sleep, and it affects everyday activities. But with the right approach, most cases resolve within 6-12 weeks.

The key is addressing the underlying cause (usually weak hip muscles and tight surrounding structures), not just treating the inflammation. Anti-inflammatory medications and injections may help short-term, but without exercise, the problem typically returns.

Be patient with the process. Do the exercises consistently. Avoid the aggravating factors. Your hip will heal, and with continued maintenance, you can prevent recurrence.

That outside hip pain doesn't have to be your new normal. Put in the work, and you'll be lying on your side comfortably again.