Hip Bursitis Exercises: Relieve Trochanteric Pain

Hip bursitis—inflammation of the bursa on the outside of the hip—causes lateral hip pain that can make sleeping, walking, and stairs miserable. The right exercises address the underlying causes and provide lasting relief.

Understanding Hip Bursitis

What's Happening

The trochanteric bursa lies between the greater trochanter (hip bone) and the IT band/gluteal tendons. When inflamed:

• Pain on outer hip
• Tender to touch
• Worse lying on that side
• Aggravated by stairs, walking, rising from chair

Modern Understanding

Recent research suggests many cases are actually "gluteal tendinopathy" rather than pure bursitis—the tendons are the primary problem. Treatment is similar: strengthen glutes, address biomechanics.

Contributing Factors

• Weak gluteal muscles (especially gluteus medius)
• Tight IT band
• Poor hip mechanics
• Leg length differences
• Sudden activity increase
• Sleeping on the affected side

Acute Phase (First 1-2 Weeks)

Rest from Aggravators

• Avoid sleeping on painful side
• Reduce stairs if possible
• Limit single-leg standing on affected side
• Avoid crossing legs

Pain Management

Ice:

• 15-20 minutes
• Several times daily
• Over lateral hip

Positioning:

• Pillow between knees when side-lying
• Sleep on non-painful side
• Avoid prolonged standing

Gentle Movement

Supine Hip Circles:

1. Lie on back
2. Lift painful leg slightly
3. Small circles in air
4. 10 each direction

Heel Slides:

1. Lie on back
2. Slide heel toward buttock
3. Slide back
4. 10 reps

Stretching Phase

IT Band Stretches

Standing IT Band Stretch:

1. Cross painful leg behind other
2. Lean away from painful side
3. Feel stretch on outer hip
4. Hold 30 seconds
5. 3 reps

Side-Lying IT Band Stretch:

1. Lie on non-painful side
2. Let top leg drop behind bottom leg
3. Relax into stretch
4. Hold 30-60 seconds

Hip Flexor Stretch

Kneeling Hip Flexor:

1. Kneel on painful side
2. Other foot forward
3. Tuck tailbone
4. Lean forward
5. Hold 30 seconds

Piriformis Stretch

Figure-4 Stretch:

1. Lie on back
2. Cross painful ankle over opposite knee
3. Pull thigh toward chest
4. Hold 30 seconds

Strengthening (Key Phase)

Weak glutes are the primary cause—strengthening is essential.

Gluteus Medius Focus

Side-Lying Hip Abduction:

1. Lie on non-painful side
2. Keep top leg straight
3. Lift toward ceiling (not too high—30°)
4. Lower slowly
5. 15-20 reps, 2-3 sets

Clamshells:

1. Lie on non-painful side
2. Knees bent, feet together
3. Lift top knee
4. Keep pelvis stable
5. 15-20 reps, 2-3 sets

Standing Hip Abduction:

1. Hold support
2. Lift painful leg to side
3. Keep pelvis level
4. 15 reps, 2-3 sets

Progressive Strengthening

Side Plank (Modified):

1. On forearm and knees
2. Lift hips
3. Hold 15-30 seconds
4. Progress to feet

Single-Leg Bridge:

1. Lie on back, knees bent
2. Lift one leg
3. Bridge on single leg
4. 10-12 reps each side

Step-Down:

1. Stand on low step
2. Slowly lower other foot to floor
3. Control with standing hip
4. 10-12 reps each side

Resistance Band Exercises

Monster Walks:

1. Band around ankles
2. Quarter squat position
3. Walk sideways
4. 15 steps each direction

Band Walks (Forward):

1. Band around ankles
2. Walk forward maintaining tension
3. 20 steps

Standing External Rotation:

1. Band around thighs above knees
2. Stand, push knees out
3. Hold 5 seconds
4. 15 reps

Isometric Options

Good for pain management:

Isometric Hip Abduction:

1. Lie on side against wall
2. Push outer thigh into wall
3. Hold 30-45 seconds
4. 5 sets

Standing Isometric:

1. Painful hip against wall
2. Push into wall
3. Hold 30 seconds
4. 5 reps

Exercises to Avoid (Initially)

High Risk

• Stretches that compress bursa
• Lying on painful side
• Deep squats and lunges (until pain decreases)
• Running or high-impact activities

Modify

• Single-leg stance activities
• Stairs (use handrail)
• Side-lying exercises (on painful side)

Daily Routine

Morning (10 min)

1. Gentle hip circles: 10 each direction
2. IT band stretch: 30 sec
3. Hip flexor stretch: 30 sec
4. Clamshells: 15 reps
5. Side-lying abduction: 15 reps

Evening (15 min)

1. All stretches: 30 sec each
2. Clamshells: 2x15
3. Side-lying abduction: 2x15
4. Standing abduction: 2x15
5. Monster walks: 15 steps each direction
6. Ice if needed: 15 min

Sleep Positioning

Best Positions

Side-lying (non-painful side):

• Pillow between knees
• Reduces stretch on bursa
• Most common position

On back:

• Pillow under knees
• May be comfortable
• Reduces pressure

Avoid

• Sleeping on painful side
• No pillow between knees when side-lying
• Positions that stretch outer hip

Activity Modifications

Walking

• Continue if not severely painful
• Avoid prolonged walking initially
• Progress distance gradually

Stairs

• Lead with non-painful leg going up
• Use handrail
• Reduce if aggravating

Exercise Substitutes

Instead of running: cycling, swimming, elliptical Instead of lunges: mini squats, bridges Instead of side-lying: standing exercises

Return to Activity

Signs You're Ready

• Pain significantly reduced
• Can do strengthening without pain
• Walking and stairs comfortable
• Single-leg activities improving

Gradual Return

• Add activity slowly
• 10% increase per week
• Monitor for pain return
• Continue maintenance strengthening

Prevention

Ongoing Maintenance

• Continue glute strengthening 2-3x/week
• IT band stretching regularly
• Address training errors
• Proper footwear

Sleep Habits

• Continue pillow between knees
• Alternate sides
• Avoid always lying on one hip

When to Seek Help

See a Professional If

• Pain not improving after 4-6 weeks
• Severe pain
• Unable to walk or bear weight
• Night pain disrupting sleep significantly

Treatment Options

• Physical therapy
• Corticosteroid injection
• Shockwave therapy
• Rarely: surgery

Summary

Hip bursitis responds well to targeted exercises:

1. Rest from aggravators - Initially reduce compression
2. Stretch tight structures - IT band, hip flexors
3. Strengthen glutes - The key to lasting relief
4. Progress gradually - Don't rush back to full activity
5. Sleep positioning - Pillow between knees
6. Maintain prevention - Continue exercises long-term

Most hip bursitis resolves with consistent exercise over 4-8 weeks. Patience and proper glute strengthening are the keys to recovery.