Written by Garett Reid | NSCA, CSCS, CISSN, M.S.E.S.S
Fact checked by Kirsten Yovino, CPT Brookbush Institute
FACT CHECKED
Experiencing hip bursitis pain is no fun. It's like trying to run with a pressure that continues to build the further you go. You can't just work through it, and ignoring it certainly won't make it go away. Instead, follow the information in this article as we'll tell you exactly what to do if you ever experience hip bursitis.
This includes the best stretches to perform to help relieve a painful hip. We'll also provide the most effective exercises to mitigate the symptoms of hip bursitis, which when done proactively, can even help prevent it altogether.
This article will discuss:
- What is hip bursitis?
- What causes hip bursitis pain?
- Best stretches to help with hip pain
- The most effective hip bursitis exercises
- Tips to prevent hip bursitis
What Is Hip Bursitis?
Hip bursitis, also known as greater trochanteric pain syndrome or trochanteric bursitis, is a painful condition that occurs from inflammation of the bursae in the hip joint.
The bursa is a tiny fluid-filled sac that's filled with synovial fluid. In fact, there are around 150-160 bursae located within the human body. These bursae are located in areas where the bone comes in contact with muscles or tendons to create a slippery surface.
However, when bursae become infected, they create too much pressure on the joint structure. As a result, the joint cannot function normally, causing movement discomfort.
Where Does Hip Bursitis Pain Occur?
There are actually two different bursae in the hip joint that can cause pain.
The first is located on the greater trochanter. The greater trochanter is located on the superior end of the femur, near the femur head (a large round structure that makes up the "ball" of a ball-in-socket joint). It sits on the lateral side of the thigh and is responsible for hip bursitis pain.
The iliopsoas bursa is another bursa of the hip. It's located on the inner thighs near the groin area. Pain with the iliopsoas bursa is less common.
What Causes Hip Bursitis Pain?
There is no single cause for hip bursitis. The primary cause is the hip joint being damaged, yet this can occur in multiple ways. Some common things that can cause damage to the hip joint are:
- Injury from a fall
- Overuse from repetitive motion, such as excessive running or biking
- Hip surgery
Regardless of what the cause is, the result is the same. When the hip joint experiences excessive stress, the bursae eventually become inflamed. What once acted as lubricant has now tightened the hip joint, creating excessive pressure on the muscles, bones, and nerves.
The end result is dull pain in the hip joint that worsens as you continue to exercise. At this point, hip strengthening exercises and stretching become necessary to help alleviate the issue.
What Does Hip Bursitis Feel Like?
Generally, hip bursitis feels like a deep, dull pain that gradually worsens. However, the pain is generally mild.
While this may seem good, the mild nature of hip bursitis can cause people to ignore it and push on with their normal cardio and workout split, eventually causing the underlying issue to worsen.
It's important to note that some people will also report a quick sharp pain instead.
4 Best Stretches & Mobility Exercises For Hip Pain
If you are already experiencing significant hip bursitis, stretches, low-intensity exercises, and low impact workouts should become your new best friend to help alleviate the issue.
If after a few weeks no improvement is seen after performing these stretches and strengthening exercises, you may need to see a physical therapist for follow-up care.
1. Hip Rotator Stretch:
The hip rotator stretch is extremely simple to perform and does a great job of loosening the hips.
How to do the Hip Rotator Stretch:
- Lie on the floor with your knees bent, and your feet off the floor. Lift the affected leg, pulling the same side foot to place it on the other thigh.
- The knee of the injured leg should now be pointing perpendicular to your body.
- Place your hands around your bottom leg, and placing your same side elbow on the injured knee, use it to gently push your knee away from you.
- You'll gradually feel a gentle stretch build. Keep pushing until the rotator muscles and the iliotibial band is stretched.
- The muscle should feel tight, but there should be no discomfort.
- Hold for 30 seconds and then gradually allow the knee to return to normal.
2. Figure 4 Stretch:
Sometimes called the iliotibial band stretch, you can either perform this standing up, which requires more balance, sitting on the ground, or lying down similar to the hip rotator stretch.
This will provide the iliotibial band and other external rotators with a gentle stretch, also making it an awesome tensor fasciae latae stretch.
How to do the Figure 4 Stretch:
- Whether you're standing up, sitting, or lying down, lift the affected leg and pull its foot to place it on the other leg. The knee of the injured leg should always be pointing perpendicular to your body.
- If you're standing up, with the affected leg crossed over the standing one, sink down as if you're squatting on one leg, gently pressing down on the knee of the affected leg until you feel a stretch.
- If you're sitting up, place your hands behind you on the floor to support you. You can deepen the stretch by sitting up straighter and moving your upper body closer to the affected bent leg.
- If you're lying down, grab the thigh beneath the bent knee, and slowly pull the knee toward your upper body. While gently pulling on the iliotibial band, keep your hips flat on the ground.
3. Lateral Straight Leg Raises:
Straight leg raises are more of a hip mobility or activation exercise, but it serves all purposes. This stretch will target your abductor muscles on the outer thighs.
Again, to perform this movement, you just need your body. You can also use a resistance band to train the abductors as well.
How to do Straight Leg Raises:
- Lie on your side with your top leg in line with the bottom leg. Your bottom leg can also be slightly bent.
- You can use your hand to keep your head propped up if needed.
- Keeping the top leg straight, lift it vertically as high as possible.
- Hold it at the top and slowly lower it to its original position.
4. Clamshells:
Clamshells look similar to straight leg raises, except they're going to stretch the hip abductors. Try adding a resistance band to make this move more challenging.
How to perform Clamshells:
- Get on the ground and lie on your side. The top knee will be the one stretched, meaning this should be the painful hip while the good leg is on the bottom.
- Pull both knees toward your upper body as if curling into the fetal position. Keep your upper body straight. This is the starting position.
- Keeping your knees bent and legs stacked, lift the top knee so it rotates upward.
- Lift it as high as you can, hold, and slowly lower it to its original position.
The 6 Most Effective Hip Bursitis Exercises
The above stretches should be plenty to stretch and activate your hips. Once ready, you must start incorporating strength exercises to keep your hip joint solid. Start each exercise slowly so you don't do too much too fast.
Here are the best exercises to keep hip bursitis at bay. Remember that if you start to feel more pain, stop immediately and reassess.
1. Hip Bridges:
Hip bridges are an easy and effective way to start building strength in your muscles. They can be done with bodyweight only to focus on hip extension. However, you may also use a resistance band or medicine ball to train your hip abductors and adductors.
If you opt for a resistance band, wrap it around the lower thigh muscles before starting the exercise. If you choose the medicine ball, with your knees bent, place it between them. Focus on squeezing the ball as you perform your hip extension.
How to do Hip Bridges:
- Lie on your back with your legs shoulder-hip width apart and knees bent.
- Place your feet flat on the floor with your shins vertical.
- Keeping your hands off to the side, focus on pressing your feet into the floor to propel your hips upward.
- Thrust your hips upward until your torso is perfectly erect. Hold and squeeze your glutes.
2. Single Leg Hip Bridge:
The single-leg glute bridge is performed similarly, except you only use one leg. This minor change completely changes the dynamics of the exercise, including muscles used and activation.
Because you are on one leg, a more significant load is placed on the stabilizer muscles around the hip joint to keep it steady. This is exactly what you want to prevent hip bursitis, making this one of the best hip bursitis exercises around.
How to do Single Leg Hip Bridges:
- Lie on your back with one leg straight and the other leg bent.
- Keep the foot of the bent knee flat on the floor.
- Drive that foot into the floor to raise your hips off the ground.
- At the same time, keep the other leg straight. This will also train the hip flexors and front thigh muscles.
3. Cable Hip Abduction:
Hip abduction (thigh moving away from the body) is a common hip movement. Hip abductor exercises such as this one can effectively be done with a cable machine.
How to do Cable Hip Abduction:
- Set up the cable pulley on the lowest setting and an ankle attachment.
- Stand next to the cable machine and attach the cable to the outside leg.
- Keeping your knees pointing forward and extended, pull your leg straight to the side as high as possible.
- Your opposite thigh should remain as still as possible with the knee straight.
4. Cable Hip Adduction:
Hip adduction exercises involve the thigh moving across the body. This is another great exercise to perform using a cable machine.
How to do Cable Hip Adduction:
- Set up the cable pulley on the lowest setting and an ankle attachment.
- Stand next to the cable machine and attach the cable to your inside leg.
- Keeping both knees pointing forward and extended, pull your leg straight across your body as high as you can go.
- Your opposite thigh should remain as still as possible.
5. Hip Thrust:
Hip thrusts are one of the best hip hinge exercises to strengthen your posterior chain and hip structure. Start with your bodyweight and then as you progress, start using weights.
How to perform a Hip Thrust:
- Set up a bench and sit in front with your back on the bench.
- Bend your knees, so your shins are vertical and your feet are flat on the ground.
- If you're using weight, place a loaded barbell in the crease of your hips.
- Drive your hips down, thrusting your hips upward. Squeeze and slowly lower the weight until your glutes hit the ground.
6. Deep Squats:
Squats are a great exercise to train the entire hip joint. To optimize these, go as low as you can with good form. Using a larger range of motion can ensure the hip is strengthened in all positions.
How to do Deep Squats:
- Stand with legs shoulder-width apart and your knee pointing forward. Keep your knees slightly bent at the top.
- Push your hips back to lower your body. Your shoulders should drop straight down and your back straight.
- Continue lowering past parallel until your form breaks.
- Power up by driving through your legs and thrusting your hips forward.
How To Prevent Hip Bursitis
As with all injuries, the best method to treat hip bursitis is to prevent it from occurring in the first place. Here are some tips to help you avoid hip bursitis altogether.
1. Strengthen Your Hip Muscles And Those Surrounding The Hip.
Your primary concern when preventing hip bursitis is increasing your hip muscle's muscular strength. This means strengthening all of your hip and leg muscles.
The overuse and trauma that causes hip bursitis result from excessive jarring and twisting. To prevent this from happening, build iron hips that withstand these forces.
It's important to note that the hip is an extremely complex joint, with many researchers identifying at least 17 hip muscles while others note 21 or more. The good thing is that many of these work together, so you don't need to perform 21 different exercises.
Your goal when training for hip strength is to exercise them through multiple movement patterns and angles.
2. Follow A Proper Exercise Program.
Following an exercise program built for your specific circumstances is a must. This is why speaking to a qualified trainer is important. If the situation warrants it, seeking healthcare professional medical advice is also a good choice.
Building muscle the fastest shouldn't be the only variable your program considers. It should also identify any mobility issues, work around injuries, and include proper exercise selection.
If you are new to training in any sport, we highly recommend you get professional help at the beginning of your journey.
3. Practice Good Form.
Good form goes a long way in preventing hip bursitis and other overuse injuries. Correct body position and biomechanics of an exercise have been identified to improve your performance and prevent injury. This includes using a full range of motion. Also make sure to exercise slowly to ensure you're using good form.
While a minor error one time won't make a huge difference, the accumulation of a joint being out of place over and over will.
4. Progress at a Slow and Steady Pace.
When we use the term "slowly," we refer to numerous aspects of lifting. This could include not jumping into exercises you're not ready for.
But. the main aspect to consider here involves progression. Hip bursitis arises from too much exercise or a heavy load or volume accumulation.
The human body is extremely smart and can adapt to its stresses. In fact, that's the basic tenet of progressive overload.
However, for this to work, you need to apply minimal increments over time. This allows the muscle to heal and the tendons and ligaments that hold the joint together to recover.
5. Be Smart!
Hip bursitis results from overuse and repetitive movements, so be smart about any nagging issues. In other words, as soon as you start to feel that dull, achy sensation in your joint, stop what you're doing!
This doesn't mean you need to go get in bed and ice your hips for days, but you must stop whatever exercise aggravates your joint.
Again, you can not just "walk it off." Once hip bursitis begins to develop, it will continue to get worse.
Can I Exercise With Hip Bursitis?
Above, we had already mentioned that you need to stop what you're doing if you feel hip bursitis developing. However, you can still do something else that doesn't cause hip pain.
It's difficult to suggest what exercises to do as everyone's case is different. However, here are some tips when training with hip bursitis.
- Keep your volume and reps low. This might be a good time to switch to a strength training program (if you're not already), as the repetitions are low.
- Don't train to failure. This is when form begins to fall apart and general stress begins to occur.
- Use upper body exercises such as a SkiErg for cardiovascular exercise.
And to reiterate, if you have doubts, see a healthcare professional or physical therapist before exercising.
A Summary Of Hip Bursitis Exercises And Prevention
Hip bursitis definitely isn't the worse ailment you can suffer from, and it's relatively common. However, to prevent the need for steroid injections or visits to physical therapists, take care of your hips. This means training them appropriately while not placing too much stress on them.
Follow the guidelines in this article and if you still have lingering questions, remember one of our favorite sayings, "Strong things don't break." Focus on building up your hip, so you don't need to worry about them breaking down.
Related:
- How to Fix Hip Pain When Squatting
- 9 Best Strengthening Exercises For Hip Flexors
- 6 Best Hip Internal Rotation Exercises And Stretches
References:
- Eliassen W, Saeterbakken AH, van den Tillaar R. COMPARISON OF BILATERAL AND UNILATERAL SQUAT EXERCISES ON BARBELL KINEMATICS AND MUSCLE ACTIVATION. International journal of sports physical therapy. 2018;13(5):871-881. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6159498/
- Pinto RS, Gomes N, Radaelli R, Botton CE, Brown LE, Bottaro M. Effect of range of motion on muscle strength and thickness. Journal of strength and conditioning research. 2012;26(8):2140-2145. doi:10.1519/JSC.0b013e31823a3b15
Garett Reid
Author