Hip Bursitis treatment

Hip bursitis is inflammation of a bursa around your hip. The bursa is a small sack of fluid located between your tendon and bone, which acts as a shock absorber to prevent friction. Hip bursitis can cause quite debilitating pain in your hip.

Hip bursitis treatment – symptoms

The symptoms of hip bursitis are usually pains on the outside of your hip. This pain is worse during activities such as running, climbing up the stairs or getting out of a car. The pain will gradually worsen over time, especially if you lean on the outside of your hip for example when sleeping. Hip bursitis pain may also radiate down the outside of your thigh.

What is hip bursitis?

A bursa is a small sack of fluid positioned between a bone and a muscle or tendon. The function of your bursa is to prevent friction between the bone and any overlying soft tissue. There are several bursas around your hip joint.

Trochanteric bursa – located on the outer side of your hip between the greater trochanter and the attachments of your gluteal muscles.

Gluteus Medius bursa – a smallish bursa, located between your Gluteus Medius muscle and your greater trochanter, just medial to your trochanteric bursa.

Iliopsoas bursa – located between your iliopsoas muscle, at the front of your hip joint and the underlying bone (bursitis in this area is sometimes called Iliopectineal bursitis).

Ischial bursa – located between your hamstring tendon attachment and the base of your pelvis (your sit bones).

Hip bursitis that we see a lot of is from your trochanteric bursa. You can injure this in one of two ways, through direct impact to the bursa, such as falling onto the outside of your hip (traumatic hip bursitis) or through repetitive friction from the muscles and tendons over the top of your bursa (eg. usually during running or long walks).  The repeated friction results in the bursa becoming swollen. With limited space around the hip, every time your tendons rub over your bursa, this results in hip pain.

Hip bursitis due to overuse injuries is mostly due to biomechanical imbalances. Certain muscles in your pelvis and lower limbs may be underactive which can create overuse issues. If you overpronate (have fallen foot arches) then you are more susceptible to hip bursitis. Your knee will collapse inwards with each step, increasing the angle of pull on your gluteal or hip muscles at the greater trochanter, creating friction, overuse and swelling. Underactive or weak hip abductors, especially Gluteus Medius can also lead to hip bursitis over time.

Other contributing causes of hip bursitis are tight structures surrounding your hip including your iliotibial band (ITB), hip flexors and hamstrings. A bony spur at the greater trochanter, which is a small excess growth of bone at your hip, can also cause hip bursitis.

Hip bursitis treatment

What can you do?

The first thing to do for hip bursitis treatment is rest from aggravating activities that cause your hip pain. Continuing to exercise will worsen the inflammation and delay your hip bursitis from healing. Apply ice to your lateral hip to assist with pain and inflammation. Hip bursitis treatment of cold packs that can be applied for 10 minutes every hour is useful for the acute pain stage.

Hip Bursitis Treatment

Physiotherapy | Hip bursitis treatment exercises | Hip bursitis rehabilitation

At City Physiotherapy we will first address any pain and inflammation with techniques such as manual therapy, mobilisations, dry needling, rest, movement and sleep posture advice. Once the pain has settled somewhat we will start to correct any muscle imbalances contributing to your painful hip. Exercises and or orthotic insoles for your feet may be prescribed to correct poor foot biomechanics. We may send you for an X-ray, US scan or MRI to confirm the injury is not as a result of a bone spur.

If muscles surrounding the hip joint are tight then these will be worked on to lengthen them to reduce pressure on your bursa. Stretches for your outer hip, gluteal muscles, hip flexors, and hamstrings are an important part of your rehab. Strengthening exercises are also very important and need to be done as an integral part of the long-term rehabilitation strategy for your hip bursitis.

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