Your hips are some of the most important joints in your body, allowing you to stand, walk, run, and perform other everyday activities. If any part of your hip is irritated or inflamed, you may feel uncomfortable and struggle to go about your normal day. 

A common cause of hip pain is a condition called hip bursitis, which sounds fancy, but really just means there’s some inflammation in the fluid-filled sacs (called bursae) in your hips. (You have bursae in other joints too — your shoulders, knees, elbows, etc.). 

“Hip bursitis is a common cause of hip pain, regardless of age or activity level. But it responds well to targeted exercises,” says Caitlin Shaw, PT, DPT, a physical therapist at Hinge Health. “Exercise therapy that promotes strength and mobility can reduce your symptoms and improve your quality of life.” As one Hinge Health member with hip bursitis recently shared, “moving and exercising does make me feel better.”

Below, learn more about hip bursitis causes and how to prevent and treat it — especially with exercises from our Hinge Health physical therapists.

What Is Bursitis of the Hip, Exactly? 

Bursae are fluid-filled sacs between your bones and soft tissues that help your joints move smoothly. “Along with helping joints slide, they help tendons glide over bone,” says Dr. Shaw. You have more than 150 bursae in your body, and each hip has two. Bursitis simply means that a bursa is inflamed or swollen. The type of bursitis depends on which bursa in your hip is affected.

• Trochanteric bursitis. The greater trochanteric bursa is on the outside of your hip. It covers the bony point of your hip bone at the top of your femur (thigh bone). Inflammation of this bursa usually causes pain on the side of the hip, says Dr. Shaw.

• Iliopsoas bursitis. Iliopsoas bursitis happens when the bursa on the inside of the hip, near your groin, becomes irritated or inflamed. People with iliopsoas bursitis usually complain of groin pain. 

While hip bursitis can occur after an acute injury, such as a fall, it’s typically caused by repetitive use that irritates the bursa. “Hip bursitis usually occurs over time as ‘micro-trauma’ to the bursa,” says Dr. Shaw. That may sound scary, but it’s important to remember that your hips can handle a lot. Plus, there’s no such thing as a “bad” activity for the hip. It is, however, possible to put more stress on your bursae than your body is ready for at a given point in time, which can contribute to bursitis. 

The silver lining is that simple exercises can help improve strength and mobility in the hips, which can reduce the risk of bursitis. Targeted exercises promote blood flow, contributing to the healing process, and reduce strain on tissues that irritate the bursae.

Hip Bursitis Symptoms 

How do you know if your hip pain is from bursitis? Hip bursitis can cause several different symptoms. The most common symptom, says Dr. Shaw, is pain or tenderness over the affected bursa.

Other common hip bursitis symptoms include: 

• Pain, swelling, redness, or tenderness of the affected bursa 

• Pain that worsens when you lie on your hip, climb stairs, walk, or lift your leg to the side

• Pain on the side of the hip that radiates down the front or side of your leg

• Groin pain 

• Stiffness in the hip 

• Difficulty exercising or performing everyday activities 

Note: It’s rare to have bursitis in both hips. It’s most common to experience hip bursitis on one side, notes Dr. Shaw. 

Hip Bursitis Causes 

Broadly, hip bursitis occurs when a hip bursa becomes inflamed. This can happen for several reasons. If the muscles or tendons around your bursae — such as your gluteus maximus muscle or IT band — are tight, they can rub a bursa, resulting in irritation. 

Other common causes of hip bursitis include: 

• Doing too much too soon. We at Hinge Health like to say movement is medicine. And while it’s true that movement is a crucial component to treating joint and muscle pain, it’s also true that doing too much exercise relative to what your body can handle at that particular moment can contribute to hip bursitis. Activities such as climbing, going upstairs, or standing for long periods are common culprits. However, the message here is not to avoid doing activities like this. Rather, it’s to continue being active while adding hip stretches and strengthening moves to your routine. This combination will help train your hips and pain system to adapt and handle these activities with less pain.

• Hip injury. Acute traumas, such as falling on your hip or bumping into something really hard, may inflame the bursae. 

• Uneven leg lengths. While unlikely to be the sole cause of hip bursitis, uneven leg lengths — common in people with hip arthritis or people who have undergone hip surgery — can contribute. “If you have uneven leg lengths, it can alter the way you walk, which can cause muscle tightness and then friction on the bursae,” says Dr. Shaw. Note: This isn’t something you can control, and that’s okay. You can counteract these effects by doing things like exercise therapy.

• Spine issues, such as scoliosis. If your spine is curved, you may develop tightness and straining on one side of your body, which can irritate your hip bursae. 

• Other medical conditions. Diseases such as rheumatoid arthritis, gout, and diabetes can contribute to hip bursitis for some people. 

While most causes of hip bursitis can be addressed with home care and physical therapy, some — such as infections or other diseases — may involve medical treatment. Your primary care provider can help you determine the appropriate cause and treatment if necessary.

Hip Bursitis Treatment 

The tips below can help you manage or prevent your hip bursitis symptoms. Ultimately, though, most cases of bursitis get better with the help of exercise and physical therapy.

• Modify activities that hurt your hip. During an episode of bursitis, your hip may hurt during everyday activities like climbing stairs or walking. But avoiding movement altogether isn’t good for your hip bursitis because it’s not teaching your hip how to adapt. So instead of being sedentary, try to modify your activity levels to find your movement sweet spot — the point between doing too much and too little. For example, you could walk or run for less time or distance to reduce irritation in the hip. You could use a standing desk or work at a countertop throughout the day instead of sitting for long periods, which can contribute to tightening of hip muscles and increased symptoms.

• Apply ice or heat. If your bursitis stems from an injury, applying ice can soothe swelling. For chronic bursitis, Dr. Shaw says heat packs tend to be preferable for people, which can help reduce stiffness and relax muscles. 

• Work on hip muscle strength and flexibility. Promoting strength and flexibility in your hip muscles can help reduce friction on your bursae and provide better stability when you walk or run. (See some good exercises to try below.) 

• Consider physical therapy. You may want to see a physical therapist to teach you exercises that help reduce muscle tightness that contributes to bursitis. “People typically respond well to PT treatment and see major improvements,” says Dr. Shaw. You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit.

• Use shoe inserts for leg length differences. If you have a leg length difference, it may help to use shoe inserts, which can decrease the load on your affected hip. “If you notice a limp or significant pain, a shoe insert may be appropriate,” says Dr. Shaw.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

Hip bursitis can be painful and impact your ability to go about your day-to-day activities. These exercises recommended by Hinge Health physical therapists help promote strong, healthy hips, which can improve bursitis symptoms and hip mobility over time.

PT Tip: Walk on Both Sides of the Road

If you’re a regular walker or runner outdoors, try using both sides of the road. Or if you use a looped path, alternate which way you start the loop. This helps your body take advantage of natural challenges you encounter because of differences in how the sidewalk or road slants. While this isn’t always possible or necessary, if you’re experiencing a hip bursitis flare, it can be a good experiment to run for yourself. “Changing which leg is on the outside, nearest traffic, is a helpful way to keep your muscle activation balanced,” says Dr. Shaw.

How Hinge Health Can Help You

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References

1. Sheth, N. P. & Foran, J. R.H. (2022, February). Hip Bursitis. OrthoInfo — American Academy of Orthopaedic Surgeons. https://orthoinfo.aaos.org/en/diseases--conditions/hip-bursitis/

2. Avruskin, A. (2022, August 31). Physical Therapy Guide to Hip Bursitis. Choose PT. https://www.choosept.com/guide/physical-therapy-guide-hip-bursitis

3. Seidman, A. J., & Varacallo, M. (2020). Trochanteric Bursitis. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK538503/

4. Williams, C. H., & Sternard, B. T. (2019, February 14). Bursitis. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK513340/

5. Seidman, A. J. & Varacall, M. (2019, February 15). Trochanteric Bursitis. Nih.gov; StatPearls Publishing. https://www.researchgate.net/publication/332230484_Trochanteric_Bursiti