Hip bursitis is a common cause of pain experienced on the lateral, or outer, side of the hip joint. This condition can limit mobility and cause discomfort, especially during activities like walking, standing, or lying on the affected side. Managing this pain involves conservative methods, and this article explores the effectiveness of stretching and specific exercises as a core component of recovery.
Understanding Trochanteric Bursitis
Trochanteric bursitis involves the inflammation of the trochanteric bursa, a small, fluid-filled sac situated over the greater trochanter of the femur (the bony prominence on the outside of the upper thigh). The bursa acts as a cushion, reducing friction between the bone and overlying tendons and muscles, such as the gluteal muscles and the iliotibial (IT) band. When irritated, the bursa swells and causes pain and tenderness localized to the outer hip area.
The inflammation is often triggered by repetitive friction or microtrauma. Common contributing factors include overuse from activities like running or cycling, spinal issues, or a difference in leg lengths that alters hip mechanics. Underlying muscle weakness or tightness can also increase the mechanical stress placed on the bursa. The condition is often grouped under the broader term Greater Trochanteric Pain Syndrome (GTPS).
The Mechanism of Relief Through Stretching
Stretching helps manage trochanteric bursitis by addressing the mechanical friction that causes inflammation. The primary goal is to reduce tension in the muscles and connective tissues that pass over the greater trochanter. When muscles, particularly the gluteals and the tensor fasciae latae, become tight, they pull the thick band of fascia known as the Iliotibial (IT) band taut.
This increased tension directly presses and rubs against the underlying bursa, creating repetitive stress. Targeted stretching loosens these tight structures, decreasing the pressure and friction applied to the inflamed sac. Reducing this mechanical load allows the bursa to rest and begin the healing process.
Specific Targeted Stretches and Strengthening
Effective management of hip bursitis requires a dual approach incorporating both stretching and strengthening exercises. Stretches restore flexibility to tight hip and lateral thigh muscles, while strengthening builds stability for long-term prevention.
Targeted Stretches
A key stretch is the standing Iliotibial Band stretch. Cross the unaffected leg in front of the painful leg and lean away from the affected side until a gentle pull is felt along the outer hip. Hold this position for 15 to 30 seconds and repeat several times.
Another beneficial stretch is the gluteal or figure-four stretch, which targets the piriformis and deeper gluteal muscles. Lying on your back, place the ankle of the affected leg over the opposite knee and gently pull the thigh toward your chest. Hold the stretch for 15 to 30 seconds.
Strengthening Exercises
The clamshell exercise targets the gluteus medius, a hip abductor muscle crucial for stabilizing the pelvis during walking. Lie on your side with bent knees and lift the top knee while keeping the feet together. Perform 8 to 12 repetitions, holding the lift for a few seconds each time. Strengthening exercises like side-lying leg lifts and straight leg raises also build muscle around the hip joint, providing support to lessen stress on the bursa.
When to Seek Professional Help
If pain persists for longer than one to two weeks despite incorporating rest and targeted exercises, consult a healthcare provider. Seek immediate medical attention if you experience signs of a potential infection, such as fever, chills, increased swelling, or spreading redness around the hip joint.
A physical therapist can identify specific biomechanical issues, such as weakness in the hip abductors, and create a treatment plan. When conservative methods are insufficient, medical treatments may include non-steroidal anti-inflammatory drugs (NSAIDs) or a corticosteroid injection directly into the bursa to reduce inflammation. In rare instances where pain is severe, an orthopedic specialist may discuss minimally invasive procedures to remove the inflamed bursa.