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Hip bursitis can be quite nagging when it won’t go away. It’s important to know what hip bursitis exercises to avoid and what exercises are okay to do while recovering from this condition.
You stretch and stretch, but still, the dull aching painful hip still comes back. And sometimes, with a vengeance. It’s impeding your everyday life — climbing stairs, walking around the house, or even sitting cross-legged hurts.
In cases like this, you may need to consider the possibility that you have hip bursitis.
Unfortunately, hip bursitis won’t be alleviated with excess stretching alone and it can be difficult to perform your regular exercise routine with this type of hip pain.
Luckily, there are still a few hip exercises you can do to treat hip bursitis and relieve any discomfort and strengthen your hip.
Let’s take a look at what these exercises for hip bursitis are and which hip bursitis exercises to avoid.
What Is Hip Bursitis?
Between your bones and connective tissues (such as ligaments and tendons), there sits a small, gel-like pillow.
This “pillow” is a fluid filled sac and acts as a sort of shock absorber for your joints — especially the hips, shoulders, and knees.
There are two primary fluid filled bursa sac locations in the hip:
- Greater trochanteric bursa
- Iliopsoas bursa
Bursitis at the greater trochanter, which is located on the outside of the hip, leads to trochanteric bursitis. Bursitis at the iliopsoas, which is located in the groin, leads to iliopsoas bursitis.
Bursitis within a given joint means there is excess inflammation of the bursa sac.
Trochanteric bursitis is more common to experience versus iliopsoas bursitis.
Hip bursitis pain can occur through a traumatic injury (like a fall) or repetitive wear and tear. Hip bursitis is often accompanied by a sharp pain that eventually becomes a constant dull ache over time.
There may be occasional tenderness around the hip or pain that extends from the hip down the side or back of your leg. This pain tends to feel worse after prolonged or repetitive activity as well.
What Causes Hip Bursitis?
There are a number of things that can cause hip bursitis, from a direct fall on your hip to running too many miles. Let’s take a look at some of those things that put you at risk.
While overuse and traumatic injuries are the most common, many individuals who suffer from arthritis and other degenerative diseases are likely to experience this type of hip pain.
Prior surgeries and biological causes should also be considered.
Any repetitive or cyclical motion of the hip that is performed over an extended time frame can lead to hip bursitis.
This includes cardio exercise machines (e.g., elliptical, bike, treadmill, stair stepper), weight bearing exercises, such as deep squats and lunges, and any exercises that puts too much pressure on the bursa sacs, such as repetitive leg lifts when you lie on your back or side.
If you’re a runner, poor running form should be considered as a possible reason for your hip bursitis.
This is where consulting with a healthcare professional, such as a physical therapist, can help to have a gait and running analysis performed.
When you walk and move, the iliotibial band (IT band) — an extension of your hip muscles that runs along the outside of the thigh and connects to the knee — slides back and forth over the hip joint. Right along the trochanteric bursa.
While the solution seems simple — simply taking pressure off the IT band — the execution is less so.
Temporary solutions to reduce friction include walking with a cane or minor stretching, such as an iliotibial band stretch.
However, there are long-term solutions and lifestyle changes that can help as well to prevent further tissue damage and relieve pain.
For instance, sleeping with a pillow between your legs can help relieve pressure every night. As well, certain daily exercises can help relieve pressure and strengthen the surrounding muscle to reduce hip pain.
Exercising with Hip Bursitis: Do’s and Don’ts
Dr. John Ryan, an orthopedic surgeon, and sports medicine specialist who focuses on hip preservation at The Ohio State University Wexner Medical Center claims there’s an underlying injury to a tendon or an impingement that is making hip bursitis worse.
“In most cases, it’s not bursitis that’s the primary culprit. It’s the tendons being the primary culprit,” Ryan says.
With that in mind, exercises that help strengthen the tendons and the muscles surrounding them and the hip joint can be helpful for alleviating hip bursitis symptoms.
Movements that move the leg outward help the IT band to relax in a non-compressed position. These are the better option according to Ryan.
“Aggressive stretching is probably not the best idea and can be counterproductive in some cases,” Ryan says.
Exercises to Avoid with Hip Bursitis
What scientists like Ryan are beginning to learn is that stretching or foam rolling the IT Band is ineffective in certain cases and can actually intensify the pain. When dealing with hip bursitis, it’s best to avoid exercises like the following:
- IT Band Stretch: When you’re stretching and leaning to one side, you tend to put more pressure on the bursa via the IT band.
- Glute Stretch: Stretching of the gluteal muscles compresses the IT band over the bone, hitting sore spots and creating more pain.
- Exercising with Poor Posture: Repetitive motion, especially in a poor posture, can cause increased pressure and strain on the impacted area.
- Cardio Machines: Most cardio machines for the lower body require an extended time performing a repetitive or cyclical motion. Those using a machine like this with hip bursitis will usually experience increased pain. You won’t have to give these machines up forever, just until your hip bursitis resolves.
- Running: Running with hip bursitis is too much of a high impact activity to allow for a quick recovery. If you continue running with hip bursitis, you’ll most likely cause severe pain and delay your healing. Taking a break from running while recovering for a few weeks, then slowly resuming your running routine is the best approach.
- Deep Squats and Lunges: Repetitive deep squats and lunges place an increased work load on the hip joints, as well as increase friction along the hip bursa. You can try modifying the depth of your squats and lunges initially, but if you’re still experiencing pain, then you may need to avoid these in your exercise program until your symptoms have resolved.
- Straight Leg Lifts While Lying Down: The leg is the heaviest limb on the body, so performing a repetitive straight leg lift, whether you’re on your back or side, requires an extreme amount of effort from the hip muscle. Performing this type of exercise in this position should be avoided with hip bursitis to reduce strain and friction forces on and around the hip.
- Outdoor Bicycling: Both indoor and outdoor bicycling are exercises to avoid while recovering from hip bursitis. Similar to running, although not as much of a high impact exercise, the workload required from the legs and hips in this repetitive motion will further irritate the inflamed bursa.
In order to combat these activities that aggravate hip pain, actively sit/stand in more neutral positions, avoid standing on one leg or leaning to one side, and avoid these other posture mistakes.
These simple changes to day-to-day movements that you’re probably not thinking about can actually make a difference.
Best Standing Hip Bursitis Exercises
While some stretching can be a short-term option to help alleviate the pain, strengthening the surrounding muscles will help keep the pain away.
Muscles that work well will protect joints from unnecessary wear and tear because muscle function and muscle balance help absorb the forces that affect the joints.
Regular exercise encourages good muscle function and can avoid potential joint pain over time.
Seeing as the most common type of hip bursitis is trochanteric bursitis, the following key in on trochanteric bursitis exercises to avoid.
1. Standing Ball Squeeze
- Stand up straight with your feet in a close, comfortable stance.
- Place a ball or rolled-up towel between your legs, just above the knees.
- Without shifting your feet, squeeze the ball or towel inward for 10 seconds. Relax.
- Avoid locking the knees out while in standing, keeping the knees slightly bent. This will avoid placing too much pressure on the knee joints.
- Repeat 5-10 times.
2. Standing Leg Kicks
- Stand upright with a chair or wall in front of you for support.
- Shift your weight to your left leg and then slowly lift your right leg out to the side.
- Be sure to not lean and maintain your upright posture the whole time.
- Repeat 10 times per leg.
- When your hip is ready, you can gently progress this exercise by adding a resistance band tied around the ankles.
3. Standing Buns Squeeze
- Stand up straight with your feet in a close, comfortable stance.
- Without actually shifting your feet, try to force the ground away with your heels. This will fire up all the muscles in your backside.
- Stay in this clenched position for 10 seconds. Relax.
- Repeat 5 times.
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4. Standing March
- Stand upright. While holding a chair or wall for support, slowly raise your right knee to hip-level (or as far as is comfortable) while keeping the left leg straight.
- Hold this position for a 3 seconds before placing your foot back on the floor and lifting the opposite leg.
- Repeat 10 times on each leg.
While these exercises are a great place to start, there are many other strategies to help reduce excess inflammation and reduce hip pain.
For example, aquatic aerobic exercises can help those in too much pain to perform standing exercises (as the water’s buoyancy makes moving easier on the joints).
If you find that doing any standing exercises makes your pain worse, then you may want to consider starting with hip bursitis exercises while sitting.
Another great option for exercising with hip pain is the stationary bike. If standing is too difficult at the moment, even with assistance, a bike can relieve that unnecessary pressure until you are strong enough to stand without pain.
Finally, one of the reasons hip pain can start is because of misalignment in your knee. By using a medical-grade knee compression sleeve, you can support your knees and hips more effectively to reduce the pressure and strain on your hips.
Something helpful to consider is that it is possible to prevent hip bursitis in the first place. It’s not that you need to avoid all cardio that involves repetitive or cyclical motion, seeing as the majority do; however, it will help to switch up your cardio routine, and not perform the same exact routine every day.
For example, alternate using the bike one day and running the next. You could switch off doing jogging in your neighborhood with aqua jogging in the pool.
Many of the exercises listed above are also good to do even if you don’t have hip bursitis but are trying to prevent it from occurring.
Keeping the hip joint as supported and stabilized as possible, while maintaining good muscle balance, is a sure-fire way to help prevent hip bursitis from occurring.
Can I still walk with hip bursitis?
You can still do day-to-day walking with hip bursitis, but try to avoid extended time frames walking around, as this may bother the hip. If you’re walking and the hip starts to hurt, be sure to take a rest.
What kind of hip exercises can I do in the pool for hip bursitis?
Lots! You can walk in the pool, practice small standing leg kicks, standing march, and many other exercises that can be practiced in a gym or home as well.
If you need further guidance, you can consult with a physical therapist at a location that has a pool for aquatic therapy.
Should I use ice or heat for my hip bursitis?
Ice would be best as part of what causes the bursitis is inflammation in the bursa.
Can I use resistance with exercises while I have hip bursitis?
Light resistance is fine as long as it doesn’t make your symptoms worse. If it does, then you may need to avoid resistance use temporarily.