Safe Stretches & Exercises for Hip Bursitis

How Stretches and Exercise Help

There are a lot of great benefits to regular exercise when you are diagnosed with hip bursitis. These benefits include:

• Increased blood flow to boost healing potential
• Reduced inflammation of the affected hip bursa
• Decreased hip pain
• Increased strength in the hip muscles and other affected leg muscles
• Increased range of motion
• Improved muscular balance and coordination
• Prevention of injury
• Boost overall quality of life

Hip Stretches

Here are some gentle stretches to improve flexibility and reduce hip pain. You should do these daily and prior to any hip exercises.

Figure 4 Stretch

This stretch is for the outside of your hips. It can be aggravating so start slowly and gently. Lie on your back with your knees bent and feet flat on the floor. To stretch the left hip, lift your left leg off the ground and rest the outside of your ankle on the top of your right knee. If this is comfortable, next  lift your right foot a few inches off the ground until you can reach behind your right thigh with both hands. Gently pull your right leg up toward your chest until you feel a stretch in your left hip/buttocks. Hold and switch to the right side when you’re ready.

Hold for 30+ seconds for 2-3 sets on each leg. If you have trouble tolerating this stretch on your back, you can also try it while sitting- bringing your chest toward your legs in this particular position.

Kneeling Hip Flexor Stretch

Stretching the hip flexors on the front of your hips is a great way to restore balance in the hips. Start on your knees and then bring one leg in front of you so that you can place your foot flat on the floor with your knee bent at a 90 degree angle so that you are in a half-kneeling position. Keeping the back flat and knees aligned with the toes, shift your weight forward as you extend the back hip. Continue shifting until you feel a stretch in the back leg down the front of your hip.

Hold for 30+ seconds for 2-3 sets on each leg. Alternatively, you can try this stretch in a full standing lunge position to add a strengthening component as well. Focus on breathing and staying relaxed.

IT Band Stretch

This iliotibial band stretch addresses many of the tissues directly affected by hip bursitis, so move cautiously. Start by lying down on your back with a stretch strap or towel and legs out straight on the floor. Place the foot of the leg you want to stretch in the strap. Straighten your knee and bring your thigh up toward the ceiling. Then, let that leg rotate across the body until you feel a stretch in the side of the thigh. The thigh should be perpendicular to the body as you keep your shoulders firmly touching the ground.

Hold for 30+ seconds for 2-3 sets on each leg. If you’re having a hard time coordinating the stretch lying down, try stretching against a wall in standing instead. Simply stand with the hip you want to stretch next to the wall and cross it behind the other leg. Then, bring your hips closer to the wall.

Hamstring Stretch

The hamstrings tend to get stiff with hip bursitis so this stretch will give you some relief. Lie on your back with a stretch strap, towel, or belt and feet flat on the floor. Wrap the strap around your heel and straighten your knee. Then, bring your entire straight leg up toward the ceiling and your chest until you feel a strong stretch in the back of the leg.

Hold for 30+ seconds for 2-3 sets on each leg.

Strengthening Exercises

Some of the most common issues that can cause or aggravate hip bursitis involve weakness in the hip area, glutes, front thigh muscles and core. A good exercise program should incorporate these key areas while also building full body coordination and lower body strength.

Exercises You Should Avoid with Hip Pain

Lateral Leg Raises

Strengthening the hip abductors is essential for recovery- start cautiously. Lie on your side with the leg you want to strengthen on top. Bend the bottom leg for support and tighten the abs. Then, lift the top leg straight up toward the ceiling as high as possible while keeping good form. Make sure to keep the thigh in line with the entire body (no hip flexion) and stabilize with your abs to prevent rotation in the spine.

Repeat for 10-15 repetitions for 2-3 sets on each leg. You should feel the muscles in the side of your hip working (where the outer edge of your pants pocket would be). Don’t force this move if it causes pain.

Clamshells

This is an exercise that specifically targets the hip rotator. Lie on your side with the hip you want to work on top. Stack your legs and bend the hips and knees to approximately 45 degrees each. Tighten the abs to prevent rotation of the spine. Then, keep the ankles touching as you lift the top knee up toward the ceiling and then close like a clam. Only lift as high as you can move without pain or rotation of the spine.

Repeat for 10-15 repetitions for 2-3 sets. To progress, you can add a loop band around the knees.

Glute Bridges

This is a great gluteal and core strengthening exercise. Lie on your back with the knees bent and feet flat on the floor hip width apart. Tighten your abs and squeeze your butt as you lift your hips off the ground. Lift as high as you can without arching the back. Keep the move slow and controlled as you return to the starting position and repeat.

Complete 15 repetitions for 2-3 sets. To progress, try single leg bridges.

Alternating Leg Kicks

This is one of many great variations for strengthening the core, particularly the abs. Lie on your back with the hip joint and knees off the ground at 90 degrees. Tighten your abs by drawing your belly button toward your spine and hold (while still breathing). Then alternate straightening one leg out toward the floor and hovering it 6-12 inches above the ground, before returning to the starting position. If your lower back arches, modify how far your leg goes down toward the floor.

Repeat 10 times on each leg for 2-3 sets. If this is too difficult, start with straight leg raises.

Single Leg Balance

Standing balance is a great way to practice full body coordination while keeping a good hip posture. Stand near a chair or table for balance and shift your weight into one leg. Lift the opposite leg and hold. Focus on keeping your waistband parallel with the floor to reduce strain on the outside of the hip joint.

Hold for 30-60 seconds for 2-3 seconds on each leg. To progress, try standing on a foam balance pad.

Physical Therapy

While there are many different possible treatment options, one of the best conservative options is physical therapy. There are many potential benefits to getting professional guidance from a movement specialist including quicker recovery and preventing onset of chronic pain.

More Ways to Treat Hip Bursitis Pain

When Should I See a Physical Therapist?

A physical therapist can help you in any stage of your hip bursitis process. Both acute and chronic hip pain can be addressed in a physical therapy clinic. Typically, people seek care when they are not recovering with home self-treatment or their pain is moderate to severe. A physical therapist may be able to recognize faulty movement patterns that you can correct to boost the healing process and get back to your daily activities more efficiently.

What to expect

A physical therapist will perform an in-depth assessment. This helps determine your specific deficits and what is causing your hip joint pain. That way a comprehensive treatment program can be designed to address underlying issues, promote optimal healing, and prevent chronic pain or further aggravation. A major piece that your therapist will also address is education to help you understand your injury and how to prevent aggravation.

Staying Safe While Exercising

Exercise is a critical part of hip bursitis recovery. Restoring functional strength and flexibility in the lower leg will help you get back to your favorite activities. Always start slowly with daily stretching and add in strengthening and progressions as you feel comfortable. If you aren’t noticing any improvements in 1-2 weeks, symptoms are getting worse, or your quality of life is worsening, talk to your orthopedic doctor or physical therapist for further medical advice.