Hip Bursitis or more correctly called Trochanteric bursitis is a common cause of lateral hip pain, affecting individuals of all activity levels. It occurs due to inflammation of the trochanteric bursa, a fluid-filled sac that sits over the greater trochanter of the femur, reducing friction between the gluteal tendons and the iliotibial band (ITB).
At Adaptive Physiotherapy & Massage in Booragoon, we take an evidence-based approach to treating trochanteric bursitis, incorporating manual therapy, progressive strengthening, and movement retraining to ensure long-term relief and injury prevention.
What is Trochanteric Bursitis?
The trochanteric bursa is a protective sac that cushions the gluteal tendons as they pass over the greater trochanter (the prominent bony point on the outer hip). When irritated or inflamed, the bursa can cause localized pain, tenderness, and discomfort with movement.
Common Causes of Trochanteric Bursitis
- Overuse injuries (e.g., excessive running, cycling, or repetitive hip movements).
- Muscle imbalances (e.g., weak glutes, tight iliotibial band (ITB), or overactive tensor fasciae latae (TFL)).
- Poor biomechanics, such as excessive hip adduction, pelvic instability, or leg length discrepancies.
- Previous hip or lumbar spine injuries altering gait and load distribution.
- Direct trauma (e.g., a fall onto the hip or prolonged pressure on the bursa).
Symptoms of Trochanteric Bursitis
- Pain on the outer hip, worsened by pressure (e.g., sleeping on the affected side).
- Tenderness over the greater trochanter, painful to touch.
- Discomfort with prolonged walking, running, or climbing stairs.
- Pain with hip abduction or rotational movements.
At Adaptive Physiotherapy & Massage in Booragoon, we perform a detailed assessment to rule out other causes of lateral hip pain, such as gluteal tendinopathy, ITB syndrome, or hip joint pathology.
Levels of Trochanteric Bursitis
Mild (Early Stage)
- Occasional hip discomfort after activity.
- Localized tenderness over the trochanter.
- No major movement restrictions.
Moderate (Intermediate Stage)
- Persistent pain during daily activities (e.g., walking, climbing stairs).
- Increased tenderness with prolonged sitting or sleeping on the affected side.
- Reduced hip strength and flexibility.
Severe (Chronic Stage)
- Constant pain, even at rest.
- Significant mobility limitations affecting daily life.
- Possible compensatory movement patterns leading to secondary lower back or knee pain.
Evidence-Based Treatment for Trochanteric Bursitis
1. Initial Pain Management and Activity Modification
In the early stages, treatment focuses on reducing inflammation and minimizing aggravating movements.
Activity Modification:
- Avoid prolonged standing, walking on uneven surfaces, or excessive hip movements.
- Limit high-impact activities (e.g., running, jumping) until pain subsides.
Pain Reduction Strategies:
- Ice therapy (10–15 minutes, every 2–3 hours) to reduce inflammation.
- Heat therapy (after the acute phase) to promote blood flow and muscle relaxation.
- Anti-inflammatory techniques, including soft tissue release for surrounding muscles (TFL, ITB, and glutes).
2. Manual Therapy for Trochanteric Bursitis
Direct compression of the bursa can worsen inflammation rather than relieve it. Instead, treatment focuses on surrounding structures that contribute to bursal irritation.
Soft Tissue Release & Myofascial Therapy
- Gluteal release techniques to reduce tension in the gluteus medius and minimus.
- TFL and ITB release techniques to address excessive hip tightness and friction.
- Hip flexor release (if compensatory tightness is present).
Joint Mobilization
- Improves hip range of motion and pelvic stability.
- Helps restore proper movement patterns, reducing stress on the bursa.
Movement Re-Education
- Gait assessment and correction to minimize excessive hip adduction and pelvic drop.
- Postural adjustments to reduce repetitive stress on the hip.
3. Exercise Rehabilitation for Trochanteric Bursitis
A structured exercise program is essential to restore hip stability, correct imbalances, and prevent recurrence.
Strengthening Exercises
For muscle weakness and instability:
- Glute bridges (activates the posterior chain).
- Side-lying clamshells (targets the gluteus medius, reducing reliance on the TFL).
- Single-leg balance drills (improves neuromuscular control and SI joint stability).
For hip stability and load tolerance:
- Banded lateral walks (reinforces hip and pelvic stability).
- Step-ups with knee drive (integrates functional single-leg control).
- Controlled squats and lunges (to rebuild load tolerance without excessive hip adduction).
Neuromuscular Control & Movement Retraining
- Pelvic control drills to reduce excessive lateral hip movement during walking.
- Core stability exercises to engage the deep core and support hip and lumbar mechanics.
4. Return-to-Activity & Injury Prevention
As pain subsides and strength improves, the focus shifts to functional retraining and returning to full activity.
Sport-Specific & Functional Training:
- Progressive loading of hip muscles to build resilience against future irritation.
- Controlled impact drills to allow a gradual return to running, jumping, and lateral movements.
- Plyometric and agility training for athletes requiring explosive hip movement.
Long-Term Injury Prevention Strategies:
- Consistent glute and core strengthening to maintain pelvic stability.
- Regular mobility work, including foam rolling and dynamic stretching to reduce muscle tension.
- Monitoring workload and exercise intensity to avoid overuse injuries.
At Adaptive Physiotherapy & Massage in Booragoon, we ensure patients regain full function and avoid chronic flare-ups through progressive strength training and movement optimization.
Conclusion
Trochanteric bursitis can be painful and limiting, but with a structured rehabilitation plan, long-term relief and injury prevention are achievable. At Adaptive Physiotherapy & Massage in Booragoon, we use a scientific, individualized approach, incorporating manual therapy, progressive exercise rehabilitation, and movement retraining to eliminate pain and restore function.
If you are experiencing hip pain, lateral discomfort, or movement restrictions, contact Adaptive Physiotherapy & Massage in Booragoon to begin your personalized rehabilitation program today.
References
Fearon, A. M., et al. (2014). “Greater trochanteric pain syndrome: A review of diagnosis and management.” British Journal of Sports Medicine, 48(14), 1036-1044.
Grimaldi, A., et al. (2015). “Gluteal tendinopathy: Integrating pathomechanics and clinical features in management.” Journal of Orthopaedic & Sports Physical Therapy, 45(11), 910-922.
Strauss, E. J., et al. (2010). “Greater trochanteric pain syndrome.” Clinical Orthopaedics & Related Research, 468(7), 1739-1745.
Mellor, R., et al. (2018). “Exercise vs corticosteroid injection for greater trochanteric pain syndrome.” BMJ, 361, k1662.
Long, S. S., et al. (2013). “Diagnosis and management of trochanteric bursitis.” American Family Physician, 88(8), 525-530.
