Working Out with Hip Bursitis: Safe Exercise & Recovery

In this article, you will find out everything you need to know about hip bursitis and the most effective ways to treat it, including an advanced treatment called Prolotherapy.

What is Hip Bursitis?

Hip bursitis is a common cause of hip pain, especially in active adults and older individuals. It occurs when one of the bursae—small, fluid-filled sacs that cushion the bones, tendons, and muscles near your hip joint—becomes inflamed. The most frequently affected bursa is the trochanteric bursa, located on the outer side of the hip, but the iliopsoas bursa at the front of the hip can also be involved.

Bursae help reduce friction and allow smooth movement. When inflamed, they cause pain, tenderness, and sometimes swelling, making activities like walking, running, or even lying on your side uncomfortable.

Symptoms of Hip Bursitis

• Pain on the outside of the hip, especially when lying on the affected side
• Tenderness to touch over the greater trochanter (bony point of the hip)
• Sharp or burning pain that may radiate down the thigh
• Stiffness or aching after prolonged sitting or activity
• Swelling or warmth over the hip (less common)
• Pain that worsens with walking, climbing stairs, or standing up from a seated position

Symptoms may develop gradually or suddenly, often worsening with repetitive use or after an injury.

Causes & Risk Factors

Hip bursitis can be triggered by a variety of factors, including:

• Repetitive activities: Running, cycling, or standing for long periods
• Direct trauma: Falls or blows to the hip
• Muscle imbalances or weakness: Especially in the gluteal muscles
• Leg length differences
• Arthritis or spinal conditions
• Obesity
• Previous hip surgery
• Age-related degeneration
• Inflammatory conditions: Such as rheumatoid arthritis

Women and middle-aged to older adults are more commonly affected¹.

Diagnosis

Diagnosis of hip bursitis is based on a combination of medical history, physical examination, and sometimes imaging. Your clinician will:

• Ask about your symptoms, activities, and any recent injuries
• Examine your hip for tenderness, swelling, and range of motion
• Perform special tests to distinguish bursitis from other hip conditions
• Order imaging (ultrasound or MRI) if needed to confirm the diagnosis or rule out other causes

Early diagnosis and treatment are key to preventing chronic pain and loss of function.

Can You Exercise with Hip Bursitis?

Yes, you can—and should—exercise with hip bursitis, but it’s important to choose the right activities. Exercise helps reduce pain, improve hip strength and flexibility, and prevent recurrence. However, certain movements can aggravate symptoms, so a tailored approach is essential.

Benefits of exercising with hip bursitis:

• Reduces inflammation and pain over time
• Strengthens supporting muscles, especially the glutes and core
• Improves joint mobility and function
• Prevents future flare-ups
• Supports overall health and weight management

Always consult a healthcare professional before starting or modifying your exercise routine.

Safe Exercises for Hip Bursitis

The following exercises are generally safe and beneficial for people with hip bursitis. Start slowly and increase intensity as tolerated. If any exercise causes sharp pain, stop and consult your clinician.

1. Hip Abductor Strengthening

• Side-Lying Leg Raises: Lie on your unaffected side, lift the top leg up slowly, hold for 2 seconds, and lower. Repeat 10-15 times per side.
• Standing Hip Abduction: Stand upright, hold onto a chair, and move your affected leg out to the side. Hold for 2 seconds, return. Repeat 10-15 times.

2. Gluteal Strengthening

• Bridges: Lie on your back with knees bent, feet flat. Lift hips up, squeeze glutes, hold for 3 seconds, lower. Repeat 10-15 times.
• Clamshells: Lie on your side with knees bent, feet together. Open knees while keeping feet together, hold, and return. Repeat 10-15 times.

3. Hip Flexor and IT Band Stretching

• IT Band Stretch: Stand, cross the affected leg behind the other, lean away from the affected side. Hold for 20-30 seconds, repeat 2-3 times.
• Piriformis Stretch: Lie on your back, cross the affected leg over the opposite knee, gently pull the knee toward your chest. Hold for 20-30 seconds.
• Hip Flexor Stretch: Kneel on one knee, other foot in front. Gently push hips forward until you feel a stretch in the front of the hip. Hold for 20-30 seconds.

4. Balance & Core Stability

• Single Leg Stance: Stand on the affected leg, hold for 10-30 seconds. Repeat 3 times.
• Planks: Hold a plank position for 10-30 seconds, focusing on core engagement.

5. Low-Impact Cardio

• Swimming or water aerobics: Reduces joint stress while improving fitness.
• Stationary cycling: Use low resistance and avoid high-intensity sprints.
• Elliptical trainer: Provides a smooth, low-impact workout.
• Walking: On even surfaces, at a comfortable pace.

Tip: Consistency is key. Perform these exercises 3-5 times per week for best results².

Exercises to Avoid with Hip Bursitis

• High-impact activities (running, jumping, plyometrics) during flare-ups
• Deep squats or lunges that cause pain
• Leg presses with heavy weights
• Stair climbing machines if they aggravate symptoms
• Any exercise that causes sharp, stabbing pain in the hip

Modify or skip exercises that worsen your symptoms. Listen to your body and progress gradually.

Tips for Working Out Safely

• Warm up thoroughly before exercise (5-10 minutes of gentle movement)
• Use proper form and technique
• Start with low resistance and gradually increase as tolerated
• Include rest days to allow for recovery
• Apply ice after exercise if you experience soreness
• Wear supportive footwear
• Consider working with a physiotherapist or exercise specialist

Remember: The goal is to stay active without aggravating your hip bursitis.

Treatments for Hip Bursitis

In addition to exercise, several treatments can help manage hip bursitis:

• Rest and activity modification: Avoid activities that aggravate symptoms.
• Ice therapy: Apply ice packs for 15-20 minutes, 2-3 times daily to reduce inflammation.
• Non-steroidal anti-inflammatory drugs (NSAIDs): For pain and swelling, as advised by your doctor.
• Physical therapy: Tailored rehabilitation to restore movement and strength.
• Corticosteroid injections: For short-term relief in severe cases.
• Shockwave therapy: May help chronic or resistant cases.
• Prolotherapy: See below for details.

Case Studies

Case Study 1: Prolotherapy for Chronic Hip Bursitis

Background: A 55-year-old runner with a year-long history of hip pain diagnosed as trochanteric bursitis.
Treatment: After three prolotherapy sessions at ProHealth Clinic, pain reduced by 90% and the patient returned to running within 8 weeks.
Outcome: At 6-month follow-up, the patient remained pain-free and had resumed all activities.

Case Study 2: Exercise and Prolotherapy Combination

Background: A 42-year-old office worker with persistent hip pain failed to improve with physiotherapy alone.
Treatment: After adding prolotherapy, pain scores dropped from 8/10 to 1/10, and function was fully restored within 3 months.
Outcome: The patient returned to regular gym workouts and reported no recurrence at 1-year follow-up.

Case Study 3: Rapid Relief in a Manual Worker

Background: A 60-year-old builder developed acute hip bursitis after a fall.
Treatment: Early intervention with prolotherapy and physiotherapy.
Outcome: Returned to work within 4 weeks, with full pain resolution and no further episodes.