How to Eliminate Pain from Trochanteric Bursitis | Precision Movement

How to Eliminate Pain from Trochanteric Bursitis

Exercises to Fix or Manage Pain from Hip Bursitis

By Coach E

ere’s how to eliminate pain from trochanteric bursitis, plus some hip bursitis exercises that will help move things along.

Sometimes our bodies’ own defense mechanisms can come back to hurt us. That’s the case in trochanteric bursitis, a common cause of lateral hip pain that can really slow you down. Instead of giving into the pain, here’s how to eliminate pain from trochanteric bursitis, plus some hip bursitis exercises that will help move things along.

What are Bursae?

Bursae are fluid-filled sacs of tissue that are present in some of your joints.

These sacs function kind of like the sliders you can use to move heavy furniture.

Placing the soft, slidable surfaces under the legs of a couch or a big cabinet helps make moving them a bit gentler on those hardwood floors.

trochanteric bursitis back pain

Like sliders under heavy furniture, bursae reduce friction.

They can do this in between your bones, muscles and tendons surrounding a joint and provide extra lubrication to help keep movements smooth. [1]

The amount of and exact location of bursae can vary a bit from person to person, and for a pretty cool reason…

Your body can create a bursa where it needs it! [2]

If there is a lot of friction building up in between a muscle and bone, your body might produce a bursa to help soften the blow.

Bursae of the Hip

Around 20 different bursae have been identified around the hip and pelvis, with some more common than others [3].

Some studies have suggested that the average may be six bursae per hip [4].

Most people have an iliopsoas bursa along the front of their hip, ischial bursae along the ischial tuberosities of the pelvis (their “sit bones”) and multiple bursae lining the various facets, or surfaces on their greater trochanter [5].

trochanteric bursitis - greater trochante

Your greater trochanter is a large bump near the top of your femur bone.

You might be able to feel your greater trochanter by running your palm
on the outside of your hip – it should feel like a notch [6].

This is where various muscles of your hip connect to your thigh.

It is the bursa located here, running along the outside of your greater trochanter that can become a problem for some.

What Causes Bursae Problems?

Although bursae are there to protect against friction, sometimes they can’t quite keep up.

If too much friction builds up in a bursa, it can become irritated, inflamed and painful – becoming a condition called bursitis.

When it comes to bursae on your greater trochanter, inflammation is usually caused by a double whammy of tightness in some muscles and weakness in others [7].

If your iliotibial band that runs along the outside of your thigh is tight, it can pull against the bursae on your greater trochanter a little too tightly [8] – and do so with every single step you take.

A weak gluteus medius can also contribute by allowing your hip to drop excessively when walking [9]. This poor form can also cause extra friction on your trochanteric bursae.

Because of your greater trochanter’s position and the movements involved in everyday, repetitive movements like walking, bursae located here are especially prone to bursitis.

As surrounding muscles and tendons in your hips rub against the inflamed bursa, you may start to feel the telltale pain of trochanteric bursitis the outside of your upper thigh…

How Do You Know It’s Bursitis?

Trochanteric bursitis usually causes pain felt over the greater trochanter, on your lateral upper thigh. This pain may start to spread elsewhere in your thigh if not dealt with [10].

The bursitis may also start to cause stiffness, trouble moving and pain when sleeping on the affected side.

The pain of trochanteric bursitis, sometimes called hip bursitis, can sometimes be confused with muscle or tendon pain – often of the tensor fasciae latae (TFL) or the gluteus medius.

But, as these issues have different causes, they will require different approaches to healing, so it’s important to tell them apart.

Issues in your glute med tendons will usually cause pain to the touch right above or superior to your greater trochanter [11] – instead of right over or superficial to it, like in bursitis.

Overuse of your TFL can also cause pain on the outside of your upper thigh, and as such, can be easily mistaken for trochanteric bursitis.

But, TFL pain more often feels like a typical sore muscle – like the sensation you might get the day after an hour at the gym.

Bursitis, on the other hand, will usually feel more sensitive to the touch – almost like a deep, painful bruise.

How to Manage Trochanteric Bursitis Pain

Once you’re convinced that hip bursitis is at play, it’s time to take some action to help yourself heal.

How you should approach the pain depends on what you are currently feeling.

If your pain is acute, meaning that it has appeared suddenly and is more “sharp” in nature, you’ll want to be a bit more conservative to start.

Once the acute pain has passed, and the sensation is more like a dull ache than a sharp jab, you can move on into the next phase of pain management, the post-acute phase.

Then finally, you can take things a step further when the pain lets up or plateaus.

Acute Pain Management Techniques

1) Avoid painful movements

Do not do any movements that hurt.

This will only exacerbate the condition and make your bursitis worse.

Pushing through painful movements will also increase the time required before you reach that pain-free place.

This means that if necessary, use crutches or a cane to help you get around pain-free when dealing with acute trochanteric bursitis pain.

2) Minimize compensatory movements

While it might be necessary to compensate a little bit when walking, especially when climbing the stairs, try to minimize this as much as possible.

By keeping changes in normal gait to a minimum, you’ll make your rehab faster and easier by strengthening the surrounding muscles.

This strengthening can help correct any weaknesses or postural habits that were contributing to bursitis in the first place.

3) RICE

Within the first 24 hours that pain develops, follow the tried and true RICE recipe.

trochanteric bursitis - rice method

This stands for Rest, Ice, Compress and Elevate.

Take it easy and give your hips and thighs a rest and use ice on the painful part of your leg.

You can also compress the painful area by wrapping it with a bandage or applying pressure, and use pillows or blankets to elevate your hip when sitting or lying down.

You can apply ice, compression and elevation for 15 minutes at a time at various periods throughout the day – whenever you get a chance and as often as feels good.

Post-Acute Management

1) Make sure movement is pain-free

At this point you want to avoid moving in a way that triggers your pain, but you will want to start to become more active than you were when pain was acute.

In other words, start to gently get back to your old habits, but play close attention to what your body is telling you.

If some movement or exercise you usually do causes pain, skip it.

If necessary, start with passive movement and build from there.

2) Ice when needed

If you’re still feeling some throbbing or swelling, continue to apply ice to the painful area.

And if you accidently trigger the pain somehow – maybe you accidently moved in a not-so-pain-free way – give it some ice.

 trochanteric bursitis - ice

3) Start to bring in gentle heat

Once the throbbing and swelling subside, you’re going to want to lay off the ice and switch to heat.

At this point, your pain will begin to switch from sensations of inflammation to feelings more akin to stiffness.

Application of heat will help you loosen you up and speed healing.

4) Start to supplement

Certain supplements can help your body heal when it is trying to recover from injury and inflammation.

Turmeric has been shown to help fight joint pain and inflammation, and one study even found it helped patients with knee osteoarthritis as well as ibuprofen did [12].

(PuraThrive is my favourite turmeric supplement if you’re looking for a good brand.)

trochanteric bursitis - remedy ginger

Fish oil can also help joint pain and inflammation, although it’s not as potent an anti-inflammatory as turmeric. I recommend going for a combined EPA + DHA option to help minimize pain, and aiming for about 3 grams of these a day.

5) Incorporate hip bursitis exercises

This Supine Banded Hip Traction exercise will help take the load off your bursa and increase blood flow to the area – which in turn helps get key nutrients and oxygen to promote healing.

Supine Banded Hip Traction

  1. Anchor a strength band low to the ground
  2. Sit on the floor and step your right leg through the band, crossing the band over the top of your foot
  3. Move back until there is good pull on the band, and lay down
  4. Use your left foot as a cushion so the right calf can rest on top
  5. Relax here for 2 to 3 minutes, allowing space to be created in the hip, then switch sides
  6. Do this exercise daily or multiple times a day for best results.

Management for When Pain Plateaus or is Decreasing

1) Stick with the heat

Like it did in the post-acute recovery phase, heat increases blood flow and promotes healing. At this point, your body is well on its way to recovery, and you just want to help ease it along.

Keep applying heat to help reduce the stiffness and keep blood flow up.

2) Amp up the non-painful movement

You still want to stay in a non-painful range, but it is probably time to start to ramp it up a little bit.

Start with the passive movement mentioned earlier, but as soon as possible, start to progress to active movement.

But just remember – once something leaves that “non-painful” range and starts to hurt – back off.

You don’t want to reinjure yourself just as you’re about to heal completely. Let the pain be a guide and respect what your body is telling you.

Keep Trochanteric Bursitis Pain Away

You should be well on your way to feeling better at this point, or the pain may be already completely gone.

To ensure hip bursitis doesn’t come back, you’ve got to restore proper function of your hip muscles from deep to superficial.

Hip bursitis exercises like the Supine Banded Hip Traction move above will help with this, as will other techniques that aim to strengthen your hip flexors.

Once proper function of your hip muscles is restored, then fundamental movement patterns can be corrected.

For example, if your glute med is strengthened, it won’t drop so much when you walk, which will reduce friction on the bursa of your greater trochanter, meaning a reduced chance of inflammation and bursitis.

Once you start to feel trochanteric bursitis pain, start to put these steps into motion ASAP – you’ll save yourself from a lot of discomfort and a lot of wasted time trying to heal improperly.

About the Author

Eric Wong (aka Coach E) is the founder of Precision Movement and has a degree in Kinesiology from the University of Waterloo. He's been a coach since 2005 and spent his early career training combat athletes including multiple UFC fighters and professional boxers. He now dedicates himself to helping active people eliminate pain and improve mobility. He lives in Toronto (Go Leafs Go!) with his wife and two kids and drinks black coffee at work and IPAs at play. Click here to learn more about Eric.