How to get out out of Hip Bursitis Pain, for good.

hip bursitis Nov 25, 2022
Hip Bursitis Exercises

Are you feeling lost after getting diagnosed with hip bursitis? What even is hip bursitis? Should you get injections? Can exercise help?

Most importantly, how the BLOODY HELL do you get rid of this nagging chronic hip pain?

I will answer these questions in this article.  Why trust me? For starters, I beat my own chronic hip pain after years of trying many things that didn’t work. 

I know how frustrating it can be to get diagnosed with something by doctors and then not get  help with what actually matters. The PAIN. 

I now help hundreds of people get out of chronic hip pain every year. 

Many of these people were diagnosed with hip bursitis, along with FAI, hip labral tear and arthritis.  

As you’ll learn below, it’s not the diagnosis that matters but the pain we experience. The goal is to get rid of the PAIN and not necessarily the bursitis. 

What is bursitis in the hip? 

The Mayo Clinic defines bursitis as “a painful condition that affects the small, fluid-filled sacs — called bursae (bur-SEE) — that cushion the bones, tendons and muscles near your joints. Bursitis occurs when bursae become inflamed.” Source 1.

What causes these “bursae” to become inflamed? According to the Cleveland Clinic, common risk factors include injury to the hip, overuse of the problem area, poor posture such as scoliosis and other conditions like arthritis and bone spurs to name a few. Source 2.

This is the conventional wisdom. Hip bursitis occurs when these little sacs around your hip become inflamed. And they get inflamed from injury, overuse or underlying medical conditions.  The theory is that this inflammation causes pain. 

The problem with this theory however is that there is no objective way to diagnose bursitis.  Unlike something like strep throat where you can test a culture of the throat, there are no reliable ways to test for hip bursitis. 

When there is no way to diagnose something through reliable testing, any step taken after that is not based on logic.  Everyone is trusting something that does not make much sense. 

What is the harm in this? Treatment methods are based on getting a hip bursitis diagnosis.  And if the diagnosis is wrong, the treatment method will also be. 

Why a Hip Bursitis Diagnosis does not make sense. 

The first method to diagnose hip bursitis is physical examination. Typical physical tests administered include touching the area of discomfort,  the FABER test and resisted hip internal rotation test to name just a few.  Source 3.

These types of physical examinations are highly subjective. If someone pokes an aggravated area of the body, it will probably hurt right? 

What if someone pushes you into a range of motion you are already limited in? That might be uncomfortable too, right?

Just because someone experiences hip pain from being poked or from being placed in an extreme range of motion does not mean they have hip bursitis. 

One of these tests, the FABER test in particular, I’ve written in depth about here.  In this test, the symptomatic hip is placed in extreme hip external rotation. 

Most “normal people,” with or without chronic hip pain, will experience discomfort when an external force pushes them deep into hip external rotation. 

The second method is imaging tests, including X-rays and MRIs.  Bursitis cannot be seen on X-rays but they are used to rule out other pathologies. 

MRIs apparently “provide clear images of inflammation in the affected bursae and tendons and may be used to confirm the extent of an injury.” Source 4.

But a 2021 study from the European Journal of Radiology showed just the opposite.  The researchers in the study performed MRIs on fifty people with no history of hip pain.  One-third of all hips showed evidence of hip bursitis on MRI. Source 5.

What does this mean? You can have no hip pain and have hip bursitis. You can also have hip pain and no hip bursitis. 

MRIs are not a reliable testing method for hip bursitis.  The same has been shown for other chronic hip pain diagnoses like FAI, hip labral tears and arthritis

Hip Bursitis Symptoms are the same as other Hip Pain Conditions 

We now know that there is no reliable way to test for Hip Bursitis.  This is true if it is done by physical examination or if we get MRI imaging. 

But the symptoms of Hip Bursitis should make things more clear right?  If ONLY people with Hip Bursitis have a particular set of symptoms, then that would make it a helpful and straight-forward diagnosis. 

The symptoms of Hip Bursitis include achiness and stiffness in the affected hip, increase in pain when pressing on the affected area, pain that gets worse during physical activities and pain after long periods of sitting. Source 6. Source 7. Source 8

What are the symptoms for other chronic pain conditions like FAI, hip labral tear and osteoarthritis? Achiness and stiffness in the affected hip, increase in pain when pressing on the affected area, pain that gets worse during physical activities and pain after long periods of sitting.  Source 9. Source 10. Source 11. 

There is no difference in symptoms between any of the common hip pain diagnoses. The only difference is what is identified through medical imaging. But medical imaging is unreliable. Many people without hip pain have evidence of hip bursitis and other common chronic conditions like arthritis. 

Why Traditional Hip Bursitis Treatments Won’t “Cure” Hip Bursitis Pain 

Treating “hip bursitis pain” does not work because the reason for the pain is NOT hip bursitis.  For many people, pain is temporary and goes away within a few weeks. 

Many people reading this article probably don’t fall into that category however.  For many of you, you’ve likely been in hip pain for quite some time. 

Pain that lasts longer than 3 months is considered “chronic.” Source 12 So if you’ve been struggling with hip pain for longer than 3 months, you’re in the “chronic hip pain” category. 

And getting a diagnosis of hip bursitis for chronic hip pain won’t help you. This creates a misunderstanding of the problem.  

Many people diagnosed with hip bursitis now believe they have to “fix” or “cure” their hip bursitis.  

This can lead to many ineffective treatment methods like steroid injections, medications (unless the condition is from an infection), activity modification, use of a cane or worst of all, unnecessary surgery. 

The goal is to get out of hip pain, not to fix hip bursitis. This is true if you’ve been diagnosed with hip bursitis, arthritis, labral tears or whatever else. 

How do we heal chronic hip pain? By reintroducing balance and movement function to our entire body.  The exercises in the next section will help you get started. 

Hip Bursitis Exercises that actually work 

When I teach students how to beat chronic hip pain, the biggest challenge is mindset.  People in chronic joint pain want to fix their unique diagnosis. 

They want exercises to fix their hip bursitis, arthritis or what have you.  But this approach is too narrowly focused. 

Pain in one area of the body does not mean the problem is in that area. The body does not move one joint at a time.  

When we walk, the hip does not do its job while the shoulder and ankles wait for their turn. All joints and muscles in the body have to work together with good function in order to move pain-free.  

So why would we exercise in a way that's different? This is where the conflict arises.  The way out of hip pain requires a change in mindset. 

In one mindset, we look for exercises to fix our hip bursitis. 

In the second mindset, we (1) realize the hip bursitis diagnosis is irrelevant, (2) view our pain as just pain and (3) focus on exercises that bring balance and function back to the entire body. 

Adopting the second mindset is how I healed my hips after years of hitting a wall.  And when students in my Happy Hips program finally shift to this mindset, they can finally find healing as well. 

In the below section, I provide some example exercises to drive home this point.  Although we are targeting the hips, we integrate a full-body approach. This means we pay special attention to what the rest of the body is doing during the exercise. 

Rebalancing Exercises for Hip Bursitis 

The first set of exercises focus on bringing the ENTIRE body into better balance.  Try them out and take a little walk around the room afterwards to see how you feel. 

Hip Bursitis Stretches 

The second set of exercises focus on opening up the body and releasing any lingering tension.  Try them out and take a little walk around the room afterwards to see how you feel. 

Hip Bursitis Exercises PDF

Want a workout sheet for the above exercises to follow along with? Download the Hip Bursitis Exercises PDF

When you sign up, you’ll also get access to one more exercise to complete the workout. You will get a link to the exercise once you download the PDF. 

Conclusion: How long does it take to heal hip bursitis? 

Many people landing on this article probably didn’t get what they wanted. A quick and easy solution to hip bursitis. 

But the faster we face reality and deal with it, the less hardship we will have in the long run.  For some people, activity modification or injections work.  And that’s great.  Feeling better is the goal. 

For others dealing with chronic hip pain, conventional treatments for hip bursitis don’t work. Especially if you live an active lifestyle and want to keep it that way.  

The path out of chronic hip pain takes time. But after 3 months of integrating a daily movement and reflection practice, you will start seeing the light.  After 6 months, pain levels will reduce. 

And after a year of practice, you have a stronger and more resilient body and mind.  You won’t just “fix” your hip bursitis but you will also understand what pain-free movement feels like.