Hip Bursitis

• A direct blow to the bursa from falling on the outside of the hip or on the buttocks, can produce inflammation and irritation.
• A fall onto the hip or bursa.
• Constant pressure from lying on the side of the bursa.
• Repeated stress or friction injury as the tendon rubs over the bursa during activity.
• Weakness of the muscles over the bursa.
• Complications from rheumatoid arthritis, osteoarthritis or gout.
• Infection of the bursa.
• Tightness in the hip, specifically the psoas hip flexor, iliotibial band and hamstrings.
• The bursa may become swollen as a response to other hip conditions.

• Pain and tenderness over the location of the bursa (especially on the outside of the greater trochanter bursae which may radiate down the outside of the thigh. The psoas bursae will produce groin pain while the ischial bursa may produce pain in the buttock area).
• Pain during activities that stress the bursa or causes stress to the tendons that are lubricated by the bursa, like kneeling, jumping, and running.
• Swelling, accompanied by loss of motion of the hip.

Physical therapy for hip bursitis must remain conservative at first to avoid further agitation. There should be a focus on rest, inflammation reduction and attempting to increase blood circulation to promote healing. Once inflammation is under control, a program of stretching and functional strengthening will begin, aiming to restore full motion, reduce imbalances by increasing strength and lowering the amount of stress on the tendons and bursae of the hip joint. Common physical therapy interventions in the treatment of Hip Bursitis include:

• Manual Therapeutic Technique (MTT) soft tissue massage, stretching and joint mobilization by a physical therapist to regain mobility and range of motion of the knee as well as to modulate pain.
• Therapeutic Exercises (TE) stretching and strengthening exercises to regain range of motion and strengthen muscles of the knee to support, stabilize and decrease the stresses placed on the burse and tendons of the hip joint.
• Neuromuscular Reeducation (NMR) aids by restoring stability and improving movement techniques and mechanics, such as kneeling, of the involved lower extremity to reduce stress on burase and tendons in daily activities.
• Modalities including the use of ultrasound, electrical stimulation, ice, cold laser and others to decrease pain and inflammation of the involved bursae.

A home program that includes strengthening, stretching and stabilization exercises to help the person perform daily tasks and advance to the next functional level.