Trochanteric Bursitis: Causes, Symptoms and Treatment

Trochanteric bursitis hip bursitis: Trochanteric bursitis, today more correctly defined as greater trochanteric pain syndrome (GTPS), is one of the most frequent causes of lateral hip pain. It affects 10-25% of the population, with a clear female prevalence (4:1) between 40 and 60 years. For more information, consult the guide on hip anatomy.

It is a pathology often underestimated and confused with hip or spinal problems. Recent research has clarified that in most cases the problem is not just bursitis, but an associated gluteus medius tendinopathy.

Table of Contents

• What is Trochanteric Bursitis?
• Causes
• Symptoms
• Treatment
• Exercises
• Healing Times
• Frequently Asked Questions (FAQ)
• Related Articles
• Frequently Asked Questions
• Scientific References
• Sources and Scientific References

What is Trochanteric Bursitis?

Trochanteric bursitis is inflammation of the fluid-filled sac (bursa) on the outer hip near the greater trochanter, causing pain and tenderness over the lateral hip. The greater trochanter is the lateral bony prominence of the femur. The gluteus medius and minimus insert on it. GTPS includes:

• Trochanteric bursitis: inflammation of the synovial bursa
• Gluteal tendinopathy: the main cause in most cases
• Iliotibial band syndrome

To be distinguished from: hip osteoarthritis (groin pain, not lateral), piriformis syndrome (posterior pain), referred low back pain.

Causes

• Gluteal weakness: main cause — weak gluteus medius doesn’t stabilize the pelvis
• Pelvic alterations: lateral tilt, limb length discrepancy
• Overload: long walks, running, stairs
• Sudden increase in activity
• Overweight
• Postural habits: sleeping on side, crossed legs, leaning on one hip
• Scoliosis, chronic low back pain
• Kinetic chain dysfunctions

Symptoms

• Lateral hip pain over the trochanteric prominence
• Pain on direct palpation of the greater trochanter
• Nocturnal pain: unable to sleep on the affected side
• Pain when walking (after 10-15 min), going up/down stairs, getting up from chair
• Lateral radiation along the thigh (down to the knee)

Treatment

Physical Therapy (cornerstone of treatment)

• Progressive gluteus medius strengthening: the most effective intervention according to literature
• Iliotibial band and tensor fasciae latae stretching
• Manual therapy, postural re-education
• Focused shockwave therapy (growing evidence)

Medications and Injections

• NSAIDs in acute phase
• Corticosteroid injections: effective short-term (4-6 weeks) but temporary benefit. PRP promising.

Lifestyle Modifications

• Pillow between knees for sleeping
• Don’t cross legs, don’t lean on one hip
• Weight loss, cushioned shoes

Exercises

Phase 1 — Acute (Weeks 1-3)

Important warning: in this phase avoid aggressive iliotibial band stretching (can compress inflamed structures on the greater trochanter). Apply ice for 15 minutes after exercises. If in doubt, consult your doctor or physical therapist.

Exercise 1: Gluteus Medius Isometric

Difficulty: Easy | Equipment: Light elastic | Duration: 4 minutes

Starting position:
Supine on mat, knees bent to about 90 degrees, feet on ground shoulder-width apart. Elastic positioned just above knees.

Step-by-step execution:

1. Step 1: Push both knees outward against elastic resistance
2. Step 2: Maintain the push for 10 seconds without knees moving (isometric contraction)
3. Step 3: Release slowly for 5 seconds
4. Step 4: Repeat keeping pelvis well supported on ground throughout execution

Sets and repetitions: 3 sets x 10 repetitions of 10 seconds — 30 seconds rest between sets

Common mistakes to avoid:

• Lifting pelvis during push (this is not a bridge)
• Moving knees: contraction must be isometric (without movement)
• Compensating by arching the back

How to tell you’re doing it correctly:
You feel muscle work in the lateral part of the gluteus, in the greater trochanter area. You shouldn’t feel acute pain on the trochanter; if present, reduce push intensity.

Exercise 2: Low Intensity Bridge

Difficulty: Easy | Equipment: Mat | Duration: 4 minutes

Starting position:
Supine on mat, knees bent to about 90 degrees, feet on ground hip-width apart, arms extended along sides.

Step-by-step execution:

1. Step 1: Contract glutes and slowly lift pelvis from floor
2. Step 2: Rise until forming a straight line from shoulders to knees
3. Step 3: Hold position for 5-10 seconds, actively contracting glutes
4. Step 4: Lower pelvis slowly to ground and repeat

Sets and repetitions: 3 sets x 10 repetitions — 30 seconds rest between sets

Common mistakes to avoid:

• Excessively arching lumbar region during lift
• Pushing primarily with feet activating posterior thigh muscles instead of glutes
• Lifting pelvis too high beyond straight shoulder-knee line

How to tell you’re doing it correctly:
Muscle work concentrates in glute area, not posterior thigh or lumbar region. Pelvis lifts symmetrically without lateral inclinations.

Exercise 3: Clamshell in Unloaded Position

Difficulty: Easy | Equipment: Mat, pillow | Duration: 4 minutes

Starting position:
Lying on healthy side (unaffected side down), hips bent to about 45 degrees, knees bent to 90 degrees. Pillow between knees. Head resting on arm or pillow.

Step-by-step execution:

1. Step 1: Keeping feet together, open upper knee (affected side) upward like a shell
2. Step 2: Lift until feeling lateral glute work, without rotating pelvis
3. Step 3: Hold for 3 seconds in maximum opening position
4. Step 4: Slowly return knee to starting position

Sets and repetitions: 3 sets x 10 repetitions — 30 seconds rest between sets

Common mistakes to avoid:

• Rotating pelvis backward during knee opening (pelvis must remain stable and perpendicular to floor)
• Separating feet from each other: only the knee opens
• Opening knee too much compensating with trunk rotation

How to tell you’re doing it correctly:
You feel muscle work in the lateral and posterior part of the glute, just behind and above the greater trochanter. Pelvis remains stable throughout the movement. After repetitions, the gluteal area is slightly fatigued.

Phase 2 — Strengthening (Weeks 4-8)

Exercise 4: Clamshell with Elastic

Difficulty: Intermediate | Equipment: Mat, resistance elastic | Duration: 4 minutes

Starting position:
Lying on healthy side, hips bent to 45 degrees, knees bent to 90 degrees. Elastic positioned just above knees.

Step-by-step execution:

1. Step 1: Keeping feet together, open upper knee upward against elastic resistance
2. Step 2: Reach maximum opening without rotating pelvis
3. Step 3: Hold for 2 seconds
4. Step 4: Slowly return knee controlling descent against elastic

Sets and repetitions: 3 sets x 12-15 repetitions — 30 seconds rest between sets

Common mistakes to avoid:

• Using too resistant elastic that forces compensating with pelvis
• Letting knee return down too quickly (return phase must be controlled)
• Rotating trunk backward

How to tell you’re doing it correctly:
You feel burning sensation or fatigue in lateral part of glute after 10-12 repetitions. Pelvis remains stable throughout exercise.

Exercise 5: Hip Abduction in Lateral Lying

Difficulty: Intermediate | Equipment: Mat | Duration: 4 minutes

Starting position:
Lying on healthy side, lower leg bent for stability, upper leg (affected side) straight with flexed foot (toes toward shin).

Step-by-step execution:

1. Step 1: Lift upper leg toward ceiling, keeping it in line with trunk (don’t bring forward)
2. Step 2: Reach height of about 30-40 cm from floor
3. Step 3: Hold for 2 seconds
4. Step 4: Lower slowly without completely resting leg

Sets and repetitions: 3 sets x 12 repetitions — 30 seconds rest between sets

Common mistakes to avoid:

• Bringing leg forward during lift (must rise laterally)
• Tilting trunk backward to lift leg higher
• Rotating foot upward (flexed foot maintains correct gluteus medius activation)

How to tell you’re doing it correctly:
Muscle work concentrates in lateral part of glute. Leg rises in controlled manner and straight line. After sets, you feel fatigue in lateral gluteal area.

Exercise 6: Single Leg Bridge

Difficulty: Intermediate | Equipment: Mat | Duration: 5 minutes

Starting position:
Supine on mat, one leg bent with foot on ground, other leg lifted with knee extended (or bent to chest).

Step-by-step execution:

1. Step 1: Contract glute of supporting leg and lift pelvis
2. Step 2: Reach position where body forms straight line from shoulder to knee
3. Step 3: Hold for 3-5 seconds keeping pelvis horizontal (without lateral inclinations)
4. Step 4: Lower slowly and repeat

Sets and repetitions: 3 sets x 8-10 repetitions per side — 45 seconds rest between sets

Common mistakes to avoid:

• Letting pelvis drop laterally toward side of lifted leg
• Excessively arching back to compensate for lack of gluteal strength
• Performing movement too quickly

How to tell you’re doing it correctly:
Pelvis remains perfectly horizontal throughout lift. Muscle work concentrates in glute of supporting leg. If pelvis tends to drop to one side, return to classic two-leg bridge.

Exercise 7: Squat with Elastic at Knees

Difficulty: Intermediate | Equipment: Resistance elastic | Duration: 4 minutes

Starting position:
Standing, feet shoulder-width apart, elastic positioned just above knees. Arms forward or at chest for balance.

Step-by-step execution:

1. Step 1: Actively push knees outward against elastic
2. Step 2: Descend into squat by bending hips and knees, as if sitting on a chair
3. Step 3: Reach comfortable depth (hips parallel to floor or less, according to abilities)
4. Step 4: Rise by pushing from heels, keeping knees open against elastic

Sets and repetitions: 3 sets x 12 repetitions — 45 seconds rest between sets

Common mistakes to avoid:

• Letting knees collapse inward yielding to elastic resistance
• Lifting heels during descent
• Excessively leaning trunk forward

How to tell you’re doing it correctly:
You feel muscle work in lateral glute area (gluteus medius) as well as quadriceps. Knees remain aligned or slightly outward relative to feet throughout movement.

Exercise 8: Lateral Step-Up

Difficulty: Intermediate | Equipment: Step or platform (15-20 cm) | Duration: 4 minutes

Starting position:
Standing next to low step or platform (15-20 cm), with affected leg positioned on step. Body faces forward, not toward step.

Step-by-step execution:

1. Step 1: Transfer weight to leg positioned on step
2. Step 2: Step up by pushing from heel, fully extending hip and knee
3. Step 3: Control pelvis: must remain horizontal without dropping to opposite side
4. Step 4: Step down slowly controlling descent with leg on step

Sets and repetitions: 3 sets x 10 repetitions per side — 45 seconds rest between sets

Common mistakes to avoid:

• Pushing with ground leg instead of leg on step
• Tilting pelvis laterally (Trendelenburg sign: indicates gluteus medius weakness)
• Using too high step in initial phases

How to tell you’re doing it correctly:
Pelvis remains stable and horizontal during step-up. You feel muscle work in glute of supporting leg. Movement is controlled without oscillations.

Phase 3 — Functional (Weeks 9+)

Exercise 9: Lunges in All Directions

Difficulty: Advanced | Equipment: None | Duration: 6 minutes

Starting position:
Standing with upright posture, feet hip-width apart, hands on hips or at chest.

Step-by-step execution:

1. Step 1: Forward lunge: take long step forward with affected leg, bend both knees to 90 degrees, return to starting position
2. Step 2: Lateral lunge: take wide step laterally with affected leg, bend knee of advancing leg keeping other straight, return
3. Step 3: Reverse lunge: take long step backward with opposite leg, bend both knees, return
4. Step 4: Complete all repetitions in each direction before moving to next

Sets and repetitions: 3 sets x 10 repetitions per direction and per side — 60 seconds rest between sets

Common mistakes to avoid:

• Letting knee go past foot tip in forward lunges
• Losing lateral balance in lateral lunges (proceed gradually with width)
• Not controlling knee that tends to collapse inward

How to tell you’re doing it correctly:
Knee remains aligned with foot in all directions. Pelvis is stable without inclinations. You feel muscle work in glutes, quadriceps and hip stabilizing muscles.

Exercise 10: Monster Walk with Elastic

Difficulty: Intermediate | Equipment: Resistance elastic | Duration: 4 minutes

Starting position:
Standing with elastic around ankles (or just above knees to facilitate), feet shoulder-width apart, knees slightly bent in half-squat position.

Step-by-step execution:

1. Step 1: Take wide lateral step with right leg, maintaining elastic tension
2. Step 2: Bring left leg closer without ever losing tension (feet never come completely together)
3. Step 3: Continue in same direction for 15 steps
4. Step 4: Reverse direction and return for 15 steps

Sets and repetitions: 3 sets x 15 steps per direction — 45 seconds rest between sets

Common mistakes to avoid:

• Straightening knees during walk (must remain bent)
• Dragging feet instead of taking controlled, wide steps
• Tilting trunk laterally with each step

How to tell you’re doing it correctly:
You feel strong activation of lateral glutes (gluteus medius) after few steps. Trunk remains stable and vertical. Burning sensation in lateral glute area is completely normal and desirable.

Exercise 11: Single Leg Deadlift

Difficulty: Advanced | Equipment: None (optional: light dumbbell) | Duration: 5 minutes

Starting position:
Standing on one leg (start with affected leg as supporting leg), other leg slightly lifted behind. Arms at sides.

Step-by-step execution:

1. Step 1: Slowly tilt forward with trunk, bringing posterior leg upward
2. Step 2: Reach position where trunk and posterior leg form line parallel to floor (“T” position)
3. Step 3: Hold for 2 seconds keeping pelvis horizontal
4. Step 4: Slowly return to upright position controlling movement

Sets and repetitions: 3 sets x 8-10 repetitions per side — 60 seconds rest between sets

Common mistakes to avoid:

• Rotating pelvis toward side of lifted leg (pelvis must remain horizontal)
• Excessively bending knee of supporting leg
• Losing balance: start with one hand against wall for safety

How to tell you’re doing it correctly:
You feel gluteus medius work in supporting leg to maintain stability. Pelvis remains horizontal throughout range. Balance improves progressively over weeks.

Exercise 12: Single Leg Balance

Difficulty: Intermediate | Equipment: None | Duration: 3 minutes

Starting position:
Standing with upright posture, feet hip-width apart, hands on hips.

Step-by-step execution:

1. Step 1: Lift one leg bending knee to 90 degrees
2. Step 2: Maintain balance on supporting leg for 30-60 seconds
3. Step 3: Focus on keeping pelvis horizontal without lateral inclinations
4. Step 4: Repeat on other side

Sets and repetitions: 3 repetitions of 30-60 seconds per side — 15 seconds rest between repetitions

Common mistakes to avoid:

• Resting lifted leg against supporting leg
• Compensating with trunk oscillations
• Looking down: keep gaze fixed on point ahead to facilitate balance

How to tell you’re doing it correctly:
Pelvis remains horizontal (without dropping to side of lifted leg). Balance improves over time, allowing progression from 30 to 60 seconds and then closing eyes as advanced progression.

Healing Times

80-85% of patients recover with conservative treatment within 3-6 months.

You might also be interested in: Knee Pain: Complete Guide — causes, diagnosis and rehabilitation

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Frequently Asked Questions (FAQ)

Frequently Asked Questions

What is trochanteric bursitis?

Trochanteric bursitis, more accurately termed greater trochanteric pain syndrome (GTPS), is a common cause of lateral hip pain. It frequently involves gluteus medius tendinopathy in addition to inflammation of the bursa.

Can trochanteric bursitis become chronic?

Yes, if left unaddressed or improperly managed, trochanteric bursitis can persist and become chronic. Early and appropriate intervention, particularly through physical therapy, is crucial for preventing long-term symptoms.

What is the role of physical therapy in treating trochanteric bursitis?

Physical therapy is considered the cornerstone of treatment for trochanteric bursitis. It focuses on progressive strengthening of the gluteal muscles, especially the gluteus medius, to improve hip function and pelvic stability.

Is trochanteric bursitis often confused with other conditions?

Trochanteric bursitis is frequently underestimated and can be confused with other hip or spinal problems, including sciatica. Recent research clarifies that it often involves gluteus medius tendinopathy, distinguishing it from simple bursal inflammation.

For a broader overview of related conditions, see our our comprehensive hip pain guide.

Scientific References

1. Grimaldi A, Fearon A. Gluteal Tendinopathy. J Orthop Sports Phys Ther. 2015;45(11):910-922.
2. Mellor R, et al. Education plus exercise versus corticosteroid injection. BMJ. 2018;361:k1662.
3. Ganderton C, et al. Gluteal Loading Versus Sham Exercises. J Womens Health. 2018;27(6):815-829.
4. Grimaldi A, et al. Gluteal Tendinopathy: A Review. Sports Med. 2015;45(8):1107-1119.
5. Segal NA, et al. Greater trochanteric pain syndrome: epidemiology. Arch Phys Med Rehabil. 2007;88(8):988-992.
6. Barratt PA, et al. Conservative treatments for GTPS. Br J Sports Med. 2017;51(2):97-104.
7. Fearon AM, et al. Defining the clinical syndrome. Br J Sports Med. 2013;47(10):649-653.
8. Rompe JD, et al. Home training, corticosteroid injection, or shock wave therapy. Am J Sports Med. 2009;37(10):1981-1990.
9. Plinsinga ML, et al. Psychological factors in gluteal tendinopathy. Clin J Pain. 2018;34(12):1109-1115.
10. Allison K, et al. Kinematics and kinetics in gluteal tendinopathy. Clin Biomech. 2016;32:56-63.

Sources and Scientific References

1. Lustenberger DP et al. (2011). Efficacy of treatment of trochanteric bursitis: a systematic review. Clin J Sport Med. 21:447-53. DOI | PubMed
2. Seidman AJ et al. (2026). Trochanteric Bursitis (Archived). .. PubMed
3. Grimaldi A et al. (2025). Gluteal tendinopathy masterclass: Refuting the myths and engaging with the evidence. Musculoskelet Sci Pract. 76:103253. DOI | PubMed
4. Grimaldi A et al. (2015). Gluteal Tendinopathy: Integrating Pathomechanics and Clinical Features in Its Management. J Orthop Sports Phys Ther. 45:910-22. DOI | PubMed
5. Williams BS et al. (2009). Greater trochanteric pain syndrome: a review of anatomy, diagnosis and treatment. Anesth Analg. 108:1662-70. DOI | PubMed