This article is a transcribed edited summary of a video Bob and Brad recorded in April of 2023. For the original video go to https://www.youtube.com/watch?v=a6UFa2uC5Ao&t=56s
Mike: If you're experiencing hip pain specifically in the outer part of your hip, you may be suffering from hip bursitis.
Brad: Fortunately, there are exercises that we can do to relieve this pain, and we're going to show you them.
Mike: Yes, three of the top ones to help fix your bursitis.
Brad: Say no more, Mike. Let's go to work.
Mike: Okay. So, a bursa is a fluid-filled sac. This is represented in our model here. It is much, much smaller than this. We don't have a small little ball. But basically what it's going to be located for this area is on the greater trochanter or lateral side of the hip here. And if it gets irritated, it can get inflamed and cause a lot of pain.
Brad: Yeah. And I think I can add that we have bursae throughout our bodies, near the joints, and their job is to lubricate. Either a ligament or a tendon goes over the top of it, and it keeps the tendon or the ligament from getting worn out if you will. And again, they're filled with a lot of nerve endings, and they can be very sensitive when inflamed.
Mike: So, a common muscle or tendon area that can cause friction on this bursa is called the IT band, and it typically runs from the lateral knee, and connects into the tensor fascia lata, which goes up around the lateral hip. When that gets tight on people, it can cause a lot of friction in this area and cause pain.
Brad: Right. So, if you look at the stripes on my pants, that's exactly where the IT band goes. Starts at the knee, just below the joint, and goes up. And again, the tensor fascia lata muscle. Bob always likes that muscle. It does connect up here. So, yeah, that is all part of the anatomy.
Mike: Another common cause of hip bursitis can be femoral anterior glide syndrome, which means your femoral head here is forward in the socket, not sitting where it's meant to be. This puts a lot of excess pressure on the front muscles here and could put more stress on this bursa as well.
Brad: That's right. So, when that starts to become unstable, then really, we get more irritation to that bursa. So, that's another component of how we're going to remedy this.
Mike: And we're going to show you a couple of exercises or stretches to fix both of these problems.
Brad: Say no more. Let's go to work.
Mike: So, the first stretch we're going to show is going to work the IT band, but it's also a hip flexor stretch, and we've shown it in many other videos. So, what you're going to do is you're going to lay down on your back, bring both knees to your chest to start, and you're going to drop one leg off the edge of the mat and try to bend it to 90 degrees. So, this is stretching my hip flexor now, but Brad, do you want to talk about how it integrates the IT band?
Brad: Right. Yeah. And you can do this off the edge of your bed. If your bed is firmer, it works a little bit better. But one thing that Mike was talking about, is if your knee tends to pull out to the side, that's an indication that your IT band is tight and we want to make sure that it's stretched out, and this will get that hip flexor. Try to keep the knee in, and then we'll show you an exercise to stretch that IT bend as well.
Mike: A couple of other points to notice is, keep your leg in a nice straight line with your arm here. Try to bend your knee as far as you can. That'll stretch your hip flexor more. The further down you are to the bed, the more hip flexor stretch you're going to get. If that's too aggressive, you can back up. Make sure to do both sides and always reset before switching.
Brad: Nice work. Nice work.
Mike: Now, if you want to work on femoral anterior glide syndrome, we're going to do a stretch. It's kind of a mobilization. You're going to need a heavy-duty resistance band for this or a belt. Either will work. You're going to tie it to something sturdy in your house that won't move. Don't do a table. It's probably going to pull away.
Brad: Before we get going, Mike, I want to mention, that if you had a total hip replacement, you do not want to do this. This is for a healthy hip, or when it's painful. No surgeries before this.
Mike: Yes. So, I have the band around my leg up by the hip and I'm going to walk forward and get some tension on this. First, we're going to go forward. I'm going to leave the leg we are stretching back and try to keep my back nice and neutral and straight, and I'm going to slowly lean forward. It's going to have a pulling force posteriorly, trying to get that femoral head back into the socket where it is meant to be. If this feels good, you are doing the exercise that is meant for you and is correct. If you don't feel much, you can try turning sideways and getting more of a lateral pull as well. This can sometimes help some people. If this isn't working, then this exercise isn't for you.
Brad: Right. It should not create pain. If it does, it is not for you, and just discontinue it or omit it from your plan.
Mike: And we've got one more strategy that we'll get to in a second here.
Brad: Looks like you're enjoying that, Mike.
Mike: Yes, it's like a bungee jump. So, the last suggestion we have is to keep soft knees when standing and also walking.
Brad: Soft knees?
Mike: Bent. A slight bend in the knee. You do not want to lock your knee. When your knees are locked, you're going to have more stress on your joints. When your knees are bent, the muscles are going to work like they're supposed to, taking the stress off of your joints. This includes the ankles, knees, hips, and lower back. So, to get some pressure off of the hip, if it's inflamed, you want to stand with bent knees. You don't have to stand overly bent, just a slight bend, as long as you're not locked out.
Mike: And walking, what you want to do is land on your forefoot when you walk, not a heel strike. Most people heel strike because of raised heels in modern-day type shoes. You can buy a different type of shoes, which are zero or flat or minimalist. You don't want to necessarily start with these right away. Progress slowly. This is not about that. It's just about forefoot walking to fix your hip pain. So, when you walk, try to land on your forefoot. You could pretend like you have some pins and needles in your heel, or popcorn kernels, as Brad likes to talk about in other videos. So, as you can see, I'm taking shorter strides. I'm not elongating landing on my heel like this. It's going to be a lot less pressure on that hip joint and make it feel better.
Brad: Great. I know personally, that if you walk around your house on a hard floor without shoes on, you can clearly feel when you do a heel strike. You can feel that bone right against the hard floor versus landing on your forefoot. So, it's not tippy-toe walking, it's just emphasis on the forefoot, taking the stress off of that heel. Makes a difference. Not so easy to do it right away.
Mike: No, it takes time and practice, and it'll feel a little weird at first, but you'll get used to it after a while.
Brad: All right. So, hip bursitis. We gave you three nice options. Chances are that you'll find one or two of them to be the best. Make sure you use those, and continue them daily. It'll get better with time.
Mike: And let us know what worked for you, what we missed. If you have bursitis, what are some common things that we maybe forgot to include? So, comment down below.
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