What are signs of Bursitis?


I get this question a lot. As it probably applies to every joint.

I have recently been seeing quite a few clients suffering from bursitis, but very few actually know what bursitis is.

Now to understand a little about bursitis and why people get it, you first need to know exactly what a bursa is.

A bursa is a fluid-filled sac (think of them as tiny cushions), that sits underneath and between tendons/bones. They are there to stop the friction from them rubbing together. Tendons are the anchor of a muscle that firmly fixes it to a bone.

The tendons are very strong and therefore are under a lot of stress almost like a guitar string. Therefore bursa is necessary to ensure the tendon doesn’t always rub on the bone.

I’m sure you have all seen the films where the hero is dangling on an old rope desperately trying to climb to the top of the cliff, whilst the rope gradually frays off the edge of the cliff.

Well, this is exactly what would happen to the tendon if the bursae were not there to reduce this friction…

So they are pretty important! As the tendon continually rubs against the bursae during repetitive activities it can become inflamed (swollen) and this can, in turn, cause pain and discomfort.

The most common type of bursitis that I have been seeing in the clinic is trochanteric bursitis. This is actually the bursae that sits on the outside of the hip.

If you feel down to the top of your pockets you will feel a large bony area that sticks out slightly. This is known as the greater trochanter of the hip.

This is simply an area where lots of muscle tendons anchor, similar to a snail attaching itself firmly onto a rock in a rock pool. Sitting just underneath these tendons is the trochanteric bursae.

With summer here and many opting to try to lose a few pounds before their vacations, means repetitive stress injuries such as bursitis can increase.

Going from doing nothing to running or cycling for hours, not adequately stretching, warming up, or cooling down can lead to muscles that are struggling. With this increase in demand becoming tight, causing excess pressure on the bursae ultimately leading to pain (bursitis).

It is important for you to be properly assessed to determine whether or not it is bursitis that is causing you discomfort in this area.

There are various structures around this area and they need to be ruled out to identify the culprit for your discomfort so that it can be effectively treated.

Signs of Bursitis can be:

  • Sharp or aching pain in the outside of your hip, (near your pocket).
  • Pain referring down the outside of your thigh.
  • Pain that is worse at night or aggravated when going from sitting to standing.

Watch this video to learn how to void bursitis.

Although it can be hard to avoid bursitis occurring. There are certain precautions that can be taken to help limit the chances of you developing one.

There are a few large and very powerful hip muscle tendons that pass over the trochanteric bursae. Therefore if any of these muscles become particularly tight, more pressure will be placed on the bursae. So there will be more chance of developing bursitis.

Hip stretches particularly of the gluteal muscles and Iliotibial band can help to release this pressure.

Limit repetitive activities if you start to feel this discomfort. Aggravated by repetitive hip bending and extending motions e.g cycling, running, etc.

Icing the area can help to reduce the amount of swelling and reduce pressure on the bursae.


Your physical therapist can fully assess to ascertain the exact nature of the injury and whether other structures could be involved that need attending to.

Physical Therapy involving hands-on deep tissue massage can help to loosen the muscles around the hip to take the stress off the bursae as well as other modalities that can help to ease bursitis.

If you would like to hear from a patient about how physical therapy can treat your bursitis, check out our success story with one of our favorite patients, JoAnn. She’ll tell you all about her experience!


And don’t stop with JoAnn! There are more than a hundred testimonial videos on our Success Stories Page of former patients who found relief with physical therapy. Check them out and see what you can look forward to after you commit to jumpstarting your recovery with us!

Nick Hunter, PT, DPT

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