TL; DR (Too Long; Didn't Read)
Hip bursitis is a common source of hip pain, especially in women over 40. Yay us!
It occurs when the bursae—fluid-filled sacs that cushion the hip—become inflamed. Symptoms include sharp or aching pain on the outer hip, discomfort when lying on the affected side, and stiffness.
The good news?
A mix of movement modifications and training (hello glutes), rehab exercises, and targeted nutrition can significantly reduce pain and improve mobility.
WHY
Women in perimenopause and menopause are more susceptible to hip bursitis due to hormonal changes, particularly the decline in estrogen and testosterone, which impact collagen production, tendon elasticity, and joint lubrication.
These shifts can lead to increased inflammation and a greater likelihood of soft tissue irritation, making conditions like bursitis more common in perimenopause.
And whatever you do–don’t ignore it!
If you leave it, the persistent inflammation can lead to compensatory movement patterns, where other muscles and joints take on extra strain, increasing the risk of secondary issues such as lower back pain, knee problems, or even gait abnormalities. The ongoing pain can make weight-bearing activities more challenging, leading to muscle atrophy and further weakening of the stabilizing muscles around the hip.
WHAT
Hip bursitis is the inflammation of the bursae, small sacs of fluid that cushion the hip joint. The most common type, trochanteric bursitis, affects the outer hip.
It typically develops due to repetitive movements such as prolonged walking, running, cycling, and excessive stair climbing. Clinically, I would always see it in runners.
Poor biomechanics also can leave you susceptible–things like weak gluteal muscles, leg length discrepancies, improper gait patterns, and poor pelvic movement, all of which contribute to uneven stress on the hip joint and bursa.
Estrogen normally gives us great tissue resilience. But when this begins to decline, we are at a higher risk for bursitis developing.
Common symptoms include:
- Sharp or aching pain on the outer hip and thigh.
- Tenderness when pressing on the area.
- Increased pain after prolonged standing or walking.
- Stiffness that worsens after periods of inactivity.
- Pain sleeping on the affected side.
HOW
MOVEMENT & REHAB
Modify Activities: If you are experiencing symptoms, avoid prolonged running or repetitive movements that worsen symptoms.
Strengthen Your Peach: Focus on glute-specific resistance training, including exercises such as:
- Hip thrusts
- Bulgarian split squats
- Step-ups (these can be done on a box or a bench or even a Hack Squat Machine)
All of these work to strengthen the gluteus medius and maximus, both of which play a crucial role in stabilizing the hip joint and preventing excessive strain on the bursa. It also makes you look great in jeans…so there’s that consolation prize, too.
I would often add in activation and hip stability exercises like:
- Clamshells
- Glute bridges
- Some sort of abduction movement like lateral leg raises or an abduction machine
Foam Rolling: I don’t know why foam rollers are so controversial (I literally see doctors arguing about foam rolling daily on social media), but I really like them as a way to help relieve pain.
Obviously do NOT roll directly on the bursa but some gentle (key word her Bettys, GENTLE!) release in the glutes and IT band.
Correct Posture & Gait: This one might need some in-person coaching from a chiropractor or physical therapist, but poor posture, such as excessive anterior pelvic tilt (overarching the lower back), rounded shoulders, or an uneven weight distribution while standing, can lead to improper biomechanics that increase strain on the hip.
A weak core and gluteal muscles contribute to instability, further exacerbating poor posture and inefficient movement patterns. Now, I’m not a fan of planks (I hate them if I’m being honest), but I do like hypopressives and stomach vacuums as a way to improve core strength. Core strengthening and improving walking mechanics both help redistribute load.
NUTRITION & SUPPLEMENTS
Anti-Inflammatory Diet: First the basics: Don’t eat ultra-processed food. Drink lots of water and sleep. You KNOW this.
Key Supplements:
- Omega 3 is the ultimate anti-inflammatory supplement. 2-4g daily
- Try BodyBio Balance Oil or Fish Oil+. Click HERE and use code DRSTEPHANIE to get 15% off.
- Collagen supports connective tissue health and repair. Aim for 25-30 g daily, ideally in a hydrolyzed form for better absorption.
- Try Equip Foods Grass-Fed Collagen. Click HERE and use code DRSTEPHANIE to get 15% off.
- Magnesium aids muscle relaxation and recovery. Take at least 400mg daily.
- Try BiOptimizers Magnesium Breakthrough. Click HERE and use code ESTIMA to get 10% off.
- Vitamin D & K2 is essential for bone and joint health. Ensure you get at least 2,000 IU of vitamin D daily with K2 for optimal calcium metabolism.
- Try Adapt Naturals. Click HERE to get 20% off. (A code will appear in a pop-up box when you click the link.)
- Creatine is an incredible compound showing promise around not only muscle and brain health, but it also has some incredible anti-inflammatory properties for muscles, brain, and bone.
NOW
- Apply Ice & Adjust Activities
If your hip is inflamed, apply ice (15-20 minutes) and avoid aggravating movements. This will at the very least provide some temporary relief.
- Strengthen & Mobilize
Add 5-10 minutes of targeted hip and glute activation exercises (above) to your daily routine. Also, consider some of the glute exercises above in your next leg day session.
- Nutritional Support
Incorporate anti-inflammatory foods and consider adding collagen, omega-3s, and magnesium to your supplement stack.
What I Recommend
Peptide Protection from Sun & Stress-related Skin Aging
You know I won’t recommend a product unless I’m absolutely obsessed. I use OneSkin because it does what skincare should—it helps your skin become healthier every time you use it.
Right now, I’m loving their sunscreen, OS-01 FACE SPF. (I wore it every day of my recent ski trip. It’s truly an all-season product.) Not only does it give you broad-spectrum UV protection, but it also reduces the effects of previous UV exposure at the cellular level. [*]
All those years you spent baking in the sun? There’s a chance you could repair some of that damage. OS-01 FACE SPF goes after free radicals, too. It’s packed with antioxidants that neutralize oxidative stress, so your skin isn’t constantly under attack. It’s doing the job of your vitamin C serum while protecting and repairing your skin. [*]
Visit oneskin.co and use code DRSTEPHANIE to save 15%.
BONUS! While sun exposure is the biggest factor for premature aging, chronic stress also plays a role. Learn how stress speeds up the aging process and get four tips for mitigating how it impacts your skin in this article.
Health Optimisation Summit Comes to Austin
It’s official! I’m speaking at the Health Optimisation Summit in Austin, Texas! I'll be talking about perimenopausal strategies like muscle, meals, and stress management.
Europe’s biggest health event lands in Austin on April 12-13. You'll hear game-changing health insights from nearly 40 industry-leading experts covering topics from biohacking and nutrition to functional and preventative medicine.
Spend two full days at the Palmer Events Center surrounded by Paleo-inspired wisdom, innovative health tech, and a community that feels like family.
If you purchase your ticket now and use code DRSTEPHANIE, you'll save 10% on VIP or General Admission.