Explanation of Diagnosis

Hip bursitis is inflammation of the bursa (a fluid-filled sac that reduces friction) over the greater trochanter (outer hip bone). It is commonly caused by repetitive stress, prolonged pressure, poor posture, hip muscle weakness, or previous injury. Symptoms include pain on the outer hip, tenderness when pressing the area, discomfort when lying on the affected side, and pain with prolonged standing, walking, or stair climbing.

Specific Work Modifications

• Avoid prolonged standing or walking; take frequent sitting breaks.
• Use an ergonomic chair with proper lumbar and hip support to reduce strain.
• Avoid crossing legs while sitting, which can increase hip irritation.
• If standing is required, use an anti-fatigue mat to reduce impact on the hip.
• Apply ice or heat during breaks if swelling or pain worsens.

Specific Activity Modifications

• Avoid high-impact activities like running, jumping, or deep squats.
• Modify workouts by switching to low-impact exercises like swimming, cycling, or water aerobics.
• Perform hip-strengthening and stretching exercises before and after activity.
• Use proper footwear with good support to maintain proper hip alignment.

Recommended Supplements

• Collagen peptides (10 g daily) – Supports joint and tendon health.
• Vitamin D3 (1000-2000 IU daily) – Supports bone and soft tissue health.
• Magnesium (300-400 mg daily) – Helps with muscle relaxation and recovery.
• Omega-3 fatty acids (1000 mg daily) – Reduces inflammation in the hip.
• Turmeric (500 mg twice daily) – Natural anti-inflammatory.

Recommended Nutrition and Hydration

Diet Recommendations:

• Anti-inflammatory foods: Fatty fish (salmon, sardines), turmeric, berries, walnuts, and olive oil.
• Joint-supporting foods: Bone broth, citrus fruits, bell peppers, and nuts.
• Protein-rich foods: Chicken, eggs, lentils, and dairy to support muscle and tendon healing.
• Limit processed foods, sugar, and alcohol, which can worsen inflammation.

Hydration Tips:

• Drink at least 2–3 liters of water daily to maintain tissue hydration.
• Limit caffeine and alcohol, which can slow healing.

Home Exercise Prescription

Perform 2-3 times daily to improve hip strength, flexibility, and stability:

Phase 1: Pain Relief & Mobility (Days 1-5, Reduce Swelling & Improve Movement)

1. Ice Therapy

1. • Apply ice for 15-20 minutes, 3-4 times daily to reduce swelling.

2. Hip Flexor Stretch

1. • Stand or kneel, lunge forward, and stretch the hip flexors.
   • Hold for 20-30 seconds, repeat 3 times per leg.

3. Seated Glute Stretch

1. • Sit upright, cross one leg over the opposite knee, and gently lean forward.
   • Hold for 20-30 seconds, repeat 3 times.

Phase 2: Strengthening & Stability (After 5-7 Days, Once Pain Improves)

4. Clamshell Exercise (Hip Abductor Strengthening)

1. • Lie on your side with knees bent, lift the top knee while keeping feet together.
   • 10 reps per side, 2 times daily.

5. Side-Lying Leg Lifts

1. • Lie on your side and lift the top leg while keeping it straight.
   • 10 reps per leg, 2 times daily.

6. Glute Bridges (Hip & Core Strengthening)

1. • Lie on your back, bend knees, and lift hips while squeezing the glutes.
   • 10 reps, 2 times daily.

Phase 3: Return to Activity (After 2-3 Weeks, If Pain-Free)

7. Standing Hip Abduction

1. • Stand tall and lift one leg sideways without tilting the torso.
   • 10 reps per leg, 2 times daily.

8. Heel-to-Toe Walk (Balance & Coordination)

1. • Walk in a straight line, placing one foot directly in front of the other.
   • 20 steps, 2 times daily.

⚠ Avoid running, jumping, or repetitive side-to-side movements until symptoms improve (typically 4-6 weeks).

Helpful Books

1. "Rehab Science: How to Overcome Pain and Heal from Injury" – Tom Walters, DPT
2. "The Hip Pain Handbook: A Guide to Preventing and Treating Hip Injuries" – Nicolas Piuzzi, MD

Contact the Key West orthopedic clinic or reach out to Dr. Jason Pirozzolo.