Symptoms: Aching or nagging pain in the outside of the hip may be a sign of hip bursitis. The pain may cause a person to wake at night, especially if lying on that side. Pain may worsen when walking up and down stairs, getting up from sitting and getting in or out of the car.

Causes: This condition usually begins when tight hip flexor muscles and weak gluteal muscles cause the lubricating fluid sacs called “bursa” to rub against the hip bone, creating inflammation. This condition is common among runners and triathletes but can also affect desk workers, especially if they’re just getting into a physical activity. Over-pronation or flat feet can pre-dispose a person to this muscle imbalance.

Relief: Correcting this muscle imbalance requires exercise to strengthen the gluteal muscles and myofascial release to stretch the tight hip flexors. Manual low back mobilization may be required to relieve lumbar stiffness, and foot biomechanics may also be needed. Ultrasound, Ice, and electrical stimulation can soothe local soreness, and steroid injections may bring short-term relief. But for a lasting recovery, the underlying muscle imbalances need to be addressed by a comprehensive manual therapy and exercise plan.