Hip Bursitis (Trochanteric Bursitis)
at Foot Foundation
Hip bursitis, also known as trochanteric bursitis, happens when the bursa on the outside of the hip becomes inflamed. This leads to pain on the outer hip, often worse when lying on the affected side, climbing stairs, or walking long distances.
Although symptoms are felt at the hip, the cause is often linked to foot and lower limb mechanics. Flat feet, high arches, or leg length differences can alter pelvic alignment, increasing strain on the hip.
At Foot Foundation, treatment focuses on correcting these drivers to relieve pain and prevent recurrence.
What is Hip Bursitis?
Hip bursitis (trochanteric bursitis) occurs when the fluid-filled sac (bursa) on the outside of the hip joint becomes inflamed and irritated. This causes pain at the outer hip, often worse when lying on the affected side, climbing stairs, or walking long distances.
Although symptoms are felt at the hip, bursitis is often driven by abnormal foot and lower limb mechanics. Excessive pronation, high arches, or leg length differences can cause the pelvis to tilt, increasing friction between the iliotibial band (ITB) and the bursa.
At Foot Foundation, we focus on treating these foot-driven causes to relieve pain and reduce recurrence.
Causes & Risk Factors
Excessive pronation or flat feet – rotating the leg inwards and straining the hip
High arches (cavus feet) – poor shock absorption increasing impact at the hip
Leg length difference – causing pelvic tilt and uneven hip loading
Poor footwear – unsupportive shoes increasing rotational stress
Overuse & repetitive activity – running, stair climbing, or hill walking
Weak gluteal muscles – poor hip stabilisation leading to ITB friction
Age & gender – more common in women over 40 due to pelvic anatomy
Previous injury – ankle, knee, or back injury altering gait mechanics
Treatment at Foot Foundation
Foot & Biomechanical Correction
Custom orthotics – correct pronation, improve pelvic alignment, reduce hip stress
Heel lifts – if leg length discrepancy contributes to bursitis
Footwear advice – recommending cushioned, supportive shoes for daily wear and sport
Load & Activity Management
Temporary reduction of aggravating activities (stairs, hills, side sleeping on painful side)
Gradual reintroduction with improved mechanics
Rehabilitation
Referral to physiotherapy for gluteal strengthening and hip stabilisation programs
Stretching of the ITB and hip flexors to reduce lateral hip tension
Adjunct Therapies
Shockwave therapy – effective for chronic bursitis resistant to standard care
Taping or padding – to reduce direct pressure and improve alignment
Symptoms
Pain on the outside of the hip (greater trochanter area)
Pain worse when lying on the affected side
Pain during walking, running, or climbing stairs
Tenderness on palpation of the outer hip
Aching pain that may radiate down the thigh
Stiffness or weakness with hip movement
Diagnosis
At Foot Foundation, diagnosis includes:
Biomechanical assessment – analysing foot posture, pronation, gait, and pelvic alignment
Functional testing – step-downs, single-leg stance, and walking analysis
Palpation of the trochanter – identifying bursal tenderness
Referral for imaging – ultrasound or MRI if further confirmation is needed
Hip Bursitis – FAQs
Yes. Poor foot mechanics, such as flat feet or leg length differences, can tilt the pelvis and increase friction at the hip.
Orthotics improve lower limb alignment, reducing rotational stress and uneven loading that aggravates the bursa.
No. It can also be caused by biomechanical problems, poor footwear, or even prolonged side sleeping.
Yes. Shockwave is effective in stimulating healing and reducing pain in chronic hip bursitis cases.
• Bursitis = inflammation of the bursa (soft tissue).
• Arthritis = degeneration of the joint cartilage itself.
Yes. Pain may radiate down the outside of the thigh due to ITB involvement.
Yes. Podiatrists treat foot and gait mechanics, which are key drivers of hip bursitis.
With treatment, most cases improve within 6–8 weeks, though chronic cases may take longer.
If hip pain persists despite rest, or is worse with walking, standing, or lying on your side, podiatry assessment is recommended.
Why Choose Foot Foundation?
At Foot Foundation, we specialise in managing hip bursitis by addressing foot mechanics and lower limb alignment. By combining:
Custom orthotics
Footwear optimisation
Shockwave therapy
Integrated rehab with physiotherapy
…we treat both the pain and the underlying cause.
With clinics in Rosedale, Takapuna, Remuera, Botany, Hamilton, and Tauranga, expert hip and lower limb care is available across New Zealand.
