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Hip & groin

Hip bursitis and outer hip pain

Sharp pain on the bony point at the side of the hip — worst lying on it at night, or climbing stairs.

What it typically feels like

  • Pain on the bony point at the outside of the hip
  • Cannot lie on that side at night
  • Worse climbing stairs or getting out of a car
  • Tender to touch over a small, specific area

A bursa is a small fluid-filled sac that lets tendon glide smoothly over bone. There is one over the bony point at the side of your hip, and when the tendons running across it are too tight, it gets compressed and irritated.

The name is slightly misleading — the bursa is often not the main problem. More often it is the gluteal tendons themselves, which is why the condition is increasingly called greater trochanteric pain syndrome.

What usually causes it

  • Weak glutes, letting the pelvis drop with every step so the tendons are repeatedly compressed against the bone.
  • A tight IT band pressing down over the area.
  • Sleeping on that side on a firm mattress, which compresses it for hours.
  • A sudden increase in walking or running, especially on cambered roads.

What treatment involves

Releasing the tension in the IT band and the muscles around the outside of the hip that are compressing the area, and settling the referred pain from trigger points in the glutes.

Then strengthening the glutes, which is what stops it recurring — this is a tendon-under-compression problem, and the fix is to control the pelvis better.

One practical thing that helps immediately: sleep with a pillow between your knees. It stops the top leg dropping across and compressing the sore side all night.

What is actually in the hip & groin

A deep ball-and-socket joint, built the opposite way round from the shoulder: it trades range for stability, and it is surrounded by some of the largest and strongest muscles in the body.

Hip joint
The head of the femur sitting deep in the socket of the pelvis, with a cartilage rim adding depth. Genuinely stable — which is why true hip joint pain is felt in the groin, not the side.
Iliopsoas
The main hip flexor, running from the lumbar spine and pelvis to the top of the thigh. It shortens with sitting, and because it attaches to the spine it can pull on the lower back as well as the hip.
Gluteus medius and minimus
On the side of the hip, keeping the pelvis level when you stand on one leg — which is every step you take. Weakness here shows up at the knee and the lower back as often as at the hip.
Adductors
The inner thigh group. The usual site of groin strain in sports that involve sprinting, kicking and rapid changes of direction.
Trochanteric bursa
A fluid-filled cushion over the bony point at the side of the hip. When it and the tendons over it are irritated, lying on that side at night becomes the main complaint.

Why it goes wrong

Where it hurts tells you a great deal here. Groin pain suggests the joint itself; pain on the bony point at the side suggests the tendons and bursa over it; deep buttock pain suggests the glutes or the structures beneath them. Sitting for long periods shortens the flexors at the front and switches off the glutes behind, and that combination sits behind a large share of what walks in.

3D anatomy See the structures involved on the interactive model

The honest next step

This page describes what is common, not what you have. The only way to know is to have it assessed — and your first session includes a full assessment, so you leave knowing what is actually going on.

Book an assessment Call 07922 884 788