Pregnancy is a beautiful journey filled with anticipation and joy, but it also brings its own set of physical challenges. One common yet often overlooked condition is hip bursitis. Understanding what hip bursitis is, why it happens during pregnancy, and how to alleviate its symptoms can help expectant mothers manage this discomfort effectively.

What is Hip Bursitis?

Hip bursitis is the inflammation of the bursae, which are small, fluid-filled sacs that act as cushions between bones and soft tissues. These bursae reduce friction and allow smooth movement in the joints. When they become inflamed, it results in pain and limited mobility in the affected area.

Symptoms of Hip Bursitis

• Pain: Typically felt on the outside of the hip, which may extend down the side of the thigh. The pain is often sharp and intense, especially with movement or pressure.

• Tenderness: The area over the hip may be tender to touch.

• Swelling: Inflammation can cause noticeable swelling around the hip joint.

• Stiffness: Movement may become difficult due to stiffness in the hip area.

If you feel sharp, hot, or pinpointed pain right over the bony part of your outer hip, it’s very likely you have bursitis. You will be most symptomatic with lying on your side, walking, standing on one leg, or putting any pressure over the bursa.

Why Does Hip Bursitis Occur During Pregnancy?

Several factors unique to pregnancy contribute to the development of hip bursitis:

Weight Gain

As the pregnancy progresses, the body weight increases significantly. This added weight puts extra pressure on the hip joints and bursae, leading to inflammation and pain.

Hormonal Changes

Pregnancy hormones, particularly relaxin, cause the ligaments in the pelvis to loosen in preparation for childbirth. While this is essential for delivery, it can also lead to instability in the hip joints, increasing the risk of bursitis.

Postural Changes

The growing baby bump shifts the center of gravity, altering the posture and gait. These changes can strain the hip muscles and joints, contributing to bursitis.

Physical Activity

Changes in activity levels, such as increased walking or altered exercise routines to accommodate pregnancy, can also put unusual stress on the hips.

If you do not have adequate hip/core strength to adapt to your changing belly and BOS, you will end up with more “wobble” in your pelvis, especially with walking or running. That excess wobble causes excess friction between your tendons, IT band, and a structure called your trochanteric bursa. Excess friction on the bursa over time will cause the inflammation aka bursitis.

How to Alleviate Symptoms of Hip Bursitis During Pregnancy

Managing hip bursitis during pregnancy requires a combination of self-care strategies, physical therapy, and, in some cases, medical intervention. Here are some effective ways to alleviate symptoms:

Rest and Activity Modification

• Avoid activities that exacerbate the pain: Prolonged standing, climbing stairs, or lying on the affected side should be minimized.

• Incorporate gentle activities: Swimming or prenatal yoga can help maintain mobility without stressing the hips.

Use of Supportive Devices

• Maternity Belts: Wearing a supportive maternity belt can help reduce pressure on the hip joints by providing extra support to the belly.

• Proper Footwear: Use cushioned, supportive shoes to improve posture and reduce hip strain.

Ice and Heat Therapy

• Ice Packs: Applying ice packs to the affected area for 15-20 minutes several times a day can reduce inflammation and numb the pain.

• Heat Therapy: Using a heating pad on a low setting or taking warm baths can relax the muscles around the hip joint.

Gentle Stretching and Strengthening Exercises

• Hip Stretches: Gentle stretching exercises can help maintain flexibility and reduce tension in the hip muscles.

• Strengthening Exercises: Focus on strengthening the muscles around the hips, such as the glutes and core muscles, to provide better support.

What can I do to help ease the pain?

• If your pain is in one hip, try to sleep on the opposite side for part of the night to offload the

painful hip as much as possible. Put a pillow between your knees to prevent the painful leg

from crossing over and falling forward.

• Use a pregnancy pillow to support your bump when lying on your side.

• When standing, stand straight and do not ‘lean’ on one hip.

• Try not to cross your legs when sitting.

• Applying ice wrapped in a tea towel to the area for 10-15 minutes every couple of hours can

help to decrease pain and inflammation.

• If you have other children, do not carry them on the sore hip.

• Try the stretches and exercises below. These will stretch tight areas and strengthen the

muscles around your hip, thereby taking some of the pressure off the sore region.

Stretches

1. Piriformis stretch

• Place your ankle on the opposite knee, and then lean forward

until you feel a stretch in the side of your bottom.

• Hold the stretch for 30 seconds.

• Repeat on the other leg.

• Repeat 3 times per day.

2. ITB (iliotibial band) stretch

• Stand near the wall and cross the painful leg behind the good leg.

• Then lean away from the wall until you feel a stretch down the side

of the painful leg.

• Hold for 30 seconds.

• Repeat 3 times per day.

3. Back stretch (lumbar rotation)

• Lie down with your knees up and feet flat on the bed, and

arms outstretched to the sides.

• Gently roll your knees to one side until you feel a stretch.

• Hold for 30 seconds.

• Repeat on the other side.

• Repeat both sides 3 times per day.

Exercises

1. Standing hip abduction

• Stand with one hand on the back of a chair or other stable

surface.

• Lift the painful leg out to the side, hold for 5 seconds, and then

bring the leg back.

• Repeat this 10 times, 3 times per day.

• When it begins to get easier, increase the number of seconds you are holding.

2. Hip stability (against wall)

• Stand with your painful leg away from the wall.

• Lift your good leg to around 90 degrees and push it against the wall.

You will feel the hip muscles in the painful leg start to contract.

• Hold for 30 seconds.

• Repeat 5 times, 3 times per day.

Maternity (Physio) / Hip pain in pregnancy (GTPS)

Hip pain in pregnancy (GTPS), December 2023 3

3. Bridges

• Lie down with your knees up and feet flat on the floor.

• Lift your bottom up and hold for 10 seconds.

• Repeat 10 times, 3 times per day.

4. Clams (do this on both sides)

• Lie on one side, knees bent.

• Keeping your ankles together, raise the top knee

towards the ceiling.

• Be careful not to roll backwards, keep your hips on top of each other.

• Repeat 10 times on both sides, 3 times per day.

5. Side leg raises (do this on both sides)

• Lie on your side, legs straight.

• Raise the top leg towards the ceiling, and hold for 5 seconds.

• Repeat 10 times, on both legs, 3 times per day.

6. Wall squats

• Stand leaning against a wall.

• Slowly bend your knees and “slide” your back down the wall until you are

in a squat position.

• Hold for 10 seconds.

• Repeat 10 times, 3 times per day

Physical Therapy

A physical therapist specialized in prenatal care can design a personalized exercise and treatment plan to address hip bursitis. This might include manual therapy, specific stretches, and exercises to strengthen the supporting muscles.

Pain Relief

• Medication: Consult with a healthcare provider before taking any medication. They may recommend acetaminophen for pain relief, which is generally considered safe during pregnancy.

• Topical Treatments: Certain topical treatments may also provide relief but should be used under the guidance of a healthcare professional.

When to Seek Medical Attention

While self-care measures can be effective, it is crucial to consult a healthcare provider if:

• The pain is severe or persistent.

• There is noticeable swelling or redness.

• Symptoms do not improve with home care.

• There is difficulty walking or significant limitation in movement.

Conclusion

Hip bursitis can be a painful and disruptive condition during pregnancy, but understanding its causes and implementing effective relief strategies can significantly improve quality of life. By combining rest, supportive devices, gentle exercises, and medical guidance, expectant mothers can manage hip bursitis and focus on the joy of their pregnancy journey. Always consult with healthcare providers to ensure the chosen methods are safe and suitable for individual circumstances.