ReviewedReviewed. The exercises, repetition counts, hold times, and order of the exercises on this sheet have been checked by Dr. Mahendira against the clinic's printed handout.
SMH Osteoarthritis Clinic · Greater trochanteric pain syndrome · Corticosteroid injection (Depo-Medrol (methylprednisolone acetate))
Reviewed by Dr. Mahendira against the clinic handout.
Your injection
A long-acting corticosteroid injected into the trochanteric bursa, the fluid-filled sac overlying the greater trochanter of the femur. It reduces inflammation of the bursa and surrounding gluteal tendons, relieving the lateral hip pain. It is not a pain reliever. It works by calming the inflammatory process that irritates the bursa.
After your injection
What to expect
- Mild soreness or increased pain at the outer hip is normal for 24 to 48 hours (a steroid flare).
- The Depo-Medrol usually begins working within 2 to 5 days. Full effect may take up to 2 weeks.
- Lateral hip pain with walking, climbing stairs, and lying on the affected side should gradually ease.
- Many people experience meaningful relief. Some may need a second injection or additional therapy.
First 24 hours
- Rest the hip. Avoid prolonged walking, stair climbing, and standing on the affected leg.
- Apply ice wrapped in a cloth for 15 to 20 minutes every 2 to 3 hours to the outer hip.
- Keep the injection site clean and dry. A small bandage may be removed after a few hours.
- Take acetaminophen (Tylenol) as needed for soreness. Avoid NSAIDs for 24 hours unless directed.
Days 2 to 14
- Gradually resume walking and daily activities as comfort allows. Start with short distances.
- Continue to avoid high-impact activities (running, lateral movements, hill walking) for at least 1 to 2 weeks.
- Begin gentle hip stretching and strengthening exercises after 48 hours.
- Sleep on the unaffected side with a pillow between the knees to reduce pressure on the bursa.
Important reminders
Limit injections to 3 to 4 per year at this site. Repeated corticosteroid injections may weaken the gluteal tendons over time. People with diabetes should monitor blood sugar closely for 3 to 5 days.
Your exercises
Begin gently after about 48 hours if you are comfortable. Move slowly and stay within a mild, pain-free range. The counts below are a guide for how much to do.
1Standing IT band stretch
Stand with the affected leg behind the other. Lean your trunk away from the affected side until you feel a gentle stretch along the outer hip and thigh. Hold 20 to 30 seconds.
3 reps of a 30 second hold, 2 to 3x daily
Hold onto a wall or chair for balance.
2Piriformis stretch (figure-4)
Lie on your back. Cross the affected ankle over the opposite knee to form a figure-4. Pull the bottom thigh toward your chest until you feel a deep stretch in the buttock. Hold 20 to 30 seconds.
3 reps of a 30 second hold, 2x daily
Keep your head and shoulders relaxed on the floor.
3Side-lying hip abduction
Lie on the unaffected side with your legs straight. Slowly lift the top leg about 12 inches, keeping the knee straight and toes pointing forward. Hold 3 seconds, lower slowly.
2 sets of 10 reps, 2x daily
Do not roll the hip backward. Keep hips stacked.
Lie on the unaffected side with knees bent at 45 degrees and feet together. Keeping feet touching, rotate the top knee upward like a clamshell opening. Hold 3 seconds, lower slowly.
2 sets of 12 reps, 2x daily
Strengthens the gluteus medius, which is key for bursitis recovery.
Lie on your back with knees bent and feet flat, hip-width apart. Squeeze your glutes and lift your hips toward the ceiling until your body forms a straight line from shoulders to knees. Hold 5 seconds, lower slowly.
2 sets of 10 reps, 2x daily
Keep your core engaged. Do not arch your lower back.
6Standing hip flexor stretch
Stand in a lunge position with the affected leg behind. Tuck your pelvis under and gently shift your weight forward until you feel a stretch at the front of the back hip. Hold 20 to 30 seconds.
3 reps of a 30 second hold, 2x daily
Keep your torso upright. Do not arch the back.
7Single-leg balance (wall tap)
Start after week 2 to 3
Stand on the affected leg near a wall. Slowly reach the opposite foot out to tap the wall in front, to the side, and behind you, returning to center each time. Builds hip stability.
2 sets of 8 reps each direction, 1 to 2x daily
Start after week 2 to 3. Hold a chair if needed.
Exercise guidelines
- Stop any exercise that causes sharp or worsening pain at the outer hip.
- Mild discomfort is fine. Sharp pain is not. Stay at 3 out of 10 or below.
- Apply ice for about 15 minutes to the outer hip after exercising if soreness develops.
- Progress slowly. Increase reps and hold times before adding resistance.
Protecting the area every day
- Avoid lying on the affected side. Sleep on the opposite side with a pillow between your knees.
- Do not cross your legs when sitting or standing. This compresses the bursa against the greater trochanter.
- Use a cushion or gel pad when sitting on hard surfaces for prolonged periods to reduce pressure.
- Avoid prolonged standing on one leg. Distribute weight evenly between both feet.
- Wear supportive, cushioned footwear. Avoid walking barefoot on hard floors when possible.
- Climb stairs one at a time, leading with the unaffected leg going up. Use the railing for support.
- Maintain a healthy weight. Excess weight increases lateral compressive forces on the hip.
- Apply ice for 15 to 20 minutes to the outer hip after activity if soreness develops. Use a cloth barrier.
Low-impact activity
Swimming, water walking, stationary cycling, and elliptical training are excellent options. Avoid running, lateral lunges, and hill walking until pain-free. Build activity duration gradually.
Tracking your progress
Tick a box each day you complete your exercises, and circle how the area feels.
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| Week 1 | | | | | | | |
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| Week 2 | | | | | | | |
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| Week 3 | | | | | | | |
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| Week 4 | | | | | | | |
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Pain level today (circle one)012345678910
0 = none10 = worst
!When to call your doctor. Contact the clinic or seek care if you notice any of the following: Increasing pain, swelling, or redness over the outer hip lasting more than 48 to 72 hours after injection; Fever above 38C (100.4F), which may indicate infection at the injection site. Seek care urgently; Inability to bear weight on the affected leg or significant new weakness in the hip; Pain radiating down the leg below the knee, or new numbness or tingling (possible nerve involvement); Skin changes at the injection site: lightening, thinning, or a visible dimple over the hip; Symptoms of high blood sugar in people with diabetes: excessive thirst, frequent urination, blurred vision; No improvement in lateral hip pain after 2 to 3 weeks.
This is general information, not medical advice. Your exercises and recovery depend on your own situation, and your clinician will guide you.
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