I have a 64 year old female client who is about 5'4" and weighs 170 pounds. She had her left hip replaced a few years back, which causes her no problems. However, she has severe bursitis in this hip to the point of extreme pain as well as a significant limp. Her IT Band is extremely tight, so I have her foam rolling the IT band as well as performing stretches. She can't do a single leg stand on the left leg. I'm having a hard time trying to figure out a routine to help strengthen her hip flexors, quads and glutes without creating discomfort in the bursitis. I would be grateful for any suggestions.
First of all, exercise should not be done until the doctor gives the go ahead to do so since exercise can make the bursitis worse if it is too soon after the condition started. Rest and ice are the two best treatments that can be done for hip bursitis initially. Assuming your client has been cleared to exercise by the doctor, foam rolling before workouts and stretching before and after should continue to be done every workout. Since your client cannot perform a single leg stand, you might want to have her start by doing one in water. The buoyancy of the water will take a lot of the strain off of her leg, and she can hopefully progress to doing it on land. Other water exercises could also be useful such as walking, doing leg lifts to the front, back and sides and performing kicks while in a prone position and holding on to the side of the pool.
If a pool is not accessible, you could try having her do a single leg stand while you and possibly someone else help hold her up so she is not putting all of her weight on the one leg. You could have her perform straight leg raises to the front, back on sides while lying on the ground. She can progress doing them with a light resistance band tied around her legs. Other beneficial exercises include partial squats in place or against an exercise ball, bridges, donkey kicks where the client is on her knees and hands with legs at 90 degrees and raising one foot to the ceiling and any core strengthening exercises. Using an exercise bike with light resistance will also help to develop quad strength.