Gluteal Tendinopathy

Gluteal Tendinopathy: Outer Hip Tendon Pain

Gluteal tendinopathy is a common cause of pain on the outer side of your hip. It affects the gluteal tendons that attach your buttock muscles to the top of the thigh bone. These tendons help keep your pelvis level when you walk, run or stand on one leg. When they become overloaded or irritated, they can become painful and weak.

Gluteal tendinopathy often links with conditions such as greater trochanteric pain syndrome and trochanteric bursitis. Many people notice pain when they lie on the affected side, climb stairs or walk longer distances. Early physiotherapy can calm the pain and guide you back to comfortable movement.

What Causes Gluteal Tendinopathy?

Gluteal tendinopathy usually develops when the tendon is asked to cope with more load than it can handle. This overload might build up slowly or follow a spike in activity. Common triggers include:

• Sudden increases in walking, running or hill training.
• Standing or walking on hard surfaces for long periods.
• Repeated stair climbing or sit-to-stand transfers.
• Prolonged positions that compress the tendon, such as side lying or hip hanging.

Weak buttock and deep hip muscles can add to the problem. When the hip muscles cannot control the pelvis well, the gluteal tendons have to work harder and become irritated. This lack of control also increases strain on the nearby trochanteric bursa, which can lead to bursitis.

Hormonal changes, especially after menopause, and reduced tendon healing capacity with ageing can also play a role.

Who Is Most Affected?

Gluteal tendinopathy can affect anyone, but it is particularly common in:

• Women over 40, especially after menopause.
• Runners, walkers and hikers who train on hills or uneven ground.
• People who stand for long hours, such as teachers, nurses and retail staff.
• People with lower back pain or core stability deficiency.

You may notice pain building over time rather than a sudden injury event.

Typical Gluteal Tendinopathy Symptoms

People with gluteal tendinopathy often report:

• Aching or sharp pain on the outer side of the hip, over the bony point (greater trochanter).
• Pain when lying on the affected side in bed.
• Discomfort when walking, especially on slopes or stairs.
• Pain stepping sideways, hopping or running.
• Morning stiffness around the outer hip.
• Tenderness when you press over the outer hip.

Symptoms can range from mild and annoying to severe and limiting. Many people notice night pain if they overload the tendon during the day.

Risk Factors for Gluteal Tendinopathy

Several factors can increase your risk:

• Load spikes: Rapid increases in walking, running or exercise volume.
• Muscle weakness: Reduced strength in the gluteal and deep hip muscles.
• Movement patterns: Hip hanging, crossing legs and poor pelvic control when standing.
• Spinal issues: Lower back pain can alter hip muscle activation.
• Metabolic health: Conditions such as diabetes or high cholesterol may slow tendon healing.
• Hormonal change: Postmenopausal changes that affect tendon health.

Your physiotherapist can help you identify which of these factors apply to you.

How Is Gluteal Tendinopathy Diagnosed?

Diagnosis is usually clinical. Your physiotherapist will:

• Discuss your symptoms and activity levels.
• Assess your hip strength and movement patterns.
• Perform specific tendon loading tests and side-lying palpation.
• Check your lower back, pelvis and gait.

Ultrasound or MRI may help if the diagnosis is unclear or if pain does not follow the expected recovery path. However, many people do not need imaging because a thorough clinical examination is often enough.

Physiotherapy Treatment for Gluteal Tendinopathy

Physiotherapy aims to calm your pain and then rebuild tendon strength and load tolerance. Your treatment plan may include:

• Education and load management: Adjusting daily activities, sitting and sleeping positions to reduce tendon compression and overload.
• Smart rest: Avoiding hip hanging, long periods standing on one leg and deep side crossing positions.
• Pain relief strategies: Short-term use of ice packs or heat, as guided by your physiotherapist.
• Manual therapy: Hands-on techniques to improve hip and lumbar mobility where appropriate.
• Exercise therapy: A progressive strengthening program tailored to your tendon and hip control.
• Gait and movement retraining: Coaching to reduce hip drop and improve pelvic control when walking or running.

If needed, your physiotherapist can liaise with your doctor about medication or injection options as part of a broader plan.

The Role of Exercise and Load Progression

Exercise is a key part of modern gluteal tendinopathy care. Research shows that progressive exercise improves function and helps many people return to daily activities with less pain.:contentReference[oaicite:0]{index=0}

Your physiotherapist will design a graded exercise program that may include:

• Isometric (static hold) exercises to settle pain when appropriate.
• Side-lying or standing hip abduction strength work.
• Bridging and single-leg bridge variations.
• Step-up and step-down drills.
• Functional strengthening such as squats and lunges.

Exercises start at a level that your tendon can tolerate and progress in small steps. Your physiotherapist will guide how often you train, how many sets and how to adjust if pain flares.

Can Injections or Other Treatments Help?

Some people consider corticosteroid or other injections. These may provide short-term pain relief for some, but they do not rebuild tendon strength. Recent reviews suggest that education and exercise should form the core of treatment, with other options considered as support, not as stand-alone care.:contentReference[oaicite:1]{index=1}

Your physiotherapist can discuss whether medical options such as injections, medications or other procedures might be appropriate in your case and help coordinate care with your GP or specialist doctor.

When Can You Return to Sport or Exercise?

Return to sport depends on your pain levels, strength and function. As a guide, you are usually ready to progress when:

• Pain during and after activity is mild and settles within 24 hours.
• You can walk briskly on level ground without a limp.
• You can perform single-leg strength exercises with good control.

Your physiotherapist will build a step-by-step plan for you. This may start with flat walking, then progress to hills, intervals, then jogging and running if appropriate.

How Long Does Gluteal Tendinopathy Take to Heal?

Tendons adapt slowly. Many people feel better within a few weeks, but full recovery often takes several months. Time frames depend on:

• How long you have had symptoms.
• How irritated the tendon is at the start.
• Your general health and sleep quality.
• Your consistency with the exercise and load plan.

Your physiotherapist will adjust your program and expectations to your stage of recovery.

Can You Prevent Gluteal Tendinopathy?

You can reduce your risk by:

• Keeping your hip and core muscles strong.
• Avoiding sudden jumps in training volume or hill work.
• Varying sitting and standing positions and avoiding hip hanging.
• Wearing supportive footwear for walking and running.
• Seeking physiotherapy advice early if you notice outer hip niggles.

What to Do Next

If you suspect gluteal tendinopathy, early assessment helps avoid long-term tendon irritation. A physiotherapist can confirm the diagnosis, explain your stage of tendon health and guide a safe, progressive plan.

Book an appointment with a Physioworks physiotherapist to discuss your hip pain, tailor your exercise program and plan your return to the activities you enjoy.

Gluteal Tendinopathy FAQs

1. What is gluteal tendinopathy?
   Gluteal tendinopathy is a condition where the tendons of the buttock muscles on the outer hip become painful and overloaded. It often causes aching over the bony point on the side of the hip.
2. What causes gluteal tendinopathy?
   It usually develops from a mix of tendon overload, weak hip muscles and positions that compress the tendon, such as hip hanging or lying on the affected side.
3. What does gluteal tendinopathy feel like?
   Most people notice pain or tenderness on the outside of the hip, pain lying on that side in bed, and discomfort with walking, stairs or hills.
4. Who is most likely to develop gluteal tendinopathy?
   It is common in women over 40, especially after menopause, and in active people who walk or run a lot, particularly on hills or uneven surfaces.
5. How is gluteal tendinopathy diagnosed?
   A physiotherapist can usually diagnose it with a clinical examination that includes your history, hip strength tests and palpation over the outer hip. Imaging is sometimes used if the picture is unclear.
6. How long does gluteal tendinopathy take to heal?
   Recovery can take several weeks to months. Tendons adapt slowly, so a steady progressive exercise program and good load management are important.
7. What exercises help gluteal tendinopathy?
   Exercises that strengthen the gluteal and deep hip muscles, such as side-lying or standing leg lifts, bridges, step-ups and functional strength drills, are usually helpful when progressed sensibly.
8. Is walking good for gluteal tendinopathy?
   Walking is often safe if pain stays mild and settles by the next day. Your physiotherapist can adjust your walking distance, pace and terrain to keep the tendon comfortable.
9. Can gluteal tendinopathy come back?
   Yes, symptoms can return if hip strength and load management are not maintained. Keeping up some strength work and avoiding rapid training spikes reduces the chance of recurrence.
10. When should I see a physiotherapist?
    See a physiotherapist if outer hip pain lasts more than a couple of weeks, disturbs your sleep, limits your walking or does not settle with simple self-care.

Related Articles

• Greater Trochanteric Pain Syndrome – Lateral hip pain condition closely linked to gluteal tendinopathy.
• Trochanteric Bursitis – Inflammation of the bursa near the outer hip that can occur with tendon overload.
• Hip Labral Tear – Cartilage injury around the hip joint that can cause groin or hip pain.
• Femoroacetabular Impingement (FAI) – Bone shape changes in the hip that may alter load on the labrum and tendons.
• Stress Fracture – Overuse bone injury that can mimic or coexist with tendon pain.
• Adductor-Related Groin Pain – Inner thigh tendon pain that may occur alongside hip and buttock symptoms.
• Piriformis Syndrome – Deep buttock condition that may refer pain to the hip or leg.
• Core Stability Deficiency – Weak core muscles that can affect pelvic and hip control.
• Sciatica – Nerve-related leg pain that can be confused with hip tendon pain.
• Lower Back Pain – Spinal pain that can refer to the hip region.

References

• Ladurner A, Fitzpatrick J, O’Donnell J. Treatment of gluteal tendinopathy: a systematic review and stage-adjusted treatment recommendation. Orthop J Sports Med. 2021. PubMed
• Cordeiro TTP, Rocha EAB, Scattone Silva R. Effects of exercise-based interventions on gluteal tendinopathy: systematic review with meta-analysis. Sci Rep. 2024. PubMed
• Bremer T, et al. The efficacy of gluteal tendinopathy treatments: a systematic review. Clin Rehabil. 2025. PubMed
• Fearon A, et al. Physiotherapy management of gluteal tendinopathy. J Physiother. 2025. Journal site
• Grimaldi A. Tendinopathies of the hip. Rheumatology Adv Pract. 2024. Journal site

Social Media

For more tips on gluteal tendinopathy, hip strength and injury prevention, follow PhysioWorks on social media. You’ll see simple exercise ideas, recovery advice and clinic updates to help you stay active and confident on your feet.