Gluteal tendinopathy is the most common cause of lateral hip pain presenting to health practitioners, yet it is frequently mistaken for bursitis or referred pain from the lower back. It involves disruption to the tendons of the gluteus medius and gluteus minimus where they attach to the outer hip bone, and it can be significantly disabling when left unmanaged. The good news is that, with the right loading programme and posture management, most people respond well to physiotherapy.
What Is Gluteal Tendinopathy?
Gluteal tendinopathy is a condition affecting the tendons of the gluteus medius and gluteus minimus muscles, which attach to the greater trochanter, the bony prominence on the outer hip. These tendons help stabilise the hip and pelvis during walking, running and single-leg activities. When they are repeatedly compressed or overloaded without adequate recovery, the tendon structure changes in ways that produce pain and reduce function. Research identifies it as a leading cause of hip-related disability and it is especially common in women over the age of forty, though it can affect anyone.
Why It Is Often Mistaken for Bursitis
For many years, lateral hip pain was commonly diagnosed as trochanteric bursitis, blaming the small fluid-filled sac over the greater trochanter. More recent research has shown that in most cases the primary problem is the tendon itself rather than the bursa, and that treating it as bursitis often leads to ineffective management. Accurate diagnosis changes the treatment approach significantly, which is why a thorough assessment matters so much for this condition.
What Causes Gluteal Tendinopathy?
Several well-documented factors contribute to the condition. Age is one of the most significant: tendons lose elasticity over time, making the gluteal tendons more vulnerable to overload in middle-aged and older adults. Women develop the condition more often than men, likely due to differences in anatomy, hormonal influences and biomechanical factors such as a wider pelvis. Excess body weight increases the compressive load on the tendons, and repetitive hip activities such as running, climbing stairs and prolonged walking are common triggers. Poor hip and pelvis control during movement, previous injury to the hip or buttock region, and sustained postures that compress the tendons such as sitting cross-legged, standing with weight on one hip, or sleeping on the side also drive or maintain the condition.
Why Compressive Load Matters
One of the most important insights from recent research into gluteal tendinopathy is the role of compressive load. The gluteal tendons do not respond well to compression, which occurs when the hip is in an adducted position, meaning when the leg crosses the midline of the body. This happens during common activities such as standing with weight shifted to one hip, crossing the legs when sitting, and lying on the side with the top leg falling forward. Reducing these compressive postures, especially in the early stages, is one of the most effective things a person can do to settle the condition alongside a loading programme.
How Physiotherapy Treats Gluteal Tendinopathy
Physiotherapy is the first-line treatment and is well supported by evidence. Management begins with education about the condition and posture modification to reduce compressive loading of the tendon. A progressive exercise programme targeting the gluteus medius, gluteus minimus and surrounding hip and pelvic muscles forms the core of rehabilitation. Isometric exercises are often introduced first to load the tendon without compression, then progressed to isotonic and functional work as symptoms settle. The aim is to build the tendon’s capacity to handle the loads of daily life and sport, rather than just reducing pain in the short term. Our hip pain physiotherapy and tendinopathy physiotherapy are built around exactly this approach.
Common Questions
What Does Gluteal Tendinopathy Feel Like?
It typically causes pain on the outer hip, over or just below the bony prominence, that worsens with sitting for long periods, lying on the side, climbing stairs, running or prolonged walking. It is often worse after activity rather than during it, and can refer down the outer thigh.
Is Rest the Best Treatment for Gluteal Tendinopathy?
Not usually. Complete rest tends to weaken the tendon further, while the right kind of progressive loading helps the tendon adapt and recover. The goal is to find the right level of activity, reduce compressive postures, and gradually build load over time.
How Long Does Gluteal Tendinopathy Take to Recover?
Most people see meaningful improvement over several months of consistent physiotherapy, though individual timelines vary. The condition can be stubborn if compressive postures are not addressed alongside the loading programme, which is why both components matter.
Can I Still Exercise With Gluteal Tendinopathy?
Often yes, with some modification. High-compression activities such as deep hip stretches and crossing the legs should be avoided early on, while walking, cycling and pool exercise are often well tolerated. A physiotherapist can advise on what suits your stage and goals.
How BeFit Can Help
At BeFit Training Physiotherapy, our physiotherapists assess and treat gluteal tendinopathy at our Edgecliff and Coogee clinics. We identify the contributing factors, teach you which postures to modify, and build a progressive loading programme tailored to your stage and lifestyle. Every initial consultation runs for forty-five minutes, one-on-one, with a thorough assessment and a clear plan. No referral is required to book.
Book an appointment at BeFit Training Physiotherapy — no referral needed.
Edgecliff: (02) 9327 7749 | Coogee: (02) 7205 2805 | befittrainingphysio.com/book-now
Related Services
Learn more about our hip pain physiotherapy, tendinopathy treatment and physiotherapy in Sydney.
Further Reading
For more on hip and glute strength, see Glutes vs Quads: The Truth About Patellofemoral Pain.
References
Mellor R, et al. Education plus exercise versus corticosteroid injection use versus a wait and see approach on global outcome and pain from gluteal tendinopathy: a randomised clinical trial. BMJ. 2018.
Fearon AM, et al. Greater trochanteric pain syndrome negatively affects work, physical activity and quality of life. J Arthroplasty. 2014.
Allison K, et al. Hip abductor muscle volume and strength differences between those with and without gluteal tendinopathy. Man Ther. 2016.
Australian Physiotherapy Association. Clinical guidelines. physiotherapy.asn.au.
