Gluteal Tendinopathy: Why Lateral Hip Pain Isn’t Just Bursitis

While that term is still commonly used, we now know that in many cases the real issue is something different: gluteal tendinopathy.

This condition is one of the most common causes of persistent hip pain, particularly in adults over 35, and it’s frequently misunderstood.

Let’s unpack what’s really going on and how physiotherapy can help.

What Causes Gluteal Tendinopathy (and How It Works)

Gluteal tendinopathy affects the gluteus medius and minimus tendons, which attach on the outside of the hip. These tendons play a critical role in:

• Pelvic stability
• Walking and running
• Single-leg tasks like stairs, standing, and balance

Rather than being an inflammatory problem, tendinopathy is a load-related tendon condition.

This means the tendon becomes painful when it’s exposed to more load than it can tolerate, or sometimes too little of the right kind of load.

Common contributing factors include:

• Sudden increases in walking, running, or gym activity
• Prolonged sitting or standing on one leg
• Weak or poorly conditioned hip muscles
• Poor load distribution through the pelvis and lower limb
• Previous hip, back, or knee pain altering movement patterns

Over time, the tendon becomes sensitive and painful, especially with compression (like lying on the sore side) or repetitive use.

How This Condition Can Be Managed or Improved

The encouraging news is that gluteal tendinopathy responds very well to structured physiotherapy, but rest alone is rarely the answer.

Management focuses on:

• Reducing excessive tendon compression (especially early on)
• Gradually rebuilding tendon load tolerance
• Improving hip and pelvic control
• Addressing contributing movement patterns

Physiotherapy isn’t just about strengthening—it’s about loading the tendon correctly.

Too much, too soon can flare symptoms. Too little, and the tendon doesn’t adapt.

A tailored rehab plan may include:

• Education around positions that aggravate symptoms
• Targeted hip strengthening (progressed carefully)
• Load management strategies for walking, running, and work tasks
• Improving lower limb alignment and movement efficiency
• Gradual return to impact or sport if relevant

With the right approach, many people see steady improvement over weeks to months.

Practical Tips You Can Start Today

If lateral hip pain sounds familiar, here are some simple steps you can take:

Avoid compressive positions

• Try not to lie directly on the painful side
• Avoid crossing your legs or hanging on one hip when standing

Modify sleep posture

• Use a pillow between your knees if side sleeping
• Consider sleeping on your back temporarily if side-lying is painful

Keep moving—but smartly

• Complete rest often makes things worse
• Aim for tolerable activity levels that don’t significantly flare pain the next day

Be cautious with stretching

• Aggressive hip stretches can increase tendon compression and aggravate symptoms.

Seek guidance early

• Early diagnosis and correct loading can prevent this from becoming a long-term issue.

Final Thoughts & Next Steps

Lateral hip pain isn’t something you just have to “put up with,” and it’s not always bursitis.

Gluteal tendinopathy is a common, manageable condition when treated with the right combination of education, movement, and progressive loading.

If your hip pain has been lingering, affecting sleep, walking, or exercise, a proper assessment can make all the difference.

If you’re ready to take control of your pain, book an appointment at M Physio or call us on 1800 992 999 —we’re here to help you move freely and live without pain.