Overview

Gluteal tendinopathy is irritation of the tendons of the gluteus medius or gluteus minimus where they attach to the bony bump on the outside of the hip (the greater trochanter).

It is now considered the most common local cause of outer-hip (lateral hip) pain in many people — more common than the "trochanteric bursitis" label it used to carry. The tendon, not the bursa, is usually the main problem, which changes how the injury is treated: tendons generally respond better to progressive loading than to rest and injection alone.

Typical Pattern

Pain on the outside of the hip, over the bony bump
Worse when lying on the affected side at night
Worse when walking, climbing stairs or standing on one leg
Ache after sitting with legs crossed or after long car rides
Tenderness when pressing on the side of the hip

Why It Develops

The gluteal tendons work hard every time you walk: the gluteus medius and minimus steady the pelvis on the standing leg. Pain often develops when the tendons are loaded more than they are used to — a big increase in walking, running, hiking or stairs — or when hip control is poor and the tendons take extra strain.

It is more common in women and in middle age, but active people of any age can develop it. Prolonged sitting, weakness in the glutes and changes in load all play a role.

How It Is Diagnosed

A clinician examines the hip, checks tenderness over the greater trochanter and tests movements like standing on one leg or resisted hip abduction. Most cases are diagnosed clinically.

Ultrasound or MRI can confirm tendon thickening, tearing or fluid, and rule out other sources. They are not needed for every case.

Treatment

The strongest evidence points to exercise plus education — not rest, and not relying on injections alone.

Education about load: understand which activities overload the tendon and adjust them temporarily rather than stopping all movement
Progressive strengthening: exercises that load the gluteal tendons in a graded way — isometrics early, then side-lying hip abduction, hip hinges and glute bridges as pain settles
Comfortable positions: avoid lying directly on the painful side; use a pillow between the knees if side-lying is needed
Pain as a guide: mild discomfort during exercise that settles afterward is often acceptable; sharp, increasing pain is a sign to back off

A well-known randomized trial found that education plus exercise produced better long-term results than corticosteroid injection or a wait-and-see approach. Recovery takes time — tendons respond slowly, and improvement is usually measured in months rather than days.

When to Get Assessed

Pain that is not improving after several weeks of sensible load adjustment
Inability to walk comfortably or pain with every step
Sudden severe pain, a pop or a feeling that the hip "gives way"
Pain with fever, redness or swelling over the hip

References

Grimaldi A, Fearon A. "Gluteal Tendinopathy: Integrating Pathomechanics and Clinical Features in Its Management." Journal of Orthopaedic & Sports Physical Therapy. 2015. https://pubmed.ncbi.nlm.nih.gov/26381486/
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: prospective, single blinded, randomised clinical trial." BMJ. 2018. https://www.bmj.com/content/361/bmj.k1662

This information is for education only and is not a medical diagnosis. InjuryAtlas does not replace an assessment by a qualified health professional. If you have severe pain, visible deformity, numbness, loss of function, or symptoms that are getting worse, seek medical care promptly.

Gluteal Tendinopathy