Gluteal Tendinopathy: The Overlooked Cause of Outer Hip Pain
Gluteal tendinopathy causes pain on the outer hip — the greater trochanter — and is one of the most commonly misdiagnosed conditions in middle-aged adults, particularly women. It's frequently labelled 'bursitis' or 'hip arthritis', and treated accordingly, with limited success. Understanding what it actually is — tendinopathy of the gluteus medius or minimus tendons — changes the management completely.
What aggravates gluteal tendinopathy — and what you should stop doing
The hallmark provocations are specific hip positions that compress the tendon: crossing your legs, sitting with your knees together, standing with your weight shifted to one side, and lying on the affected hip. These 'compression loads' are distinct from the tensile loads that drive recovery. This is why people with gluteal tendinopathy often inadvertently make it worse through the positions they adopt to rest.
Understanding compression versus tension loading is one of the most practical insights we share with patients across the Berwick and Casey area. Small habit changes — uncrossing your legs, equalising your standing posture — can significantly reduce baseline pain while the tendon heals.
Progressive loading as the treatment
As with all tendinopathies, progressive loading is the treatment of choice for gluteal tendinopathy. Research by Jill Cook and colleagues has established a clear loading protocol that begins with isometric holds and advances through isotonic and functional phases. Manual therapy at RISE Sports & Spinal supports pain management and addresses contributing hip and lumbar mechanics alongside the loading programme.
If outer hip pain has been limiting your walking, sitting, or exercise tolerance, a proper tendinopathy assessment will give you a clear roadmap. Book at our Berwick clinic and we'll get you started.
Why gluteal tendinopathy is so often misdiagnosed as bursitis
Greater trochanteric pain syndrome was historically attributed to trochanteric bursitis — inflammation of the bursa overlying the greater trochanter. Imaging and surgical evidence now shows that the bursa is rarely the primary pain source; the underlying gluteus medius and minimus tendon insertions are. This distinction matters because bursal injections, while providing short-term relief, do not address the tendon pathology and are associated with high recurrence rates. Ultrasound-guided steroid injection into the bursa is still widely prescribed, but research consistently shows inferior long-term outcomes compared to progressive tendon loading.
Patients across Berwick and South-East Melbourne who have had one or more corticosteroid injections for hip pain without lasting improvement are often dealing with undertreated gluteal tendinopathy. At RISE Sports & Spinal, assessment distinguishes between tendon and bursal involvement and identifies the specific compression positions and movements driving symptom provocation. A structured loading programme — progressed carefully to avoid tendon compression — is then the primary intervention. Most patients with genuine gluteal tendinopathy achieve significant and lasting improvement within eight to twelve weeks of appropriate loading.
Book an initial consultation at RISE Sports & Spinal in Berwick. Clear diagnosis, hands-on treatment, and a plan that actually gets you better.
