By Dr. Zach Greenwade, DC, MS | Published: August 4th, 2026

Pressing on the sore spot tells only part of the story—accurate diagnosis of gluteal tendinopathy comes from how the tendon responds during specific loading tests.

Quick Checklist.  You may have gluteal tendinopathy if:

✓ Pain directly over the outside of the hip
✓ Worse lying on that side
✓ Pain with stairs or hills
✓ Pain standing on one leg
✓ Pain with prolonged sitting

No single test confirms gluteal tendinopathy by itself. Diagnosis is based on the combination of symptoms, pain location, tendon loading tests, and exclusion of other causes of lateral hip pain

4 Best Diagnostic Tests for Gluteal Tendinopathy

• Greater Trochanter Palpation (with Resisted Abduction)

  • How it’s performed: The clinician applies direct pressure over the insertion of the gluteus medius and minimus tendons on the greater trochanter while combining with resisted hip abduction.

  • Diagnostic Value: Highly sensitive; reproduces localized focal trochanteric pain.

• 30-Second Single Leg Stance Test (SLST)

  • How it’s performed: The patient stands unassisted on the affected leg for up to 30 seconds with hands on hips.

  • Diagnostic Value: High specificity; places sustained tensile and compressive load on the lateral hip stabilizers. Reproduction of lateral hip pain within 30 seconds indicates a positive result.

• FADER-R Test (Flexion-Adduction-External Rotation with Resistance)

  • How it’s performed: The hip is passively moved into Flexion, Adduction, and External Rotation (putting the gluteal tendons under maximum compressive stress over the greater trochanter), followed by resisted isometric internal rotation or abduction.

  • Diagnostic Value: High diagnostic accuracy; combines tensile compression with active load to provoke tendinopathic pain.

• Resisted Hip Abduction Test

  • How it’s performed: Performed in side-lying or neutral position; the patient abducts the leg against clinician resistance.

  • Diagnostic Value: Directly isolates and loads the gluteus medius and minimus contractile unit, confirming tendon involvement when localized trochanteric pain is reproduced.

Key Differential Diagnosis Red Flags

Condition	Pain Location & Characteristics	Key Distinguishers
Gluteal Tendinopathy	Focal greater trochanter pain; may radiate down lateral thigh.	Pain in side-lying, single-leg stance, stair climbing; no hip joint stiffness.
Hip Osteoarthritis (OA)	Anterolateral (‘C-sign’), groin, or lateral/buttock pain.	Morning stiffness, difficulty putting on shoes/socks, painful restriction in FABER test.
Lumbar Referred/Radicular Pain	Diffuse back/buttock ache or dermatomal leg/foot pain.	Paresthesia/dysaesthesia, distal foot symptoms, pain aggravated by spine flexion/bending.
Vascular/Nerve Entrapment	Burning, neuralgic, or claudication-type leg pain.	Triggered by walking, relieved promptly by rest; neuralgic pattern without focal tenderness.

Ready for a Complete 12-Week Protocol?

If you want a fully structured, day-by-day blueprint to eliminate outer hip pain, check out our comprehensive digital guide:

👉 Download the 12-Week Gluteal Tendinopathy Protocol Online

Master the Recovery Process

• Main Blog Guide: Gluteal Tendinopathy Causes, Symptoms, & Diagnosis – Learn how to identify lateral hip pain, understand compressive load mechanisms, and build a foundational understanding of treatment.

• 6 Essential Tips for Managing Lateral Hip Pain – Quick, actionable adjustments you can implement today to stop aggravating your hip.

• Why Clamshells Don’t Work (And Make Hip Pain Worse) – Discover why this popular exercise increases tendon compression and what to do instead.

• Walking Modifications for Gluteal Tendinopathy – How adjusting your gait width and stride length can dramatically reduce hip pain while walking.

• Pain Reduction & Sleep Modifications – Learn optimal side-sleeping positions using pillow support to eliminate night-time trochanteric pain.

• Posture Modifications to Protect Your Hips – Simple standing and sitting fixes to eliminate compressive stress on the gluteal tendons throughout the workday.

• The Best Exercises for Gluteal Tendinopathy (Level 1–4 Progression) – Step-by-step loading progressions from low-compression isometrics to heavy slow resistance training.

Frequently Asked Questions (FAQ)

What is the most reliable physical test for gluteal tendinopathy?

A combination of greater trochanter palpation with resisted hip abduction, alongside the 30-Second Single Leg Stance Test and the FADER-R test, yields the highest overall diagnostic accuracy.

How do you differentiate gluteal tendinopathy from hip osteoarthritis?

Gluteal tendinopathy presents with localized pain on the outer point of the hip without joint stiffness. Hip osteoarthritis causes deeper groin/anterolateral pain and functional stiffness, such as difficulty tying shoes or putting on socks.

Can lumbar spine issues mimic gluteal tendinopathy?

Yes. Lumbar disc or nerve root conditions can refer pain to the lateral hip. However, lumbar-referred pain usually lacks focal greater trochanter tenderness and may cause numbness, tingling, or pain extending past the knee into the foot.

Is an MRI or ultrasound required to diagnose gluteal tendinopathy?

No. Clinical physical examination combined with patient history provides strong diagnostic accuracy. Imaging is typically reserved for recalcitrant cases or when excluding surgical pathology.

Why should I avoid traditional clamshell exercises for gluteal tendinopathy?

Clamshells require flexing the hip to 45–90 degrees and bringing the leg into adduction/rotation, which pulls the gluteal tendon tightly over the greater trochanter. This creates excessive compressive force and friction, aggravating tendinopathy symptoms rather than strengthening the tendon safely.

About the Author

Dr. Greenwade, DC, MS is an evidence-based sports chiropractor, movement specialist, and the founder of Performance Sport & Spine, serving patients across the Eastside in Redmond and Seattle. Holding a Master of Science in sports medicine alongside a Doctorate of Chiropractic, Dr. Greenwade specializes in modern physical medicine, progressive loading, and active, movement-based recovery. The clinic’s mission is to help active individuals and office professionals resolve acute and chronic musculoskeletal conditions without unnecessary injections, medications, or surgeries.

References

Grimaldi, A., Ganderton, C., & Nasser, A. (2025). Gluteal tendinopathy masterclass: Refuting the myths and engaging with the evidence. Musculoskeletal Science and Practice, 76, Article 103253. https://doi.org/10.1016/j.msksp.2025.103253

Medical Disclaimer

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