Pain on the Outside of Your Hip? 6 Tips for Gluteal Tendinopathy (Not Hip Bursitis)

By Dr. Zach Greenwade, DC, MS | Published: June 18th, 2026

🎥 Watch: Stop Treating Hip Bursitis Until You Watch This! (Understanding GTPS & Gluteal Tendinopathy)

If you are dealing with nagging pain on the outside of your hip—especially when sleeping on your side, walking, climbing stairs, or standing on one leg—you may have been told you have hip bursitis.

While that diagnosis is incredibly common, current research shows that most people actually have a condition called gluteal tendinopathy, also known as Greater Trochanteric Pain Syndrome (GTPS).

Understanding the true cause of your pain is the first step toward lasting relief.

Need expert relief right now? Don’t stay in pain. 👉 Book an Online Consultation with Our Specialists Today.

What Is Greater Trochanteric Pain Syndrome (GTPS)?

Greater Trochanteric Pain Syndrome is a condition involving the tendons of the gluteal muscles where they attach to the outside of the hip. These tendons act as the anchors that help stabilize your pelvis when walking, running, climbing stairs, and standing on one leg.

The pain is usually felt directly over the bony prominence on the outside of the hip called the greater trochanter. In some cases, symptoms may radiate into the buttock or down the outer thigh, but they typically do not extend below the knee.

Common Symptoms

• Pain on the outside of the hip

• Pain when lying on the affected side

• Pain when standing on one leg

• Discomfort climbing stairs

• Pain after prolonged walking

• Tenderness when pressing on the side of the hip

• Aching pain that worsens at night

Note: Unlike nerve-related conditions like sciatica, gluteal tendinopathy usually does not cause numbness or tingling.

Is It Really Hip Bursitis?

Many patients walk into clinics having been told they have “trochanteric bursitis.” While the fluid-filled sac (bursa) can become irritated, research suggests that isolated bursitis is actually quite uncommon.

MRI studies show that the vast majority of patients with lateral hip pain have some degree of gluteal tendon involvement. In many cases, the bursa only becomes inflamed because the neighboring tendon is overloaded and failing to handle the pressure—meaning the bursa is a symptom, not the primary problem.

This distinction matters. Treatments that only focus on reducing inflammation (like ice and rest) may provide temporary relief, but they fail to address the underlying tendon weakness.

🔗 Read more: The Real Difference Between Hip Bursitis and Tendinopathy

How Is Gluteal Tendinopathy Diagnosed?

An accurate diagnosis does not always require expensive MRIs or X-rays. A clinician can highly accurately identify gluteal tendinopathy using four physical tests:

1. Palpation of the Greater Trochanter: Pressing directly on the bony area on the outside of the hip reproduces your familiar pain.

2. Single Leg Stance Test: Standing on the affected leg for 30 seconds triggers your symptoms.

3. Resisted Hip Abduction Testing: Pushing your leg outward against resistance reveals weakness and pain.

4. FABER Test: A specific movement assessment (Flexion, Abduction, External Rotation) that stresses the hip structures to see if it reproduces symptoms.

When these tests are positive together, diagnostic accuracy is extremely high.

Why Does This Condition Develop?

Gluteal tendinopathy is generally caused by excessive compression and load on the gluteal tendons over time. Instead of being an “inflammatory” problem, it is a “wear and capacity” problem.

Several factors can contribute to this overload:

• Weak hip and gluteal muscles

• Changes in walking mechanics

• Prolonged sitting or poor posture

• Improper sleeping positions

• Sudden increases in training volume (e.g., walking or running more)

• Women over the age of 50 are particularly affected due to biomechanical and hormonal changes.

Daily Habits That Can Reduce Hip Pain

Small changes throughout your day can significantly reduce the compressive forces on your hip tendons and give them a chance to heal.

1. Sitting

Avoid sitting with your knees together or crossing your legs, which stretches and compresses the outer hip tendons.

• Instead: Keep your feet wider than shoulder-width apart and sit with your hips slightly higher than your knees.

2. Standing

Avoid “hanging” on one hip or standing with all your weight shifted to one side.

• Instead: Stand evenly on both legs and maintain a level pelvis.

3. Walking

Try to keep your feet from crossing the midline of your body (like walking on a tightrope). A slightly wider walking stance helps reduce compression on the tendons.

4. Sleeping

Many people experience their worst pain at night.

• Instead: If sleeping on your back, use pillows for support under your knees. If sleeping on your side, place a thick pillow between your knees to keep your leg from dropping down and compressing the hip.

🔗 Read more: How to Modify Your Posture and Positions to End Hip Pain

What Treatments Work Best?

Research consistently shows that education and progressive exercise provide the strongest long-term outcomes for gluteal tendinopathy. The goal is not simply to rub the pain away—it is to rebuild the tendon’s ability to tolerate load.

Effective Treatment Approaches

• Progressive strengthening exercises: Gradually overloading the glutes to build tendon resilience.

• Load management & activity modification: Finding your baseline and avoiding movements that severely aggravate the hip.

• Movement retraining: Correcting walking and standing habits.

Additional Treatments That May Help

Some patients benefit from supplemental therapies like Dry Needling, Shockwave Therapy, or Platelet-Rich Plasma (PRP). However, these should be viewed as supplements to a structured exercise program, not replacements for it.

What About Cortisone Injections?

Corticosteroid injections can provide excellent short-term pain relief. However, they do not strengthen the tendon. In fact, repeated injections can weaken tendon tissue over time. Use them only to open a pain-free window so you can successfully begin your rehabilitation exercises.

🔗 Read more: Debunking Hip Pain: Myths vs. Facts on Cortisone and Rest

How Much Pain Is Safe During Exercise?

Pain does not automatically mean damage. When rehabilitating a tendon, a helpful guideline is the “4 out of 10 rule.”

During exercise:

• Mild discomfort is acceptable.

• Pain should generally stay below a 4/10 (where 0 is no pain and 10 is unbearable).

• Symptoms should return to your baseline within 24 hours.

If your pain significantly worsens or remains elevated the following day, the exercise load was too high and needs to be scaled back.

Recovery Takes Time

One of the most frustrating aspects of gluteal tendinopathy is that recovery is gradual. Tendons adapt slowly because they have a limited blood supply compared to muscles.

Progress occurs through consistent loading, good movement habits, and patience. Temporary flare-ups do not mean you are starting over; they simply provide information about what your tendon can currently handle.

Avoiding Spikes and Dips in Physical Activity

To get your hip moving in the right direction, you need to find your activity baseline and avoid the frustrating trap of “spikes and dips.”

Tendons crave steady, predictable activity, but they hate sudden changes. Here is how to break the common “boom-and-bust” cycle:

• Avoid the “Spikes”: When your hip feels good, it’s tempting to celebrate by going for a long walk or doing a heavy workout. This sudden spike overloads the healing tendon and triggers a painful flare-up.

• Avoid the “Dips”: When a flare-up happens, your instinct might be to completely rest and sit on the couch for a week. This deep dip is actually counterproductive, as total rest makes the tendon weaker and less capable.

• Find Your Baseline: Instead of riding this rollercoaster, find a safe “middle ground.” This is an amount of daily walking or exercise that keeps your hip discomfort at a mild level (under a 4/10) and allows your pain to completely clear up within 24 hours.

Once you lock in this safe foundational floor, you can gradually and safely build your hip’s strength without triggering another setback.

When Should You Seek Professional Help?

If you have persistent hip pain that keeps you awake at night, limits your walking or exercise, or continues to return despite resting, it’s time for professional guidance.

A thorough, personalized evaluation can identify the exact source of your symptoms and build a step-by-step roadmap to get you back to living comfortably.

📅 Ready to fix your hip pain for good?

👉 CLICK HERE to book your online expert assessment today

Frequently Asked Questions (FAQ)

1. How can I tell the difference between hip arthritis and gluteal tendinopathy?

Hip osteoarthritis typically causes pain deep in the groin or front of the thigh and is often accompanied by stiffness in the morning. Gluteal tendinopathy causes pain specifically on the outside of the hip that is tender when pressed directly.

2. Should I stretch my outer hip if it hurts?

Generally, no. Traditional “IT band” or glute stretches (like crossing your leg over and pulling it to your chest) compress the gluteal tendon against the bone, which can actually make tendinopathy worse. Focus on strengthening rather than stretching.

3. How long does it take for gluteal tendinopathy to heal?

Because tendons adapt slowly, a comprehensive recovery plan usually takes anywhere from 3 to 6 months of consistent, progressive strengthening. However, daily pain levels often improve much sooner with proper posture modifications.

4. Can I still exercise with lateral hip pain?

Yes! Complete rest actually weakens tendons. You should continue to stay active but modify your movements to avoid high-impact activities or positions that cross your legs, keeping your pain under a 4/10.

Contact Performance Sport & Spine

If you are local to the Seattle Eastside area and need a tailored rehabilitation strategy, visit our clinic or reach out to our team:

• 📍 Address: 16770 NE 79th Street, Suite 100, Redmond, WA 98052

• 📞 Phone: 425-896-7151

• 🌐 Online Scheduling: Book an Appointment Here

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.

Medical Disclaimer

Disclaimer: The information provided in this article, including text, graphics, images, and other material, is for educational and informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider, such as a sports chiropractor, physical therapist, or medical doctor, with any questions you may have regarding a medical condition or treatment plan. Never disregard professional medical advice or delay seeking it because of something you have read on this website.