If you are dealing with nagging, burning pain on the side of your hip, you have probably been told you have “hip bursitis” or a tight IT band. You might even have tried stretching it out or aggressively foam rolling the area, only to find that the pain feels even worse the next day.
There is a reason for that. True outer hip pain is most often gluteal tendinopathy—an injury to the tendons that anchor your glute muscles to your hip bone. Unfortunately, standard advice often backfires. When it comes to treating gluteal tendinopathy, doing the wrong things only irritates the tissue further.
At Performance Sport & Spine, we treat hundreds of patients dealing with this exact issue. Whether you visit us at our clinic in Seattle or our specialized rehabilitation space in Redmond, WA, our goal is to cut through the misinformation and give you evidence-based strategies that actually work.
Here are four practical, clinical-grade tips to calm your hip pain down and get your quality of life back.
1. Load the Tendon with Isometric Contractions
When a tendon is highly irritated, it hates movement, but it absolutely loves load. The secret is using isometric contractions—which means contracting the muscle without moving the joint. Isometrics allow you to stimulate and strengthen the tendon without compressing it against the bone.
Try introducing these one to two times a day. Start with 5 to 10 repetitions of 5-second holds. Choose the variation that feels most comfortable for your hip:
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Seated: Sit tall and press the outside of your knee outward against your hand or a resistance band.
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Supine (On your back): Lie down with a pillow supporting your knees, loop a resistance band around your thighs, and gently press outward.
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Standing: Stand with feet hip-width apart and imagine “ripping the floor apart” with your feet, activating your lateral glutes.
Ensure your knees and hips stay at least hip-width apart to avoid compression. Over time, you can gradually increase the band resistance to build cellular tolerance in the tendon.
2. Utilize Tactical Pain Relief (TENS & Heat)
While passive modalities won’t cure a tendinopathy long-term, breaking the pain cycle is crucial for recovery—especially if hip discomfort keeps you awake at night.
Applying a heating pack or using a portable TENS unit directly on the lateral hip can provide immense temporary relief. Using a TENS unit or heat right before bed can desensitize the nervous system, lower your acute pain scores, and help you get the restful sleep your body needs to heal.
To see exactly how to position the electrodes for maximum relief, we feature a complete walkthrough in our comprehensive YouTube video on lateral hip pain relief solutions, where we demonstrate proper placement and execution.
3. Consider Dry Needling for Moderate to Severe Pain
Many people default to corticosteroid injections for severe hip pain, but high-quality clinical data suggests there is a better, non-invasive alternative. A recent study found that dry needling can be just as effective as steroid injections for reducing gluteal tendinopathy pain without the degenerative side effects of cortisone.
Dry needling is highly effective if you meet these criteria:
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Your hip pain wakes you up consistently at night.
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Your average daily pain is a 5/10 or higher.
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Your peak pain spikes hit a 7/10 or worse.
To maximize results, the research indicates you should receive dry needling three times over a two-week window. While needling drops the pain signal, remember: it clears the path for rehab, but you still must do the exercises to structurally rebuild the tendon. Brennan et al 2017
4. Eliminate Tendon Compression and High Spikes
The most critical long-term strategy is removing the structural stressors that trigger tendinopathy flare-ups.
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Stop Stretching and Foam Rolling: Pulling your leg across your body or rolling directly on the side of your hip compresses the tendon against the greater trochanter. Irritated tendons hate compression.
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Watch Your Posture: Avoid hanging on one hip while standing, crossing your legs when sitting, or sleeping on your side without a thick pillow between your knees.
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Stabilize Your Step Baseline: Tendons thrive on predictability and hate sudden spikes in activity. If your average baseline is 4,000 steps a day, jumping to 8,000 steps for a weekend hike will likely cause a massive inflammatory setback. Keep your daily activity shifts gradual.
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Monitor the 24-Hour Response: Just because an exercise doesn’t hurt in the moment doesn’t mean it was safe. An overloaded tendon often delays its pain response. If you try a new routine, assess how your hip feels the next morning before increasing your sets or weight. In the early stages, avoid deep lunges, running, or walking on uneven trails.
Rebuild Your Hip for the Long Term
Gluteal tendinopathy is an incredibly stubborn condition, but it is entirely fixable with the right advice. If you are tired of temporary fixes and want an elite, structured progression, we have built a comprehensive 12-week Gluteal Tendinopathy Rehab Program designed to systematically reduce pain, restore pelvic stability, and safely reload your hips.
If you are local to the Pacific Northwest and want an individualized assessment, you can visit our clinical team in Seattle or at our clinic in Redmond, WA.
Don’t let poor advice keep you on the sidelines. Click here to book an appointment online with our sports specialists today, or check out our digital rehab guides to start your recovery from anywhere.
About the Author
Dr. Zach Greenwade, DC, MS, is a sports chiropractor, movement specialist, and the owner of Performance Sport & Spine. Utilizing an evidence-based framework that integrates clinical rehabilitation, strength progression, and joint mechanics, Dr. Greenwade helps active adults and athletes in Redmond and the greater Seattle area bypass unnecessary surgical interventions and return to full performance safely and naturally.
Medical Disclaimer
This article is intended for educational and informational purposes only and should not be considered medical advice or a substitute for individualized evaluation or treatment.
While we aim to provide evidence-informed rehabilitation guidance, every individual and injury is different. Always consult a qualified healthcare professional regarding your specific condition, symptoms, or treatment plan.
Participation in any exercise program is done at your own risk.
