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Hip · Gluteal Tendinopathy (Greater Trochanteric Pain Syndrome)

Gluteal Tendinopathy

Irritation of the buttock-muscle tendons where they attach to the bony point on the side of your hip. They've been overloaded and squeezed against that bone — nothing is torn, and it's not the old 'bursitis' label.

The tendons get compressed against the bone when the hip falls into adduction (legs crossed, hanging on one hip, lying on the side) and overloaded faster than they're conditioned for. That's why the fix is reducing compression + progressive abductor loading — not stretching or rest.

How it typically shows up

Pain over the bony point on the side of the hip (the greater trochanter), tender to press and worse lying on that side or standing on one leg, with deep-joint, groin, mechanical, and back-referred sources excluded.

How long recovery takes

This responds well to understanding it plus gradually strengthening the muscles on the side of your hip — that combination works better than a cortisone shot or just waiting it out. Expect steady improvement over weeks to a few months; flare-ups along the way are normal.

The phased recovery approach

  1. Phase 1 · 1–2 weeks

    Calm

    Calm the irritated tendon with isometric abductor loading and reduce compression; no stretching.

    What you get back: calmer days on your feet.

    • Isometric Hip Abduction (lying) — 3–4 sets × 10–20s hold · Lie on your back, gently press the outside of the leg into a wall or belt
    • Isometric Hip Abduction (standing) — 3–4 sets × 10–20s hold · Stand tall, press the outside of the leg gently into a wall
    • Double-Leg Bridge — 1–3 sets × 8–10 reps · On your back, knees bent, lift the hips
    • Offset (Single-Leg-Biased) Bridge — 1–3 sets × 8–10 reps · Bridge with most weight through one leg

  2. Phase 2 · 2–6 weeks

    Rebuild

    Progressively load the hip abductors with single-leg-biased work.

    What you get back: standing on one leg without the ache.

    • Isometric Hip Abduction (standing) — 2–3 sets × 15–30s hold · Stand tall, press the outside of the leg gently into a wall
    • Isometric Hip Abduction (lying) — 2–3 sets × 15–30s hold · Lie on your back, gently press the outside of the leg into a wall or belt
    • Offset (Single-Leg-Biased) Bridge — 2–3 sets × 8–12 reps · Bridge with most weight through one leg
    • Offset (Single-Leg-Biased) Squat — 2–3 sets × 8–12 reps · Squat with most weight through one leg, fingertips on a support

  3. Phase 3 · 3–6 weeks

    Back to daily life

    Higher abductor loading to return to walking, stairs, and training.

    What you get back: walking, stairs, and training again.

    • Graded Walking — 1 sets × 600–1800s hold · Walk on flat ground at an easy pace, keeping your stride smooth and level
    • Offset (Single-Leg-Biased) Squat — 2–3 sets × 8–12 reps · Squat with most weight through one leg, fingertips on a support
    • Standing Band Abduction — 2–3 sets × 8–12 reps · Band at the ankles, take one leg out to the side
    • Sidestepping — 2–3 sets × 8–12 reps · Small athletic stance, step side to side

  4. Phase 4 · 3–8 weeks

    Back to running

    Carry compression-free externally-loaded hip-abduction and gluteal strength into a graded walk-jog → continuous-jog progression — advancing only when the side of the hip settles within 24h.

    What you get back: running again.

    • Run-Walk Intervals (lateral-hip response) — 1 sets × 600–1800s hold · Alternate easy jogging with walking recoveries on flat ground; keep the pelvis level and the stride smooth
    • Machine / Cable Hip Abduction — 3–4 sets × 8–12 reps · Seated abduction machine, or a cable/ankle-strap: drive the leg OUT to the side against the load, hips level
    • Standing Band Abduction — 3–4 sets × 8–12 reps · Band at the ankles, take one leg out to the side
    • Sidestepping — 3–4 sets × 8–12 reps · Small athletic stance, step side to side

  5. Phase 5 · 3–8 weeks

    Back to the gym

    Progressive externally-loaded gluteal/abductor strength — loaded hip abduction, hip thrust, and loaded step-up — built WITHOUT compression, to return to lower-body lifting and training.

    What you get back: lower-body training without the lateral-hip ache.

    • Machine / Cable Hip Abduction — 3–4 sets × 8–12 reps · Seated abduction machine, or a cable/ankle-strap: drive the leg OUT to the side against the load, hips level
    • Standing Band Abduction — 3–4 sets × 8–12 reps · Band at the ankles, take one leg out to the side
    • Sidestepping — 3–4 sets × 8–12 reps · Small athletic stance, step side to side
    • Barbell Hip Thrust — 3–4 sets × 8–12 reps · Shoulders on a bench, a padded barbell across the hips: drive the hips up to a level bridge and lower with control

Exact exercises, sets and progression depend on your severity, equipment and goal — this is the shape of the program, not a one-size prescription.

What matters while you recover

  • Take the squeeze off the tendon

    The biggest needle-mover is keeping the hip out of compression: don't sit with knees together or legs crossed (sit with hips a little wider, hips higher than knees), don't stand hanging on one hip, and don't sleep on the painful side — put a pillow between your knees so the top leg doesn't drop across.

  • Skip the stretches

    It's tempting to stretch the outside of the hip, but ITB and 'glute' stretches pull the hip across your body — exactly the position that compresses this tendon. They tend to flare it. Strength, not stretch.

  • This responds to exercise

    Education plus a graded strengthening program is the best-evidenced treatment — it outperformed a cortisone injection and beat waiting it out, with the benefit lasting. Give it weeks, expect ups and downs.

Common questions

Should I stretch it?
No — the usual ITB/'glute' stretches pull the hip across the body, which compresses the sore tendon and tends to make it worse. Strengthening, not stretching, is the fix here.
Is some discomfort during the exercises okay?
Yes — up to about 5/10 is fine as long as it settles by that night and isn't worse the next morning.
Is it bursitis?
'Trochanteric bursitis' is an old name for the same thing — imaging usually shows tendon involvement, not a bursa, and it's managed as a tendinopathy.

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