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Lateral hip pain (gluteal tendinopathy):
symptoms, what it means, and practical next steps

Pain on the outside of the hip that makes it hard to lie on your side, walk, or climb stairs is often due to gluteal tendinopathy, also known as greater trochanteric pain syndrome (GTPS). It’s common in women over 40 and can be frustratingly persistent if the tendon keeps being overloaded or compressed.

 

This page explains how lateral hip pain from gluteal tendinopathy typically behaves, why it happens, what current research says about exercise versus injections, and when imaging or surgery are considered.

 

It’s written for active women 45–70 in Camberwell and Melbourne’s inner east who want clear, realistic guidance and a plan that doesn’t involve giving up on movement.

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What you’ll learn on this page

  • How to recognise a typical GTPS / gluteal tendinopathy pattern

  • Simple changes to sleeping, sitting, and walking that often help

  • Where exercise, injections, and imaging realistically fit into treatment

Typical symptoms & patterns

GTPS is now thought to be driven mainly by irritation or degeneration in the gluteus medius and minimus tendons at the side of the hip, often with local bursal irritation.

Common features include:

  • Aching or sharp pain on the outside of the hip, over the bony point (greater trochanter), sometimes spreading down the outside of the thigh

  • Pain when you lie on the sore side, and often also if you lie on the other side with the sore hip on top

  • Discomfort with walking, stairs, hills, or standing on one leg, especially after a spike in activity

  • Pain when getting up from low chairs, or after sitting with legs crossed or “hanging” the hip out to the side

  • Tenderness if you press firmly over the outside of the hip – sometimes enough to make you “jump” off the bed.

 

Some people also notice a sense of weakness or fatigue in the hip, especially when walking longer distances or on uneven ground.

Why it happens

Your gluteus medius and minimus tendons help keep the pelvis level and control the hip when you walk, climb stairs, or stand on one leg. If those tendons are exposed to more load or compression than they can currently tolerate, they can become painful and less able to cope – that’s tendinopathy in simple terms.

 

Common contributing factors include:

  • Sudden changes in load – a new walking routine, more hills, or a big spike in steps

  • Postures that compress the tendon, like:

    • Standing with the hip “dropped out” to one side

    • Sitting with legs crossed

    • Lying directly on the sore hip without support

  • Reduced hip strength or control, so the tendon works harder with everyday tasks

  • Hormonal and metabolic factors (GTPS is especially common in post-menopausal women).PubMed+1

 

Lateral hip pain can also coexist with lower back issues, hip osteoarthritis, or other tendon problems, which is why a careful assessment matters.

When to see someone – and when to scan

​When to see a physio

It’s reasonable to seek help if:

  • The outside of your hip has been sore for more than a few weeks

  • You’re struggling to lie on your side, walk, or take stairs

  • You’ve already tried “resting it” and it keeps flaring up when you get going again

  • You’re unsure which exercises are safe or how much to push

A physio with hip and pelvic experience can check whether your pattern fits GTPS or if something else needs to be ruled out.

 

When scans may be considered

For typical GTPS, imaging is not always needed upfront. Diagnosis is usually based on your story and physical examination – including palpation around the greater trochanter and specific strength tests.

 

Ultrasound or MRI might be considered if:

  • Your symptoms are atypical or severe

  • There’s concern about partial or full-thickness gluteal tendon tear, other hip joint pathology, or stress fracture

  • You’re not improving with appropriate conservative care and more invasive options are being considered

 

Even when imaging shows “tears” or bursal changes, treatment decisions still prioritise your symptoms and function, not the scan alone.

How we assess & plan at The Hip and Knee Physio (Camberwell)

In an initial consult for lateral hip pain, we typically:

  • Clarify your story – when the pain started, what aggravates it, how it behaves overnight and across the week

  • Pinpoint the pain – using palpation around the greater trochanter and surrounding structures

  • Assess hip strength, control, and endurance, especially in single-leg stance and functional tasks

  • Look at posture and movement habits – how you stand, sit, lie, and walk

  • Screen for other causes of lateral hip pain (e.g. hip joint pathology, referred lumbar pain, more serious causes).

 

From there, you’ll leave with:

  • A plain-English explanation of what’s likely driving your pain

  • Specific changes to sleeping, sitting, and standing to reduce tendon compression

  • A progressive but realistic strength plan, usually starting with 2–4 key exercises

  • Clear expectations about how load might be reintroduced (walking, stairs, classes, or sport)

 

If imaging or a surgical opinion might be appropriate, we’ll discuss this openly and liaise with your GP or hip specialist.

FAQs – Patellofemoral pain

1. Why does lying on my side hurt so much?

When you lie on the affected side, body weight compresses the irritated gluteal tendons and bursa against the greater trochanter, which can be very sensitive. Even lying on the opposite side with the sore hip on top can pull the tissues into compression if the top leg crosses over.

Pillows between the knees, under the top leg, or switching to back-lying can often reduce this.

 

2. Is this “bursitis” or “tendinopathy” – and does it matter?

The umbrella term GTPS covers both gluteal tendinopathy and trochanteric bursitis, which frequently occur together. Current evidence suggests the gluteal tendons are often the primary pain source, with bursal irritation as a secondary feature.

In practice, treatment still focuses on reducing compression and improving tendon load capacity – so the broad management approach is similar.

 

3. Do I need an injection to fix it?

Not necessarily. In the main gluteal tendinopathy trial, education plus exercise produced better global improvement at both 8 and 52 weeks than a single corticosteroid injection. Injections can help short term, but they don’t replace the need to address tendon load and strength.

 

For some people with severe pain, an injection may be one tool to “take the edge off” while rehab gets going – but it’s rarely the whole answer.

Local practicals – Camberwell clinic

​The Hip and Knee Physio consults from 1/3 Prospect Hill Road, Camberwell, a short walk from Camberwell Junction and public transport. The building offers good access and facilities, including accessible entry and amenities, and there is parking available nearby.

Book Now

If your hip pain is starting to limit your walking, stairs, or confidence, a structured assessment can help you understand what’s going on and what to do next.

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  • Book a Gluteal Tendinopathy consult in Camberwell – Book Now Hip and Knee Physio

  • Prefer to talk first? You can contact the clinic to discuss whether an appointment is appropriate for your situation

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