Understanding Lateral Hip Pain: Gluteal Tendinopathy and GTPS
- Emma Glynn
- Aug 19
- 5 min read
Updated: Sep 5
Lateral hip pain (over the bony point on the side of your hip) is common. Two frequent labels you’ll hear are:
Gluteal tendinopathy — irritation/sensitivity of the gluteus medius/minimus tendons.
Greater trochanteric pain syndrome (GTPS) — an umbrella term that can include tendon pain and, at times, bursal irritation (“hip bursitis”).
The everyday plan usually centres on reducing compression over the outside of the hip and gradually building tendon capacity with tolerable loading.
What is Gluteal Tendinopathy?
Your gluteus medius and minimus tendons help keep your pelvis level when you walk, climb stairs, or stand on one leg. When those tendons are overloaded or sensitised, they can become sore, especially with certain positions.
Common patterns people report include:
Soreness directly over the outer hip.
Pain with side-lying, particularly lying on the sore side.
A dull ache after longer walks, standing, or stairs.
Language check: Lots of people call this “hip bursitis.” True bursal inflammation can occur, but many cases are primarily tendon-related. The ideas below target tendon load and comfort.
Signs That Fit a Tendon-Related Picture
Green Flags (Often Settle with Simple Changes)
Discomfort with prolonged positions (e.g., sitting cross-legged, hitching off one hip).
Next-day ache after a long walk or a day on your feet.
Tenderness to touch over the outer hip.
Yellow Flags (Book an Assessment for Tailored Guidance)
Night pain most nights despite simple changes.
Pain that spikes with small tasks or lingers for hours afterward.
Repeated flare-ups when returning to running or gym work.
Red Flags (Seek Medical Care Promptly)
Recent fall/trauma, sharp groin pain, or inability to weight-bear.
Fever, unexplained weight loss, or spreading redness/warmth.
Numbness, tingling, or weakness down the leg.
Everyday Tweaks to Try
Try these for 1–2 weeks and notice patterns of improvements. Ease off anything that flares symptoms during or after.
1. Reduce Compression on the Outside of the Hip
Side-sleep: Add a pillow between the knees; if lying on the sore side, lean slightly forward/back onto a pillow so you’re not directly on the bony point.
Sitting: Limit long periods cross-legged; sit with feet flat, hips level.
Standing: Avoid “hanging on one hip.” Share weight evenly or change sides regularly.
2. Begin with Tolerable Loading
Two gentle entry points many people start with:
Isometric hip abduction hold (standing): 20–30 seconds, 3–5 holds, comfortable effort.
Short-lever side-lying leg hold (knee bent): 10–20 seconds, 3–5 holds.
These are starting ideas only. The important bit is progression—building duration, then sets/reps, then more challenging positions over time.
3. Walking and Stair “Dosage”
Keep most walks comfortable; if a long day causes issues, shorten the next one.
Stairs: Slow pace, handrail if needed, and limit repeats while symptoms are irritable.
What a Physio Looks for in an Assessment
The aim is to confirm what’s driving your pain and find a tolerable starting point. A typical session may explore:
History & Patterns: Where the pain is located, what aggravates and eases it, how the pain started.
Red/Yellow Flags: Recent trauma, night pain trend, systemic symptoms, nerve changes.
Simple Physical Tests: Single-leg stance, resisted strength tests, functional assessments, and palpation to map sensitivity.
Load Tolerance: Finding positions you can perform without flaring up.
Plan Outline: A small set of day-to-day tweaks and a graded loading plan that fits your life.
Example of Graded Loading
Everyone starts in a different place. As a general guide:
Weeks 1–2: Low-irritation exercises, plus position changes for sleep/sitting/standing. Walks stay comfortable.
Weeks 3–4: Progress exercises. Monitor the 24-hour response; if symptoms spike, scale back the next day.
Weeks 5–6: Progress to longer holds or controlled reps with slightly more load (resistance band or less hand support), and gradually reintroduce hills or stairs.
If pain escalates during or lingers long after, step back to the last tolerable dose.
Information only; seek assessment if symptoms persist or you’re unsure.
Common Mistakes (and Easy Fixes)
Stretching into sharp end-range when the tendon is irritable → Swap to tolerable holds first; add range later.
Hanging on one hip while standing → Share weight; keep hips level.
Cross-leg sitting for long periods → Feet flat, hips level, change posture regularly.
Leaping ahead too fast on “good” days → Progress in small steps and watch the next-day response.
Stopping everything → Complete rest often deconditions the tendon; a gentle, graded plan usually works better.
FAQs
Is imaging always needed?
Not usually at first. Imaging decisions depend on your history, examination findings, and red flags.
Can I stretch the outside of my hip?
If the tendon is sensitive, heavy end-range stretching can backfire. Many start better with avoiding this early on.
Can this coexist with hip osteoarthritis?
Yes, sometimes. Management still revolves around load management and strength, tailored to you.
When to Consider an Assessment
Symptoms haven’t settled over 2 weeks despite simple changes.
Night pain is persistent or worsening.
You’re unsure whether this matches your situation.
An assessment helps confirm what’s driving your pain and sets a plan you can actually follow.
Next Steps (Choose What Suits You)
Prefer to read and try basic exercises? Explore the Gluteal Tendinopathy Kickstarter (6-week, home-based program)
Want individual guidance? Book an assessment in Camberwell
Unsure where to start? Take the 2-minute hip quiz to get clarity on your pain
Can't Find What You're Looking For?
Explore more of our most popular services and guides:
Disclaimer
The content provided on this website is for general information and educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. While The Hip and Knee Physio strives to present accurate and up-to-date information, we do not guarantee results or outcomes based on the information provided. Any exercises, strategies, or recommendations featured on this site should not be considered a personalised treatment plan. Always seek the advice of a qualified healthcare provider before starting any exercise program, particularly if you are experiencing pain, injury, or a pre-existing medical condition. Use of this website does not create a physiotherapist–patient relationship. The Hip and Knee Physio accepts no responsibility for any injury or loss arising from reliance on or use of this information. By using this website, you agree to these terms.
References
Education + exercise works for gluteal tendinopathy (LEAP RCT). Mellor R, Bennell K, Grimaldi A, et al. BMJ 2018;361:k1662. Education + exercise outperformed corticosteroid injection and wait-and-see at 8 weeks and remained superior at later follow-ups. BMJ
Gluteal tendinopathy is a primary source of lateral hip pain (not just “bursitis”). Grimaldi A, Fearon A. JOSPT 2015;45(11):910–922. Clinical commentary integrating pathomechanics and management for gluteal tendinopathy/GTPS. jospt.org
GTPS clinical features and case definition. Fearon A, Scarvell JM, Neeman T, et al. Greater trochanteric pain syndrome: defining the clinical syndrome. Br J Sports Med 2013;47(10):649–653. bjsm.bmj.com
Diagnosis is clinical; imaging rarely changes early management. NICE CKS: Greater trochanteric pain syndrome — Diagnosis & assessment (UK primary-care guidance). cks.nice.org.uk
Typical symptoms + self-care (including pillow between knees; avoid compressive postures). Royal Berkshire NHS: Greater Trochanteric Pain Syndrome (patient leaflet, 2024). Royal Berkshire NHS United Lincolnshire Hospitals NHS: Greater Trochanteric Pain Syndrome (patient leaflet, 2025). United Lincolnshire Hospitals
Load management + progressive strengthening principles in tendon rehab. Cook JL, Rio E, Purdam CR, et al. Revisiting the continuum model of tendon pathology. Br J Sports Med 2016;50(19):1187–1191. bjsm.bmj.com
Step-width modification: wider steps reduce hip adduction angle/moment (biomechanics). Sports Medicine – Open 2024 systematic review: The Biomechanical Influence of Step Width on Typical Locomotor Activities. Findings: increasing step width reduces hip adduction angle/moment; a plausible clinical cue for some hip/lateral chain problems. SpringerOpen
Practice guideline overview for GTPS (load-management focus). Ohio State University Wexner Medical Center: GTPS Clinical Practice Guideline
Comments