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How Long Does Gluteal Tendinopathy Take to Heal?

By Emma Glynn - The Hip & Knee Physio



a woman with gluteal tendinopathy

When I explain a gluteal tendinopathy diagnosis, the question that follows almost every time is: how long is this going to take?


You have probably been dealing with this outer hip pain for weeks or months. You have modified your walking, stopped the activities you care about, and tried resting it. The pain eases slightly when you do less, then comes straight back when you try to resume.


You may have had an injection that gave you a few good weeks and then wore off. Now you want to know whether you are looking at months or years, and what is actually going to fix it.


The honest answer is that it depends but "it depends" without any detail is not useful, so here is what the research shows.



What Is Happening in the Tendon

The gluteus medius and gluteus minimus tendons attach to the bony prominence on the outside of your hip, called the greater trochanter. In gluteal tendinopathy, these tendons have been subjected to repeated loads - particularly compressive loads from certain postures and movements, that exceed what they can currently tolerate. The tendon tissue responds with a reactive or degenerative change (Cook & Purdam, 2009).


Tendons do not respond to rest the way a muscle strain does - they need progressive, appropriate load to remodel and strengthen.

Too little loading slows the process down. Too much loading at the wrong stage provokes a flare and sets recovery back. This is why gluteal tendinopathy requires more precision in management than simply waiting for the pain to ease.


If you have been told your pain is bursitis, it is worth reading this overview of how bursitis and gluteal tendinopathy differ - the two conditions are often confused, and the management is not the same.


What the Research Says

The best evidence on gluteal tendinopathy recovery comes from a landmark randomised trial published in the BMJ (Mellor et al., 2018). The trial compared three groups: those who received an education and progressive exercise program, those who received a corticosteroid injection, and those who took a wait-and-see approach.


The results were clear:

  • The exercise group showed meaningful improvement at 8 weeks and continued to improve through 52 weeks

  • At 12 months, the exercise group had significantly better outcomes than either of the other groups

  • The wait-and-see group showed some improvement, but significantly less at every time point

  • The corticosteroid injection group had better short-term outcomes than exercise at 8 weeks but by 52 weeks, the exercise group had overtaken them decisively


What this means for you: the timeline is not fixed. It is heavily influenced by whether you are doing the right things.

Practical Recovery Timelines

Mild gluteal tendinopathy - onset within the last few months, manageable pain, limited activity restriction.


With appropriate load management and a structured progressive exercise program, most people notice meaningful improvement within 6 to 12 weeks. This does not mean full resolution — it means pain is reducing, load tolerance is building, and you can start doing more.


Moderate gluteal tendinopathy - symptoms for several months, some activity limitation, flares after walking or prolonged sitting.


Expect 3 to 6 months for significant improvement. The first 4 to 6 weeks often feel slow - the tendon is adapting before the pain reliably shifts. Progress picks up after that. Setbacks during this phase are common and normal; they do not mean you are going backwards if you are managing them correctly.


Chronic or persistent gluteal tendinopathy - symptoms for 12 months or more, significant functional loss, multiple failed treatments.


Recovery in 6 to 12 months is achievable, but it requires the right program and genuine consistency. This is the group most likely to have been doing things that inadvertently compress the tendon and changing those patterns is as important as the exercise itself.


What Makes the Biggest Difference

Eliminating compressive positions. Research by Grimaldi and Fearon (2015) identified compression of the gluteal tendons against the greater trochanter as a key driver of tendon irritation. Until those postures are consistently modified, the tendon stays irritated regardless of what you do in your exercise sessions.


The compressive positions to change immediately:

  • Crossing your legs

  • Sitting with your knees falling inward

  • Sitting in deep or low chairs for extended periods

  • Pulling the knee across the body to stretch the glutes

  • Sleeping on the affected side without a pillow between your knees


If you are unsure whether your sleep position is a factor, there is more detail in the lateral hip pain at night post.


Progressive hip abductor loading. Allison et al. (2016) found that people with gluteal tendinopathy have significantly weaker hip abductors compared to those without the condition. The gluteus medius and minimus need to be progressively strengthened to tolerate daily demands. This starts with isometric exercises, where you contract the muscle without movement and progresses from there.


Working within an acceptable pain range. Waiting until you are pain-free before exercising will significantly delay recovery. The research-supported approach is to exercise within a manageable pain range: a pain score of 3 to 4 out of 10 during the exercise, returning to baseline within 24 hours. Staying completely still does not build the load capacity the tendon needs.


Not chasing short-term fixes. Injections, massage, and other passive treatments can reduce pain enough to make exercise more tolerable, but they do not address the underlying load capacity problem. If you have had an injection that has worn off, the window of reduced pain needed to be used for progressive loading - not rest.


Consistency over months. Tendon remodelling takes time. Progress in the early stages can feel invisible. The patients who recover fastest are the ones who do the work even when they cannot yet feel it helping, and who do not abandon the program after a flare.


Why Stretching Often Makes It Worse

One of the most common things I see is people stretching their glutes to relieve hip pain - pigeon pose, figure-four stretch, pulling the knee across the body. These feel like they should help because the hip feels tight.


They tend to make gluteal tendinopathy worse.


These stretches place the gluteal tendons in exactly the compressive position that drives the condition. If your hip feels tight, that tension is more likely a protective response from the tendon than a flexibility problem that needs stretching. The walking modification post goes into more detail on movement patterns worth changing if this is something you have been doing.


When to Get Help

If you have been managing this independently for more than 6 to 8 weeks without meaningful improvement, a proper assessment is worth pursuing. An APA Titled Musculoskeletal Physiotherapist who focuses entirely on hip and knee conditions can clarify the severity, identify specific aggravating patterns, and build a progressive loading program calibrated to where your tendon currently is, not a generic protocol.

The goal is not to manage this forever. It is to build enough load capacity that your tendon can handle your actual life again, the walking, the exercise, the work day, the sleep.


If you are in Melbourne, I work from Camberwell and see a lot of people with exactly this presentation. I also run an online rehabilitation program for people who cannot access in-person physiotherapy. You can find out more about what to expect from an initial assessment.


Emma




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References

Allison, K., Vicenzino, B., Wrigley, T. V., Grimaldi, A., Hodges, P. W., & Bennell, K. L. (2016). Hip abductor muscle weakness in individuals with gluteal tendinopathy. Medicine & Science in Sports & Exercise, 48(3), 346–352. https://doi.org/10.1249/MSS.0000000000000781


Cook, J. L., & Purdam, C. R. (2009). Is tendon pathology a continuum? A pathology model to explain the clinical presentation of load-induced tendinopathy. British Journal of Sports Medicine, 43(6), 409–416. https://doi.org/10.1136/bjsm.2008.051193


Grimaldi, A., & Fearon, A. (2015). Gluteal tendinopathy: Integrating pathomechanics and clinical features in its management. Journal of Orthopaedic & Sports Physical Therapy, 45(11), 910–922. https://doi.org/10.2519/jospt.2015.5829


Mellor, R., Bennell, K., Grimaldi, A., Nicolson, P., Kasza, J., Hodges, P., Wajswelner, H., & Vicenzino, B. (2018). Education plus exercise versus corticosteroid injection use versus a wait and see approach on global outcome and pain from gluteal tendinopathy: Prospective, single blinded, randomised clinical trial. BMJ, 361, k1662. https://doi.org/10.1136/bmj.k1662



Medical Disclaimer: The information in this post is for general educational purposes only and does not constitute medical advice. It is not a substitute for assessment, diagnosis, or treatment by a qualified health professional. If you are experiencing hip pain, please seek assessment from a registered physiotherapist or your GP.

 
 
 

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