Why Your Hip Pain Isn't Getting Better
- Emma Glynn
- Mar 23
- 5 min read
By Emma — The Hip and Knee Physio, Camberwell Melbourne
Does any of this sound familiar?
You have pain on the side of your hip that you cannot explain — no fall, no obvious injury
Your pain is worse after walking, exercise, or a busy day on your feet
Sleeping on your side wakes you during the night
Crossing your legs or climbing stairs aggravates it
It eases once you get moving — but the next day, you pay for it
If you are searching for answers about hip pain not getting better in Melbourne, this post is for you.
You have likely tried rest, Panadol, and Nurofen. You may have seen someone about it without lasting results. The reason it is not improving is almost certainly related to how it has been managed — not anything permanent about your hip.
What is most likely causing your hip pain
Pain on the outer side of the hip — not in the groin, not deep in the joint, but directly on the side — is frequently caused by [gluteal tendinopathy]. This condition affects the tendons of the gluteal muscles at their attachment to the greater trochanter, the bony prominence on the outside of your hip. It is also referred to as [greater trochanteric pain syndrome] in the research literature.
Gluteal tendinopathy predominantly affects active adults over 40, particularly women, and is one of the most frequently mismanaged presentations in musculoskeletal physiotherapy (Mellor et al., 2018).
Despite being well documented, it is routinely misdiagnosed as hip bursitis, referred pain from the lumbar spine, or dismissed as something that will resolve on its own. In many cases, without the right approach, it does not.
Why rest is not resolving your hip pain
The most common advice for hip pain is rest. For gluteal tendinopathy, this recommendation is poorly supported by current evidence and may contribute to a longer recovery.
Tendons respond to load — and the gluteal tendons require progressive, appropriate loading to remodel and adapt (Cook & Purdam, 2009). Without it, they remain sensitised and reactive to compression and changes in demand. Complete rest removes the stimulus the tendon needs to recover and contributes to weakness in the surrounding musculature, which increases tendon load when activity resumes.
This is why hip pain not getting better in Melbourne is such a common pattern — people rest, feel slightly better, return to activity, and the pain comes back.
It is not a sign something has gone seriously wrong. It is a sign the tendon has not been given the right conditions to adapt.
The positions that compress the tendon and slow your recovery
Certain positions place direct compression on the gluteal tendon and can perpetuate symptoms even when overall activity levels are low. These include:
Sitting with your legs crossed
Standing with your weight shifted onto one hip
Sleeping on the affected side without support between your knees
Stretching the hip by pulling your knee across your body
Many of these positions feel intuitively helpful — particularly hip stretching — but for a sensitised gluteal tendon, compression and stretch can slow recovery rather than support it (Mellor et al., 2018).
This is one of the reasons why well-intentioned self-management — general hip exercises from the internet or a generic app — often does not lead to improvement. The exercises may be appropriate for hip pain broadly but are not matched to this specific condition at this specific stage.
What the evidence supports for hip pain that is not improving
The current best evidence supports a structured, progressive loading program. This begins with load management — understanding which positions and activities to modify — and progresses through a specific sequence of exercises designed to systematically reload the tendon over time.
A randomised controlled trial by Mellor et al. (2018), published in the BMJ, found that an education and exercise program produced significantly greater improvements in pain and function compared to corticosteroid injection or a wait-and-see approach, with benefits maintained at 12 months.
A systematic review by Docking and Cook (2020) further supports progressive tendon loading as the primary rehabilitation strategy for tendinopathy across multiple presentations.
The program must be progressive and individually matched. Beginning too aggressively can set recovery back. Staying at too low a level does not drive the adaptation the tendon needs. This is why understanding your baseline strength, activity levels, and current tendon sensitivity matters before a rehabilitation program begins.
When to seek a professional assessment
If your hip pain has been present for more than six to eight weeks, consider seeking assessment if:
It is affecting your sleep consistently
It is limiting activities important to your daily life or fitness
You have tried self-management without meaningful improvement
You are unsure whether what you are experiencing is gluteal tendinopathy or something else
A thorough assessment helps confirm the diagnosis, identifies contributing factors such as gluteal muscle weakness or hip joint involvement, and establishes a rehabilitation plan matched to your specific presentation. Earlier assessment generally means a clearer and more direct path forward.
Your next step
If you are based in Melbourne and would like to be assessed in person, I consult at Life Ready Physiotherapy in Camberwell on Mondays, Wednesdays, and Thursdays.
If you are elsewhere in Victoria — or would prefer to begin working on this independently — my [Gluteal Tendinopathy Rehab Program] is available online. It is a self-paced, evidence-based program that follows the same progressive rehabilitation framework I use with my in-clinic patients.
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Medical disclaimer: This blog post is intended for general informational purposes only and does not constitute medical advice. Please consult a qualified health professional for assessment and management of your individual condition.
Emma is an APA Titled Musculoskeletal Physiotherapist and Clinical Exercise Physiologist with 13 years of clinical experience treating hip and knee conditions.
References
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
Docking, S. I., & Cook, J. (2020). How do tendons adapt? Going beyond tissue responses to understand positive adaptation and pathology development. Journal of Applied Physiology, 126(6), 1719–1727. https://doi.org/10.1152/japplphysiol.00151.2019
Mellor, R., Bennell, K., Grimaldi, A., Nicolson, P., Kasza, J., Hodges, P., Thorborg, K., & Vicenzino, B. (2018). Education plus exercise versus corticosteroid injection use versus a wait and see approach on global outcome and pain from gluteal tendinopathy. BMJ, 361, k1662. https://doi.org/10.1136/bmj.k1662
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