Gluteal Tendinopathy: Causes, Prevention and What the Research Says

Experiencing pain on the outside of your hip? Gluteal tendinopathy is a common cause of hip pain that can make walking, climbing stairs, sleeping on your side and exercising uncomfortable.

 

The good news is that research supports education and progressive exercise as effective approaches to managing symptoms and improving function. Understanding what aggravates your hip and how to gradually build strength can help you return to the activities you enjoy.

 

What is gluteal tendinopathy?

 

Gluteal tendinopathy occurs when the tendons of the gluteus medius and/or gluteus minimus muscles become painful and less tolerant of loading. These muscles help stabilise your pelvis and control hip movement during everyday activities.

Common symptoms include:

• Pain or tenderness on the outside of the hip.
• Discomfort when lying on the affected side, particularly at night.
• Pain when walking, climbing stairs or standing on one leg.
• Stiffness or discomfort after prolonged sitting.

 

Although often called hip bursitis, gluteal tendinopathy primarily affects the tendons, although nearby bursae can also contribute to symptoms.

 

What causes gluteal tendinopathy?

 

Gluteal tendinopathy often develops when the demands placed on the tendons exceed their current capacity to tolerate them.

 

Several factors may contribute:

• Sudden increases in activity: Rapidly increasing walking distances, running volume or gym intensity can overload the tendons before they have time to adapt.
• Compression around the hip: Positions such as crossing your legs, standing with your weight resting on one hip or sleeping directly on the painful side can increase compression of the gluteal tendons.
• Changes in strength and load tolerance: When the hip muscles and tendons struggle to tolerate everyday demands, activities such as stair climbing and single-leg movements may become uncomfortable.
• Individual factors: Gluteal tendinopathy is more common in women, particularly during middle age and beyond. Age, hormonal changes and individual differences in tendon health may contribute, although there is no single cause.

 

Importantly, experiencing gluteal tendinopathy does not mean your hip is permanently damaged or that you need to stop exercising altogether.

 

How can you help prevent it?

 

While not every case can be prevented, a few strategies can help support hip health and manage tendon loading.

 

• Build activity gradually. Avoid making large increases in walking, running or training volume too quickly.
• Maintain hip strength. Regular strengthening helps build your capacity for everyday activities.
• Modify aggravating positions. If your hip is painful, try reducing prolonged leg crossing or standing on one hip. A pillow between your knees may help when sleeping.
• Balance activity and recovery. If symptoms repeatedly flare after exercise, adjust the intensity, duration or frequency rather than stopping all movement.

What does the research say about rehabilitation?

Research supports education and progressive exercise as key components of gluteal tendinopathy rehabilitation.

 A landmark Australian clinical trial published in The BMJ in 2018 also found that an education and exercise programme resulted in better overall recovery than corticosteroid injections or a wait-and-see approach, with benefits in overall improvement still evident at 52 weeks.

 These findings support an active, individualised approach to rehabilitation.

 

Practical rehabilitation tips include:

• Start with manageable exercises: Begin with strengthening activities that suit your current symptoms and gradually increase the challenge.
• Progress towards functional movement: As your tolerance improves, exercises such as bridges, sit-to-stands and step-ups may help build strength for daily activities.
• Monitor your symptoms: Some discomfort may be manageable, but significant or prolonged increases in pain may indicate that your exercise load needs adjusting.
• Be consistent: Tendons adapt gradually, so meaningful improvements may take several weeks or months.

 

The right program will depend on your symptoms, strength, activity levels and personal goals.

 

How can an Accredited Exercise Physiologist help?

 

An Accredited Exercise Physiologist (AEP) can help you develop an evidence-informed exercise programme tailored to your needs.

 

At Exercise Physiology Brisbane, an AEP can help by:

• Assessing your function: Identifying activities that aggravate symptoms and assessing relevant hip strength and movement.
• Developing a personalised programme: Selecting and progressing exercises to improve strength, control and tendon load tolerance.
• Providing education: Helping you understand your symptoms and manage activity without unnecessarily avoiding movement.
• Monitoring progress: Adjusting your programme as your pain, strength and functional capacity improve.
• Supporting your goals: Gradually building towards activities such as walking comfortably, returning to the gym or enjoying Pilates.

 

Where appropriate, an AEP can also work alongside your GP or physiotherapist to support coordinated care.

 

The takeaway:

 

Gluteal tendinopathy can interfere with sleep, exercise and everyday life, but you do not necessarily need to give up the activities you enjoy.

 

Research supports education, sensible load management and progressive strengthening as important parts of rehabilitation. With the right support and an individualised approach, you can gradually build your hip's capacity, improve confidence and return to the activities that matter to you.

 

Experiencing persistent hip pain? Contact Exercise Physiology Brisbane to discuss how an individualised exercise programme may support your recovery.

 

Further reading:

1. The efficacy of gluteal tendinopathy treatments: A systematic review (2025)
2. Mellor et al. (2018), The BMJ: Education plus exercise for gluteal tendinopathy