Hip & Thigh

What It Is

One cause of pain on the outside of the hip is gluteus medius tendinopathy, a problem with the tendon of the gluteus medius muscle where it attaches to the side of the hip. In tendinopathy, the tendon tissue breaks down rather than simply becoming inflamed (Cleveland Clinic, 2022). Nearby bursae (small fluid-filled sacs) can also become irritated. The gluteus medius is a hip muscle on the outer part of the buttock. If you put your hand on your buttock, it sits close to where your thumb lies. It works to stabilise the hip and help control movement, especially when you are standing and walking.

Tendons can become painful when they are irritated by a load they are not used to. This can happen with a sudden change in activity, too much or too little, or if the muscles around the hip are weak (King's College Hospital NHS Foundation Trust, 2021). Other causes include extra pressure on the tendons from weight gain, an inactive lifestyle, or a wide pelvis (Cleveland Clinic, 2022).

Women are about three times more likely than men to get this condition, because women's hips are generally wider, which increases the force on the gluteal tendons (King's College Hospital NHS Foundation Trust, 2021). It is particularly common in women over 40, and it also affects younger people who run, ski and dance (Cleveland Clinic, 2022).

Previous surgery around the hip, or hip implants, can also irritate the bursa (American Academy of Orthopaedic Surgeons, n.d.).

Gluteus Medius Tendinopathy Anatomy

The gluteal muscles run from the pelvis to the greater trochanter, the bony bump at the top of the thigh bone on the side of the hip (Cleveland Clinic, 2022). Bursae are small sacs of fluid that sit between a tendon or muscle and the bone. They help prevent friction between the overlying soft tissues and the bone. There are bursae in this area of the hip, lying beneath the gluteal muscles and their tendons where they attach to the greater trochanter.

Not a diagnosis — for more information, contact me or another trusted healthcare provider.

Treatment

Self-Care & Treatment

How to Treat Gluteus Medius Tendinopathy

Specific exercises that gradually strengthen the hip muscles are the key treatment (King's College Hospital NHS Foundation Trust, 2021), and in one large study, education plus exercise gave better results after a year than a steroid injection (Mellor et al., 2018). I can guide you through a graded strengthening programme, with massage alongside your exercises (American Academy of Orthopaedic Surgeons, n.d.) and advice on positions that ease the tendon. See the My Approach tab for how I work.

1. Relative Rest

Reduce the activities that make your symptoms worse, for example the amount of time you spend on your feet (King's College Hospital NHS Foundation Trust, 2021). Complete rest doesn't usually help this condition (Cleveland Clinic, 2022).

2. Ice or Heat

Wrap an ice pack (or frozen peas) in a damp towel and apply it to the sore area for up to 15 minutes, every three hours and up to four times a day. Never put ice directly on the skin. Applying heat to the area can also help with pain relief (King's College Hospital NHS Foundation Trust, 2021).

3. Medication

The American Academy of Orthopaedic Surgeons (n.d.) says anti-inflammatory medicines (NSAIDs), such as ibuprofen, may relieve pain in hip bursitis, but should be used cautiously and for limited periods. King's College Hospital NHS Foundation Trust (2021) says painkillers bought from a pharmacist can help manage the discomfort in the short term. (This medicine information comes from the American Academy of Orthopaedic Surgeons and King's College Hospital NHS Foundation Trust, not from me. Always check with a pharmacist or your family doctor or nurse practitioner before taking any medicine.)

Treatments you may want to discuss with your family doctor or nurse practitioner

Options outside my scope

Steroid injection: an injection of a corticosteroid near the painful area. It can help in the short term, but exercise gave better long-term results in research (Mellor et al., 2018).
Surgery: surgery is rarely needed for this condition (American Academy of Orthopaedic Surgeons, n.d.).

How I can help (see the My Approach tab)

A graded hip strengthening programme
Hands-on work for the low back, buttock and thigh
Advice on sitting, sleeping and standing positions that ease the tendon

Tips

Pain tends to be worse going up and down stairs, getting up from a chair, and getting into and out of a car.
Pain is often worse at night and when lying on the side where the hip hurts (American Academy of Orthopaedic Surgeons, n.d.).
Pain can spread down the outside of the thigh, sometimes to the knee (King's College Hospital NHS Foundation Trust, 2021).
Avoid crossing your legs, standing with your weight hanging on one hip, lying on the painful side, sitting on low chairs, too much stair climbing, and stretching the gluteal muscles, as these can squeeze or strain the tendon. Sleeping with a pillow between your knees can help (King's College Hospital NHS Foundation Trust, 2021).
This condition can take around 3 to 6 months to settle (King's College Hospital NHS Foundation Trust, 2021). If your hip pain does not improve after 6 to 12 weeks, speak to your family doctor or nurse practitioner.

Treatment

My Approach

Pain on the outside of the hip usually comes from the tendons that attach to the bony point at the side of your hip, and these tendons don't like being squashed. My aim is to take the compression off first, then build the strength of your hip muscles gradually so the tendon copes with walking, stairs and the activities you enjoy.

I start by assessing how your hip and low back move, the strength of your hip muscles, and how you stand, walk, sit and sleep, since some positions keep the tendon irritated.

Settling It Down

Avoiding positions that squash the tendon: crossed legs, low deep seats, hanging on one hip and lying on the sore side, with a pillow between your knees if you lie on your side
No pressing into the sore spot: I work the low back, buttock and thigh around it, including trigger points and myofascial work
Gentle, pain-free holds, such as pressing your legs out against a belt without moving
Warm applications in the clinic, and I'll show you how to use ice or heat safely at home

Building Strength

Bridges, sit-to-stands, mini-squats, single-leg standing, side-stepping and step-ups, keeping the knee from collapsing inward
Retraining the deeper buttock muscles so the muscle at the front and outside of the hip stops doing too much
A home programme between visits and, when you're ready, gym-based strength work such as hip hinges and deadlift variations, and a graded return to running or sport
No pain over the side of the hip: if it hurts, we reduce the range, speed or effort

Shorter, softer strides often help when walking. Work on the buttock and hip muscles is only done with your informed consent and a written consent form, and you can say no at any time. If it isn't improving, or the area becomes hot, red and very painful, I'll ask you to see your family doctor or nurse practitioner.

What to Expect

Typical Course

Typical course: Most people come once or twice a week at first, then weekly, then less often as they manage more on their own, with a reassessment at about 4 to 6 weeks. This condition usually takes around 3 to 6 months to settle.

What I Focus On

Offloading Compression

Gentle Isometrics

Progressive Glute Strength

Posture & Gait

Soft Tissue Release

Sources

References

King's College Hospital NHS Foundation Trust (2021) Hip soft tissue injury (gluteal tendinopathy or bursitis). Available at: https://www.kch.nhs.uk/wp-content/uploads/2023/01/pl-942.1-hip-soft-tissue-injury.pdf (Accessed: 7 October 2026).
Mellor, R. et al. (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. doi: 10.1136/bmj.k1662.
American Academy of Orthopaedic Surgeons (n.d.) Hip bursitis. OrthoInfo. Available at: https://www.orthoinfo.org/en/diseases--conditions/hip-bursitis/ (Accessed: 7 October 2026).
Cleveland Clinic (2022) Gluteal tendinopathy. Available at: https://my.clevelandclinic.org/health/diseases/22960-gluteal-tendinopathy (Accessed: 7 October 2026).

Massage therapy · Kitchener–WaterlooGluteus Medius Tendinopathy

What It Is

Gluteus Medius Tendinopathy Anatomy

Self-Care & Treatment

How to Treat Gluteus Medius Tendinopathy

1. Relative Rest

2. Ice or Heat

3. Medication

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

My Approach

Settling It Down

Building Strength

Typical Course

References

Related Conditions

Book a session

Massage therapy · Kitchener–WaterlooGluteus Medius Tendinopathy

What It Is

Gluteus Medius Tendinopathy Anatomy

Self-Care & Treatment

How to Treat Gluteus Medius Tendinopathy

1. Relative Rest

2. Ice or Heat

3. Medication

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

My Approach

Settling It Down

Building Strength

Typical Course

References

Related Conditions

Adductor Tear

Adductor Tendinopathy

Biceps Femoris Tendinopathy

Femoroacetabular Impingement (FAI)

Book a session