Maybe you heard the term from your GP, or read it at the bottom of a scan report. Either way, you already know the pain. It sits on the outside of your hip and sometimes spreads down the side of your thigh. It's worse lying on that side, worse on stairs, and sore when you first get moving after a long rest 1. This page covers what's going on, and why resting it so often doesn't help.
A tendon is the tough cord that joins a muscle to bone. Your gluteus medius and minimus sit on the side of your hip. Their tendons attach to the greater trochanter, the bony bump you can feel on the outside of your upper thigh 1.
This surprises most people: the tendons aren't normally inflamed, which is why rest and anti-inflammatory tablets often don't fix it 1. The nearby bursa, a small fluid-filled cushion, shows changes on scans in only a minority of people 3.
Load and compression are what aggravate it. Pain tends to flare with deep squats, stairs and impact exercise 1. Reducing compression on the tendons is one of the main principles of managing it 3. Patient guidance also lists everyday positions to avoid: crossing your legs, standing with your weight hanging on one hip, sitting in low chairs, and sleeping on the sore side 1.
It's recorded in about 1.8 of every 1,000 patients a year 6, and while it's most common in women over 40, younger people and men get it too 3.
If you were told you had hip bursitis, you may have the same thing under an older name. The condition used to be called trochanteric bursitis. That explanation has largely been replaced, because scans show bursa changes in only a minority of people, and tendinopathy is the main finding 3. So the useful question usually isn't "bursitis or tendinopathy?" It's whether the tendon is the whole story.
Things that can sit alongside it, or be mistaken for it 3,6:
An assessment works out which of these is actually driving your pain.
Much of this can be worked out in the clinic with two simple checks. If standing on the sore leg brings on your outer hip pain within 30 seconds, gluteal tendinopathy is very likely. If pressing on the bony point of the hip doesn't hurt, it's unlikely 4. We also use movements that compress or stretch the tendons to see which ones reproduce your pain 4.
No test is perfect, though. In that study of 65 people with outer hip pain, 20 had tendinopathy on MRI but tested negative in the clinic, and the authors warned that the sample was small 4. MRI is also how the Australian treatment trial confirmed each physiotherapist's diagnosis 2.
The strongest evidence comes from an Australian trial of 204 people aged 35 to 70, all with gluteal tendinopathy confirmed on MRI. Fourteen sessions of education and exercise led by a physiotherapist, over 8 weeks, beat both a single steroid injection and a wait-and-see approach. At 8 weeks, average pain was 1.5 out of 10 with education and exercise, 2.7 after the injection, and 3.8 for wait-and-see 2.
Our approach follows the same principles:
The longer term is less clear-cut: at 12 months, the trial found education and exercise still gave better overall improvement than the injection, but pain scores were no longer different between the two 2.
Manual therapy can help keep you comfortable while the exercise work does its job. One caution, straight from patient guidance: deep massage over the sore spot isn't recommended, and neither is a lot of stretching 1. We treat hands-on work as support, not the main event.
The evidence is limited. In one trial, shockwave did better than a steroid injection at 15 months 8, but there are few studies and little high-quality evidence 3. It's worth discussing if progress stalls. See our shockwave therapy page.
This is a medical procedure, not something Well Motion physiotherapists administer. It can ease pain in the short term, but the relief usually doesn't last 1,3. Repeated injections are often not advised because they may weaken the tendon 1. That conversation belongs with your GP or specialist.
Because the tendon isn't normally inflamed, anti-inflammatories often don't fix it 1. Your GP or pharmacist can advise on pain relief.
Gluteal tendinopathy is slow to settle, so we plan it in stages along The Well Motion Recovery Path™. What your hip tolerates decides when you step up, not the calendar.
How long it usually takes. With exercise therapy, symptoms can take 6 to 12 months to settle 1. That range comes from hospital patient guidance, not a study. One small trial of 44 people, with no untreated group, found pain and disability still improving across 6 months of follow-up 9. It stopped there.
No trial has tested prevention on its own. What has been tested, as part of treatment, is teaching people how to load the tendon:
Get an assessment instead of managing it on your own if:
None of this means something is seriously wrong. Most cases settle with conservative care 6. It usually just means the plan needs adjusting, or the cause hasn't been fully pinned down yet.
We start by listening: how it began, what makes it worse, and what it's stopping you from doing. Then we examine the area, explain what we find in plain English, and agree a plan with you. Your first visit is 40 minutes at Engadine and 30 minutes at our other clinics.
We see patients at Engadine, Mount Annan, Narellan and Appin, and at home through our mobile physiotherapy service. If you have private health cover, here's how health fund rebates work for physiotherapy.
For most people, yes. Most cases can be managed with conservative, non-surgical care 6. It's slow, though: with exercise therapy, symptoms can take 6 to 12 months to settle 1.
Patient guidance lists several 1. Don't rest completely, don't stretch a lot, don't massage deeply over the sore spot, don't ignore ongoing moderate or severe pain, and don't rely on repeated steroid injections. Day to day, avoid crossing your legs, hanging on one hip, low chairs, and sleeping on the sore side.
No. A steroid injection can bring short-term relief 1,3. But in the Australian trial, education and exercise gave lower pain at 8 weeks and better overall improvement at 12 months 2. Tendons take time to adapt 1, and the best-supported route is the steady one.
It's linked, but it isn't the whole cause. The condition is particularly common in women after menopause 3, when oestrogen falls. Men and younger people get it too 3, so hormones are only part of the picture.
Pain on the outside of the hip, usually worst lying on that side and on stairs. Often called trochanteric bursitis.
Read moreTight, sore hip flexors at the front of the hip. Common in runners, tradies and anyone whose day is mostly seated, and it deserves a better answer than "just stretch more."
Read moreA hip socket that's shaped differently from the start. For parents of a child who's been diagnosed, and for adults managing it long-term.
Read moreHip osteoarthritis is a long-term condition that affects the whole joint (cartilage, bone, joint lining, ligaments, tendons and muscles), not just "worn cartilage".
Read morePiriformis syndrome is when the piriformis, a muscle deep in your buttock, puts pressure on the sciatic nerve. It usually affects one side
Read moreIn FAI, the ball and socket of your hip meet too early as it bends, because one or both have an unusual shape, called cam or pincer
Read moreA snapping hip is a snap you can hear or feel as the hip moves. It's usually a tendon or band of tissue flicking over a bony point
Read moreThe labrum is a rim of cartilage around your hip socket. It helps absorb shock, spread pressure and keep the joint stable
Read more
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