What it is

Gluteal tendinopathy is sensitivity of the gluteus medius and minimus tendons at their insertion on the greater trochanter. It is a key driver of lateral hip pain and overlaps with GTPS.

Pain rises with side-lying, stair climbing, and long walks, and settles when compressive positions are reduced and strength is rebuilt.

What happens when it occurs

Repeated compression and tensile load irritate the tendon. Reducing adduction and building abductor strength improves tolerance.

Common causes and risk factors

  • Prolonged hip adduction postures and side-lying without support
  • Weak abductors and poor single-leg control
  • Rapid increases in walking or hill work

Who is most affected

Adults in midlife, especially women, walkers, runners, and people who stand for long periods.

Typical symptoms

  • Lateral hip pain and tenderness over the greater trochanter
  • Pain on stairs, hills, and side-lying
  • Morning stiffness that eases with movement

When to seek care

If pain persists beyond two weeks, disturbs sleep, or limits walking.

How we diagnose

History, palpation over the trochanter, and resisted abduction tests. Imaging is used when a tear is suspected or when progress stalls.

Management

  • Avoid deep adduction and side-lying on the painful side
  • Heavy slow abductor loading and gait retraining
  • Shockwave therapy for persistent cases

Rehabilitation milestones

Phase 1 weeks 0 to 2: reduce compressive postures, isometrics, short flat walks.

Phase 2 weeks 2 to 6: heavy slow abductor and extensor loading.

Phase 3 weeks 6 to 12: step-downs, hills, return to run plan.

Phase 4 weeks 12 to 16: full activity.

Readiness to progress

  • Side-lying is pain-free
  • Abductor strength within 90 percent
  • Hills and step-downs without flare

Prevention

  • Maintain abductor strength and control
  • Pillow between knees in side-lying
  • Progress hill and walking loads gradually

Australia snapshot

  • Common cause of lateral hip pain in primary care
  • Women present more often than men by several fold
  • Walking and standing occupations feature strongly

Latest insights

Reduce compression first, then strengthen. Night comfort is a good early marker of progress.

Strength and gait work provide durable change.

Frequently Asked Questions

Many improve over 6 to 12 weeks with compressive-load reduction and strengthening. Long-standing cases take longer.

Yes, keep flat walks and easy runs in small, regular doses. Avoid long hills until strength improves.

Use imaging if a tear is suspected or if progress stalls. Ultrasound or MRI can guide care.

Use a pillow between the knees and avoid lying on the painful side early.

Heavy slow abductor loading and step-down control, progressing to hills and running.

Alternate standing and sitting, and avoid prolonged hip adduction postures.

When side-lying is comfortable, strength is within 90 percent, and hill sessions cause no next-morning flare.