Gluteal Tendinopathy: The Outer Hip Pain Women Miss

Gluteal tendinopathy is irritation of the tendons that attach your side glute muscles to the outer hip bone. It causes pain on the side of the hip, often worse lying on that side, climbing stairs or crossing your legs. Gradual strength work and avoiding compression usually help more than stretching.

With more than 20 years as a trainer and a NASM corrective exercise certification, I can tell you this is one of the most overlooked causes of hip pain I hear about from women over 40. Many have been told it is bursitis and handed a stretch that keeps it sore.

This guide explains what gluteal tendinopathy is, why it shows up more often in midlife, how it differs from bursitis, and the loading plan that tends to help it settle.

What Gluteal Tendinopathy Is

Your gluteus medius and gluteus minimus are two side glute muscles that keep your pelvis level when you stand on one leg. Their tendons attach to the greater trochanter, the bony knob on the outside of your upper thigh.

Coach Luke’s Top Pick

The two with the most research behind them.

Creatine + HMB

Creatine is the most studied performance supplement there is, and HMB is aimed at protecting the muscle you already built. Together they cover strength and recovery without the pre-workout jitters.

• Strength & power
• Supports lean muscle
• No stimulants

Read My Creatine + HMB Review →

My honest review — contains affiliate links. 90-day money-back guarantee.

Tendinopathy means a tendon that has become sore and less able to handle load. It is not usually a tear or a sudden injury. Instead, the tendon is irritated by too much squeeze and too much load for its current strength.

It is the most common cause of what doctors call greater trochanteric pain syndrome, the umbrella term for pain on the side of the hip. If you want a wider view of side hip aches, my guide to outer hip pain covers all the usual causes.

Gluteal Tendinopathy Symptoms

The pattern is fairly typical. Common gluteal tendinopathy symptoms include:

• Pain on the outside of the hip, right over the bony point, sometimes spreading down the outer thigh
• Tenderness when you press on that bony point
• Pain lying on the sore side, and often on the other side too, as the top leg drops across
• Pain when standing on one leg, such as putting on pants or climbing stairs
• Stiffness or pain when you first get up after sitting
• An ache after crossing your legs or standing with your weight on one hip
• Pain that builds through a long walk, especially up hills

The pain rarely goes below the knee and does not usually cause numbness. If yours does, something else may be involved.

Why IT Is More Common After 40

Gluteal tendinopathy is up to three or four times more common in women than in men. Several things likely play a role.

Pelvis Shape

A wider pelvis changes the angle of the tendons as they wrap over the hip bone. That can increase the squeeze on them, especially when your hip drops to one side.

Menopause and Estrogen

Estrogen helps tendons stay healthy and repair themselves. As estrogen drops through perimenopause and after menopause, tendons may become less resilient and slower to recover from load. Many women notice hip pain starting in this window.

My guide to perimenopause joint pain explains more about how hormone shifts affect joints.

Changes in Activity

A drop in strength work over the years, followed by a sudden jump in walking, hiking or stairs, is a very common pattern before symptoms start.

Gluteal Tendinopathy vs Bursitis

For years, most side hip pain was called trochanteric bursitis. Imaging studies now suggest that in many cases the tendon is the main source, with the bursa irritated alongside it.

In practice the advice overlaps a lot. Both tend to settle with less compression and gradual strength work. My hip bursitis exercises guide covers what to do and skip for a cranky bursa.

Why Stretching Often Makes IT Worse

This is the part that surprises people. Stretches that pull the leg across the body, like the figure four, deep IT band stretches or pigeon, press the tendon hard against the bone. That compression is one of the main things that keeps gluteal tendinopathy sore.

Current evidence favors a load plan over stretching. Research on side hip pain suggests that people who learn to reduce compression and follow a gradual exercise program tend to do better over time than those who simply wait it out. Strength and smart habits are the backbone.

That does not mean you can never stretch again. Once the tendon is calm and stronger, gentle mobility work often feels fine. It just should not be the first thing you reach for while the side of your hip is sore.

Daily Habits to Reduce Compression

Before any exercise, take the squeeze off the tendon during the day.

• Sit with your knees hip-width apart, and stop crossing your legs.
• Stand with your weight even on both feet instead of hanging on one hip.
• Choose higher seats so your hips sit above your knees.
• Take smaller steps on stairs and use the handrail.
• Shorten long walks and avoid steep hills for a few weeks.
• Carry heavy bags in both hands, or switch sides often, rather than hitching one hip out.

These changes can feel small, but the tendon is squeezed every time you cross your legs or lean into one hip. Cutting those moments down for a few weeks gives your exercises a much better chance of working.

Coach Luke's Pick

Fitness & Workouts

Complete Plant-Based Protein

Clean, dairy-free protein to hold muscle and recover faster after every workout. Prefer whey? I review that one too.

Holds MuscleDairy-Free

Read My Honest Review →

✓ 90-Day Guarantee · Member Pricing

My honest review — contains affiliate links. I may earn a commission at no cost to you.

Gluteal Tendinopathy Exercises

These gluteal tendinopathy exercises follow the usual stages of tendon rehab: calm it, build it, then progress it. Aim for no more than 3 out of 10 discomfort during the exercise, and no flare the next morning.

Stage 1: Calm IT

1. Standing wall press. Stand side-on to a wall with your sore side away. Bend the knee nearest the wall and press that thigh gently into it. Hold 30 to 45 seconds, 5 times, once or twice a day.

2. Lying abduction squeeze. Lie on your back with a belt looped around your knees. Gently press your knees out into the belt at about half effort. Hold 30 seconds, 5 times.

These static holds, called isometrics, can ease tendon pain and are a safe starting point.

Stage 2: Build IT

3. Glute bridge. Lie on your back with knees bent and feet hip-width apart. Lift your hips, pause 2 seconds and lower slowly. Do 3 sets of 10.

4. Sit to stand. Stand up from a sturdy chair without using your hands, then sit down slowly. Do 3 sets of 8 to 10, keeping your knees in line with your feet.

5. Supported side step. With a hand on a counter, step slowly to the side and back with level hips. Do 10 steps each way for 3 rounds.

Stage 3: Progress IT

6. Step up. Step up onto a low step with the sore leg, keeping your pelvis level, then step down slowly. Do 2 or 3 sets of 8 to 10.

7. Single leg stand. Stand on one leg near a counter with your pelvis level. Hold 30 seconds, 3 rounds per side, then progress to small mini squats.

Move to the next stage only when the current one feels easy and causes no next-day flare. Most women spend one to three weeks in each stage, and that is completely normal. My hip strengthening exercises can take you further once you are pain-free.

Gluteal Tendinopathy Sleeping Position

Night pain is one of the most common complaints. These changes often help:

• Sleep on your back with a pillow under your knees.
• If you sleep on your side, lie on the good side with one or two pillows between your knees and ankles so the top leg stays level.
• Avoid lying directly on the sore hip.

If pain wakes you no matter how you lie, see the red flags below.

How Long Gluteal Tendinopathy Takes to Heal

Tendons adapt slowly. Many women notice less pain within 4 to 6 weeks of steady work, with bigger changes around 8 to 12 weeks. Long-standing cases can take several months.

The key is consistency. Doing your exercises three or four days a week and keeping compression low matters more than any single session.

Expect some ups and downs. A long day on your feet or a night on the wrong side can bring a flare. That is not a setback in the bigger picture. Drop back a stage for a few days, then build up again.

Walking usually stays part of the plan. Shorter, flatter walks keep you active while the tendon gets stronger. If you want gentle cardio that is easy on the hips, my guide to low impact cardio has good options.

When to See a Doctor or Physical Therapist

Gluteal tendinopathy is not dangerous, but it can look like other problems. See a doctor or physical therapist if you notice:

• Numbness or tingling in your leg or foot
• Leg weakness, or your leg giving way
• Pain after a fall, especially if you can’t bear weight
• Fever with hip pain, or a hip that is hot and swollen
• Pain that wakes you at night no matter how you lie
• Loss of bladder or bowel control, which needs emergency care
• No improvement after 2 to 3 weeks of gentle care

A physical therapist can confirm the diagnosis and set the right starting level. Talk to your doctor about treatment options if exercise is not enough.

Your This-Week Plan

1. Every day: Stop crossing your legs and sleep with a pillow between your knees.
2. Days 1 to 3: Do the standing wall press 5 times, once or twice a day.
3. Days 4 to 5: Add the lying abduction squeeze.
4. Days 6 to 7: Add glute bridges, 2 sets of 10, if the first moves cause no flare.

Quick Questions

This guide is part of my hip and lower body pain guide, where you’ll find help for outer hip pain, hip bursitis, glute pain and SI joint pain, plus honest advice on when to see a doctor.

The Bottom Line

Gluteal tendinopathy is a very common, often missed cause of side hip pain in women over 40. Taking compression off the tendon and loading it gradually helps most women far more than stretching.

Start with the wall press, build up to bridges and step ups, and give it at least 8 to 12 weeks. If you notice numbness, weakness or fever, get checked first.

This article is for general education and isn’t medical advice. Talk to your doctor or a physical therapist before starting if you have ongoing hip pain, a recent injury or hip surgery, and follow your surgeon’s plan after any operation. Get medical help promptly for numbness or tingling, leg weakness, pain after a fall, fever with joint pain or a hot swollen hip, pain that wakes you at night, or any loss of bladder or bowel control.