Gluteal Tendinopathy (Outer Hip Pain)
Osteopathic Management for Gluteal Tendon Pain — Melbourne & Caroline Springs
Gluteal tendinopathy is a common cause of pain on the outside of the hip, often affecting walking, standing, stairs, and sleeping on the affected side.
At Live Well Health Centre, osteopaths help assess and manage gluteal tendinopathy by evaluating how the hip, pelvis, and lower limb move and share load.
Our approach focuses on improving hip muscle function, supporting tendon load tolerance, and helping you return to comfortable daily activity.
What is gluteal tendinopathy?
Gluteal tendinopathy refers to pain and dysfunction affecting the tendons of the gluteal muscles, which help stabilise the pelvis and control hip movement.
These tendons attach to the outer part of the hip (greater trochanter). When they become sensitive to load or movement, pain can develop in the outer hip region.
Gluteal tendinopathy is commonly included within Greater Trochanteric Pain Syndrome (GTPS) — a broader term describing pain around the outer hip involving tendons, bursae, or surrounding soft tissue.
Symptoms often develop gradually rather than after a single injury.
Common symptoms
Gluteal tendinopathy commonly causes:
- pain on the outside of the hip
- discomfort lying on the affected side
- pain with walking or standing for long periods
- pain climbing stairs or hills
- tenderness when pressing the outer hip
- stiffness after rest
Some people also notice pain when crossing legs or standing on one leg.
What causes gluteal tendinopathy?
Gluteal tendons are exposed to repeated loading during walking, standing, and single-leg activity.
Symptoms may develop when loading exceeds the tendon’s ability to adapt.
Common contributing factors include:
- prolonged single-leg loading (e.g. standing with weight shifted to one side)
- reduced hip muscle strength
- altered pelvic control
- sudden increase in walking or activity
- repetitive stair climbing
- reduced recovery between loads
Hip, pelvis, and lower limb mechanics all influence tendon loading.
Who is most likely to experience gluteal tendinopathy?
Gluteal tendinopathy can occur at any age but is commonly seen in:
- middle-aged and older adults
- women more frequently than men
- people who walk long distances
- individuals with reduced hip strength
- people who stand for prolonged periods
- individuals with lower back or pelvic issues
How is gluteal tendinopathy assessed?
Osteopathic assessment typically includes:
- detailed symptom and activity history
- hip movement testing
- strength assessment of gluteal muscles
- pelvic control evaluation
- lower limb movement assessment
- functional movement testing
Assessment focuses on identifying how load is applied to the hip and how surrounding structures contribute.
Imaging is not always required but may be recommended if clinically indicated.
Referral to a GP or specialist may be advised where appropriate.
How osteopathy may help manage gluteal tendinopathy
Osteopaths help manage gluteal tendinopathy by addressing factors that influence tendon load and hip stability.
Management may involve:
- improving hip muscle strength and endurance
- supporting pelvic stability
- reducing excessive tendon compression
- guiding progressive loading programs
- modifying aggravating activities
Care is individualised and often focuses on restoring efficient movement and load tolerance.
Rehabilitation is typically central to management.
Techniques that may be used
Based on assessment findings, management may include:
- progressive hip strengthening programs
- movement retraining
- load management education
- soft tissue techniques
- joint mobilisation of hip and pelvis
- muscle energy technique (MET)
- clinical Pilates
- shockwave therapy (in selected persistent cases)
Technique selection depends on clinical reasoning and individual presentation.
Evidence and research
Clinical guidelines support targeted strengthening and load management as primary management strategies for gluteal tendinopathy.
Evidence supports:
- progressive hip abductor strengthening
- load modification and activity management
- movement retraining
- multimodal conservative care
Education and exercise are widely recommended first-line approaches.
Key guideline and research sources
Clinical Practice Guidelines for Greater Trochanteric Pain Syndrome
Support exercise-based rehabilitation as central management.
Systematic reviews of gluteal tendinopathy rehabilitation
Support progressive strengthening and load management.
Contemporary tendinopathy management frameworks
Recommend movement-based and load-based rehabilitation.
Clinical interpretation
Management that focuses on improving hip strength, pelvic control, and tendon load tolerance is widely supported for outer hip pain.
What to expect from management
Recovery experiences vary depending on:
- symptom duration
- tendon load tolerance
- activity demands
- adherence to rehabilitation
Many people experience gradual improvement with progressive strengthening and load modification.
Active participation in rehabilitation is often essential.
Self-management and lifestyle support
Education is a key part of management.
Your osteopath may guide:
- sleeping position strategies
- activity modification
- progressive strengthening programs
- walking and load management
- posture and movement strategies
Consistency is important for tendon adaptation.
When to seek medical review
Medical assessment is recommended if symptoms involve:
- significant trauma
- inability to bear weight
- severe or worsening pain
- persistent symptoms despite rehabilitation
If unsure, seek professional advice.
Frequently asked questions
Is outer hip pain always bursitis?
Not always. Many cases involve gluteal tendon overload rather than inflammation of the bursa.
Should I avoid lying on the painful side?
Temporary modification may help reduce irritation depending on symptoms.
Is walking bad for gluteal tendinopathy?
Walking may need to be modified depending on pain and load tolerance.
Do I need imaging?
Imaging is not always required and depends on clinical findings.
Related conditions
- Hip pain
- Lower back pain
- Knee pain
- Tendinopathy
Not sure if your hip pain is gluteal tendinopathy?
If you are unsure what is causing your symptoms, an osteopathic assessment can help identify contributing factors and guide appropriate management.
Book an appointment to discuss your symptoms.