Understanding Lateral Hip Pain

If you’ve ever been told you have hip bursitis but treatments haven’t provided lasting relief, you’re not alone. Research shows that most cases of pain on the outside of the hip are not caused by bursitis at all, but by a condition called gluteal tendinopathy — irritation or degeneration of the tendons that attach your gluteal muscles to the hip bone.

These tendons, particularly the gluteus medius and gluteus minimus, are essential for stabilizing your pelvis when you walk, run, or stand on one leg. When overloaded, compressed, or weakened over time, they can become painful and sensitive.

The Real Cause: Tendon Overload and Compression

The clinical commentary published in the Journal of Orthopaedic & Sports Physical Therapy (JOSPT) highlights that gluteal tendinopathy often develops when the tendons experience too much stress or not enough load capacity.

Common aggravating factors include:

• Sitting for long periods
• Lying on the affected hip
• Crossing one leg over the other
• Standing with your hip “dropped” to one side
• Sudden increases in walking, running, or exercise

Over time, this combination of compression and weakness can cause the tendons to become irritated, leading to sharp or aching pain on the outer hip — often mistaken for bursitis.

The Path to Healing: Load, Don’t Rest

The good news? Gluteal tendinopathy responds well to a progressive loading approach — carefully prescribed exercises that strengthen the gluteal tendons and improve movement mechanics.

Key recovery principles include:

• Identify and modify painful postures or habits
• Begin controlled strengthening (starting with isometrics, then progressing to dynamic movements)
• Gradually increase loading capacity through guided exercise
• Address full-body mechanics — from hip alignment to core control

At Aureum Physio, we specialize in helping patients transition from pain to performance through customized, evidence-based rehabilitation. Our focus is not only on recovery but on long-term resilience — so you can move confidently and live well.