Gluteal Tendinopathy and Greater Trochanteric Pain Syndrome

 

Gluteal Tendinopathy and Greater Trochanteric Pain Syndrome Treatment in Princeton & Lawrenceville, NJ

Gluteal tendinopathy is irritation or overload of the gluteus medius or gluteus minimus tendons on the outside of the hip. These tendons help stabilize the pelvis during walking, running, stairs, squats, and single-leg activity.

This condition is part of a broader diagnosis called greater trochanteric pain syndrome, or GTPS. Patients often describe pain on the outside of the hip, tenderness over the bony side of the hip, pain lying on that side, or discomfort with walking, running, stairs, hills, or getting out of a car.

For patients in Princeton, Lawrenceville, West Windsor, Plainsboro, Hopewell, Pennington, Robbinsville, and nearby Mercer County communities, the goal is to identify whether lateral hip pain is coming from gluteal tendinopathy, hip bursitis, hip arthritis, low back pain, sciatica, hip impingement, or another nearby condition.

This page is educational. It can help you understand symptoms, diagnosis, treatment options, and when to schedule an evaluation.

QUICK TAKEAWAYS

• Gluteal tendinopathy is a common cause of pain on the outside of the hip.
• It is often grouped under the term greater trochanteric pain syndrome.
• Symptoms may worsen with side sleeping, walking, running, stairs, hills, standing on one leg, or getting out of a car.
• It is often mistaken for “hip bursitis,” but the tendon is frequently an important part of the problem.
• Most cases start with non-operative care, including load modification, progressive strengthening, and movement retraining.
• Shockwave therapy may be considered in selected persistent tendon-related cases when paired with a broader rehab plan.
• If lateral hip pain is limiting walking, running, sleep, work, or training, schedule an evaluation with Princeton Sports and Family Medicine, P.C. or start here: Request Appointment.

WHO THIS AFFECTS + WHY IT HAPPENS

Who gets gluteal tendinopathy?

Gluteal tendinopathy can affect active adults, runners, walkers, athletes, and people whose daily activities repeatedly load the outside of the hip.

Common groups include:

• Runners and walkers
• Hikers
• Court-sport athletes
• Field-sport athletes
• Adults returning to exercise after time off
• People who recently increased walking, running, hills, or stairs
• People who stand for long periods
• Adults with hip or low back pain history
• People with hip weakness or pelvic control deficits
• Adults with pain when lying on one side
• People with symptoms previously called “hip bursitis”

Why it happens

The gluteus medius and gluteus minimus tendons attach near the greater trochanter, the bony area on the outside of the hip. These tendons help keep the pelvis level when one leg is on the ground.

Symptoms may develop when the tendon and surrounding tissues are overloaded by:

• Sudden increase in walking or running volume
• Hill training
• Stair climbing
• Prolonged standing
• Side sleeping compression
• Weakness in the hip stabilizers
• Poor single-leg control
• Returning to activity too quickly
• Running gait changes
• Hip or low back compensation
• Training through symptoms
• Repeated stretching or positions that compress the tendon

This condition is not just inflammation. It often reflects a mismatch between tendon capacity and load. That is why simply resting, stretching, or getting temporary pain relief may not fully solve it.

SYMPTOMS + WHAT’S NORMAL VS NOT

Common symptoms

Gluteal tendinopathy and greater trochanteric pain syndrome usually cause pain on the outside of the hip.

Symptoms may include:

• Pain over the side of the hip
• Tenderness over the bony outside of the hip
• Pain lying on the painful side
• Pain lying on the opposite side if the top leg crosses over
• Pain with walking or running
• Pain with stairs or hills
• Pain standing on one leg
• Pain getting out of a car
• Pain rising from a chair
• Pain after long periods of standing
• Aching that travels down the outside of the thigh
• Reduced tolerance for running, hiking, or lower-body training

Pain usually stays on the outside of the hip or upper thigh. It should not typically cause true numbness, tingling, or weakness down the leg.

What can be monitored briefly

Mild lateral hip soreness after a new workout or longer walk can sometimes be monitored briefly if symptoms improve quickly.

Early steps may include:

• Reducing painful walking, running, hills, or stairs temporarily
• Avoiding side sleeping directly on the painful hip
• Using a pillow between the knees when side sleeping
• Avoiding aggressive hip stretching into pain
• Avoiding repeated leg-crossing if it compresses the painful area
• Switching temporarily to lower-impact activity
• Tracking next-day symptoms after exercise

Schedule a visit if…

A scheduled evaluation is appropriate if:

• Lateral hip pain lasts more than 1–2 weeks
• Pain keeps returning with walking, running, or stairs
• Pain disrupts sleep
• You are limping or avoiding activity
• Pain travels down the outside of the thigh
• Symptoms are worsening despite rest
• You were told it was bursitis but symptoms keep returning
• You are unsure whether pain is coming from the hip, tendon, back, or nerve
• You need guidance on imaging, PT, shockwave therapy, injections, or return to activity

Seek urgent care now if…

Seek urgent or prompt medical evaluation if you have:

• Inability to bear weight after injury
• Severe hip pain after a fall
• Sudden major weakness
• Numbness, tingling, or loss of bowel/bladder control
• Fever, redness, warmth, or concern for infection
• Severe night pain that is worsening
• Rapidly worsening swelling or bruising
• Chest pain, shortness of breath, or fainting
• Severe calf pain or marked leg swelling

Most lateral hip pain is not urgent, but traumatic, neurologic, infectious, or rapidly worsening symptoms should be evaluated promptly.

DIAGNOSIS

Gluteal tendinopathy is diagnosed with a focused history, physical exam, and imaging when needed.

What history matters?

Your clinician may ask:

• Where the pain is located
• When symptoms started
• Whether symptoms began gradually or after an injury
• Whether side sleeping is painful
• Whether walking, running, stairs, or hills trigger symptoms
• Whether pain travels below the knee
• Whether there is numbness or tingling
• Whether low back pain is also present
• What training or activity changes happened recently
• What you have already tried
• What activity, sport, or daily function you want to return to

What the exam may include

A typical exam may assess:

• Tenderness over the greater trochanter
• Hip range of motion
• Hip abductor strength
• Single-leg stance tolerance
• Squat or step-down control
• Walking or running mechanics when appropriate
• Low back contribution
• Nerve-related symptoms
• Hip joint signs
• Hamstring and glute strength
• Balance and pelvic control

The exam helps separate gluteal tendinopathy from hip bursitis, hip arthritis, hip impingement, low back pain, sciatica, hamstring strain, and other causes of hip or leg pain.

When imaging may be considered

Imaging is not always needed at the start.

X-rays may be considered when:

• Hip arthritis is possible
• Symptoms are persistent
• Pain follows trauma
• Walking is significantly limited
• The diagnosis is unclear
• Bone or joint problems need to be ruled out

Ultrasound or MRI may be considered when:

• Tendon tear is suspected
• Symptoms persist despite appropriate care
• The diagnosis is unclear
• Injection or procedure planning is being considered
• Low back or hip joint causes need clarification
• Return to sport or work requires a clearer diagnosis

Testing should be used when it helps clarify the diagnosis or change the plan.

TREATMENT OPTIONS

Treatment depends on symptom severity, activity goals, tendon irritability, strength, sleep disruption, and whether other conditions are involved.

Most cases start with non-operative care.

Load modification

Early treatment usually focuses on reducing the specific loads that irritate the tendon.

This may include temporarily reducing:

• Running volume
• Hill training
• Long walks
• Stair climbing
• Side lying on the painful hip
• Deep hip stretching
• Single-leg standing for long periods
• Heavy lateral hip loading
• Exercises that spike pain during or after activity

The goal is not to stop moving. The goal is to calm symptoms while keeping the hip active enough to rebuild capacity.

Sleep and compression strategies

Side-sleeping pain is common.

Helpful strategies may include:

• Avoid lying directly on the painful side during a flare
• Use a pillow between the knees when lying on the opposite side
• Avoid letting the top knee drop across the body
• Avoid prolonged hip-adduction positions that compress the tendon
• Try back sleeping temporarily if side sleeping keeps flaring symptoms

Better sleep positioning can reduce repeated overnight irritation.

Rehab and progressive strengthening

Rehab is usually central to treatment.

A plan may include:

• Hip abductor strengthening
• Gluteus medius and minimus loading
• Hip and trunk control
• Balance and single-leg stability
• Squat and step-down mechanics
• Gait or running mechanics review
• Gradual walking or running progression
• Return-to-hills progression
• Sport-specific loading progression

Strengthening should be progressive. Starting too aggressively can flare symptoms. Avoiding load completely can leave the tendon underprepared.

Medications

Pain control may include acetaminophen, topical anti-inflammatory medication, or oral anti-inflammatory medication when appropriate. Medication choices should be individualized based on medical history, blood pressure, kidney function, stomach history, medication list, and other risk factors.

Medication can help symptoms, but it does not replace load management and strengthening.

Shockwave therapy

Shockwave therapy may be considered for selected patients with persistent tendon-related lateral hip pain that has not improved as expected with an appropriate conservative plan.

It is not a standalone cure. It should be paired with:

• A clear diagnosis
• Load management
• Progressive strengthening
• Return-to-activity planning
• Follow-up reassessment

Shockwave therapy is not appropriate for every case of hip pain. It is most useful when the painful tissue and treatment goal are clear.

Injections

Injections may be considered in selected cases, especially when pain is significant and limiting sleep or activity.

The decision depends on:

• Diagnosis
• Severity
• Symptom duration
• Whether bursitis, tendon pain, or another structure is the target
• Imaging findings when available
• Prior response to rehab
• Medical history and safety considerations
• Activity goals

Injections can help symptoms in some patients, but repeated steroid injections around tendons should be approached thoughtfully. The long-term plan still needs to address strength, load, and mechanics.

Surgery or specialist referral

Surgery is not the starting point for most patients.

Referral may be considered when:

• Symptoms persist despite well-directed non-operative care
• A gluteal tendon tear is suspected
• Significant weakness is present
• Walking remains limited
• Imaging shows a more complex tendon problem
• The diagnosis remains unclear
• Hip arthritis, lumbar radiculopathy, or another condition may need specialist input

RETURN TO SPORT / ACTIVITY GUIDANCE

Return to activity should be based on symptoms, sleep tolerance, strength, walking tolerance, and next-day response.

Early phase: calm symptoms

Goals:

• Reduce lateral hip pain
• Improve sleep
• Walk without limping
• Avoid repeated tendon compression
• Maintain safe activity

Usually avoid temporarily:

• Hill running
• Speed work
• Long walks that increase symptoms
• Stair repeats
• Side-lying on the painful hip
• Aggressive IT band or hip stretching
• Single-leg loading that spikes pain
• Jumping or cutting during a flare

Often allowed:

• Shorter flat walks if tolerated
• Cycling if comfortable
• Swimming
• Upper-body training
• Lower-body strength work that does not flare symptoms
• Hip isometrics or early glute loading
• Core training

Mid phase: rebuild capacity

Goals:

• Improve hip abductor strength
• Restore pelvic control
• Increase walking tolerance
• Reduce next-day pain after activity
• Reintroduce controlled loading

Progressions may include:

• Side-lying modifications or standing hip work
• Bridges and hip hinge variations
• Step-ups
• Controlled squats
• Single-leg balance
• Lateral movement progressions
• Gradual walking progression
• Walk-jog progression when appropriate

Late phase: return to running or sport

Goals:

• Tolerate repeated single-leg loading
• Return to hills, running, hiking, or sport
• Avoid recurrence
• Restore confidence

Late-stage progression may include:

• Jogging progression
• Flat running before hills
• Easy pace before speed work
• Hiking progression
• Lateral movement
• Cutting drills
• Jumping and landing
• Sport-specific drills
• Running gait review when needed

Common mistakes

• Stretching aggressively into lateral hip pain
• Treating all lateral hip pain as simple bursitis
• Resting until pain improves, then returning too fast
• Ignoring side-sleeping compression
• Running hills before flat running is tolerated
• Skipping progressive hip strengthening
• Using injections without a loading plan
• Assuming pain down the outside thigh is always sciatica

PREVENTION

Not every case can be prevented, but recurrent flares can often be reduced.

Helpful steps include:

• Increase walking and running volume gradually
• Add hills carefully
• Build hip abductor and glute strength
• Improve single-leg balance and pelvic control
• Avoid sudden spikes in stairs, hiking, or lateral movement
• Address sleep positions that compress the hip
• Avoid repeatedly stretching into painful compression
• Monitor next-day pain after workouts
• Use running gait or stride assessment when symptoms keep returning
• Build recovery into training plans

Prevention is usually about load management, strength, recovery, and reducing repeated compression.

HOW PSFM CAN HELP

At Princeton Sports and Family Medicine, P.C., we evaluate lateral hip pain by first clarifying the source. Gluteal tendinopathy can overlap with hip bursitis, hip arthritis, hip impingement, low back pain, sciatica, hamstring pain, and other hip or spine-related conditions.

A visit may include a focused hip and low back exam, strength testing, gait or single-leg control assessment, review of training load, and discussion of sleep positioning. We can also help decide whether X-rays, ultrasound, MRI, physical therapy, shockwave therapy, injection, or referral should be considered.

For many patients, treatment includes education, load modification, sleep-position changes, progressive strengthening, and a gradual return to walking, running, hiking, sport, or training. The plan should fit the patient’s actual goals and daily life.

Depending on the situation, care may involve Sports Medicine Services, coordination with Physical Therapy Services, Shockwave Therapy for selected persistent tendon cases, and Run Stride & Performance Evaluation when running mechanics or recurring load issues are part of the picture.

Schedule an evaluation with Princeton Sports and Family Medicine, P.C. in Lawrenceville, NJ, or start here: Request Appointment.

FAQs

What is gluteal tendinopathy?

Gluteal tendinopathy is irritation or overload of the gluteus medius or gluteus minimus tendons on the outside of the hip.

Is gluteal tendinopathy the same as hip bursitis?

Not exactly. Many cases once called hip bursitis involve the gluteal tendons as well. Greater trochanteric pain syndrome is a broader term that can include tendon and bursa-related pain.

What does gluteal tendinopathy feel like?

It often causes pain on the outside of the hip. Pain may worsen with side sleeping, walking, running, stairs, hills, standing on one leg, or getting out of a car.

Can it cause pain down the outside of the thigh?

Yes. Pain can travel down the outside of the thigh, but it usually does not cause true numbness or tingling. Nerve symptoms may suggest a back or sciatic nerve component.

Do I need imaging?

Not always. Many cases can start with a focused exam and conservative plan. X-rays, ultrasound, or MRI may be considered if symptoms persist, the diagnosis is unclear, weakness is present, or tendon tear or arthritis is suspected.

Can I keep running?

It depends on symptoms. If running increases pain during or after activity, training should be modified. Return should usually start with tolerable flat running before hills, speed work, or longer distances.

Should I stretch my IT band or hip?

Aggressive stretching can sometimes worsen symptoms by compressing the irritated tendon. Strengthening and load management are often more important than forcing stretches.

Does shockwave therapy help?

Shockwave therapy may be considered for selected persistent tendon-related cases. It works best when paired with a clear diagnosis, rehab, load management, and return-to-activity planning.

Are injections helpful?

They can help selected patients, especially when pain is limiting sleep or daily activity. Injections should be considered carefully and paired with a plan to address strength and load.

Do you treat lateral hip pain near Princeton and Lawrenceville?

Yes. Princeton Sports and Family Medicine, P.C. evaluates hip pain and tendon-related injuries for patients from Princeton, Lawrenceville, West Windsor, Plainsboro, Hopewell, Pennington, Robbinsville, and nearby Mercer County communities.

RELATED CONDITIONS

Patients with gluteal tendinopathy or greater trochanteric pain syndrome may also want to learn about:

• Hip Pain
• Hip Bursitis
• Hip Arthritis
• Hip Impingement and FAI
• Low Back Pain
• Sciatica
• Hamstring Strain

Because several hip, tendon, bursa, joint, low back, and nerve-related conditions can cause overlapping symptoms, a focused exam can help identify the most likely source of pain and guide the next step.

RELATED PSFM SERVICES

• Sports Medicine Services
• Physical Therapy Services
• Shockwave Therapy
• Run Stride & Performance Evaluation

Lateral hip pain can be frustrating because it affects walking, running, stairs, sleep, sitting, standing, and exercise. Gluteal tendinopathy is one common cause, but hip bursitis, arthritis, hip impingement, low back pain, sciatica, and hamstring-related pain can feel similar.

You do not need to guess whether your pain is tendon-related, bursa-related, joint-related, nerve-related, or coming from the low back. A focused evaluation can help clarify the diagnosis and create a practical plan.

Schedule an evaluation with Princeton Sports and Family Medicine, P.C. in Lawrenceville, NJ, or start here: Request Appointment.

MEDICAL DISCLAIMER

This page is for general education and does not replace medical advice. Symptoms can have more than one cause. If you have severe symptoms, rapidly worsening pain, chest pain, shortness of breath, one-sided weakness, uncontrolled bleeding, signs of serious infection, inability to bear weight after injury, or any urgent concern, seek immediate medical evaluation.