Swimming can be a good option for gluteal tendinopathy, but with important caveats about which strokes you choose and how you move in the water. The buoyancy of water reduces load on the hip, making it a lower-impact alternative to land-based activities like running or walking uphill. However, certain kicking patterns and hip positions during swimming can compress or stress the gluteal tendons, potentially worsening symptoms if you’re not careful about technique.
Why Low-Impact Exercise Matters
Gluteal tendinopathy, often part of a broader condition called Greater Trochanteric Pain Syndrome (GTPS), causes pain on the outside of the hip where the gluteal tendons attach to the upper thigh bone. These tendons become irritated when they’re compressed against the bone, particularly during movements that pull the leg inward across the body’s midline.
Nonoperative treatment is the first-line approach for GTPS. Clinical guidelines recommend a combination of rest, activity modification, and structured exercise over a 12-week period. The goal is to gradually strengthen the hip muscles while avoiding positions that compress the tendon. Swimming fits into this framework because water supports your body weight, reducing the overall mechanical load on the hip joint. But the specific movements you perform in the pool matter more than simply being in the water.
Which Strokes Help and Which Can Hurt
Freestyle (front crawl) is generally the safest stroke for people with gluteal tendinopathy. The flutter kick keeps your legs in a relatively neutral position, moving them up and down without significant inward or outward rotation at the hip. Backstroke uses a similar kick pattern and is another reasonable option.
Breaststroke is the stroke most likely to cause problems. The whip kick forces your hips into a wide, rotated position before snapping the legs together, which loads the inner thigh and hip structures aggressively. Research on competitive swimmers found that breaststroke swimmers had significantly higher rates of groin injury compared to swimmers who didn’t train breaststroke. Nearly 43% of breaststroke swimmers had been unable to train at some point during the year due to groin pain, compared to just 5.8% of swimmers who avoided the stroke entirely. While groin pain and gluteal tendinopathy aren’t the same condition, breaststroke’s extreme hip movements create the kind of adduction and compression forces that aggravate the gluteal tendons.
Butterfly is another stroke to approach with caution. The dolphin kick generates force through the hips and core, and the undulating motion can place rotational stress on the hip joint that may irritate an already sensitive tendon.
How to Swim Without Flaring Symptoms
If you’re dealing with active gluteal tendinopathy, a few adjustments can make your time in the pool more productive and less painful.
- Stick to freestyle or backstroke. Both keep the hip in a neutral range with minimal side-to-side movement.
- Skip the kickboard. Holding a kickboard isolates your legs and increases the demand on your hip muscles. If flutter kicking alone causes discomfort, use a pull buoy between your thighs instead, which takes your legs out of the equation and lets you focus on upper-body pulling.
- Avoid crossing your legs at the wall. Flip turns and push-offs can momentarily force the hip into an adducted, internally rotated position. Open turns, where you touch the wall and turn without flipping, give you more control over hip positioning.
- Start with shorter sessions. Even though water reduces impact, sustained kicking still works the gluteal muscles. Begin with 15 to 20 minutes and increase gradually over several weeks.
Swimming vs. Land-Based Rehab Exercises
Swimming alone won’t resolve gluteal tendinopathy. The most effective treatment programs involve targeted strengthening exercises for the gluteal muscles, performed consistently over at least 12 weeks. The widely used rehabilitation protocol includes exercises like straight leg raises, wall squats, and gluteal strengthening movements, starting with twice-daily sessions in the first week and tapering to once daily for the remaining weeks. By around week six, patients are typically encouraged to begin gradually returning to their previous sporting activities.
Swimming works best as a complement to these land-based exercises, not a replacement for them. It gives you a way to maintain cardiovascular fitness and stay active during the early, more painful phase of recovery when running, hiking, or even brisk walking may be too uncomfortable. The water provides enough resistance to lightly engage the hip muscles without the compressive forces that come from bearing your full body weight on one leg.
Pool Activities Beyond Lap Swimming
If lap swimming isn’t appealing or you find that even flutter kicking bothers your hip, water walking and aqua jogging are alternatives worth trying. Walking in waist-deep or chest-deep water lets you move through a natural gait pattern with significantly less load on the hip. The water’s resistance also provides a mild strengthening stimulus for the muscles around the joint.
Aqua jogging with a flotation belt eliminates ground contact entirely. You mimic a running motion in the deep end, which keeps the hip moving through a functional range without any impact. This can be especially useful in the first few weeks of a flare-up when even low-impact land activities are painful. As your symptoms improve and your rehab exercises progress, you can transition back to land-based cardio in stages.