Gluteal tendinitis, often more accurately referred to as gluteal tendinopathy, is a frequent cause of chronic pain on the outer side of the hip. This condition falls under the umbrella diagnosis known as Greater Trochanteric Pain Syndrome (GTPS), which describes pain around the bony prominence of the upper thigh bone. It is a common source of discomfort that can significantly interfere with daily activities and sleep quality.
Anatomy and Pathology of Gluteal Tendinitis
The condition centers on the tendons of the gluteal muscles, specifically the Gluteus Medius and Gluteus Minimus, where they anchor onto the Greater Trochanter. The Greater Trochanter is a large, palpable bony knob located on the side of the upper thigh bone (femur). These tendons are responsible for stabilizing the pelvis and enabling hip movement, such as lifting the leg sideways.
While historically called “tendinitis,” the chronic nature of this condition often involves degeneration and structural changes in the tendon tissue, which is why the term “tendinopathy” is now more widely accepted. This involves micro-tearing and breakdown of the tendon fibers due to failed healing and mechanical overload. The pain results from irritation and thickening of the tendon where it attaches to the bone, not just simple inflammation.
Gluteal tendinopathy is a primary component of Greater Trochanteric Pain Syndrome (GTPS). Research indicates that irritation or degeneration of the Gluteus Medius and Minimus tendons is the main source of pain in the majority of GTPS cases. This distinction helps guide treatment away from anti-inflammatory measures alone and toward strengthening the compromised tendons.
Recognizing the Pain and Symptoms
The characteristic pain of gluteal tendinopathy is localized to the outer side of the hip, directly over the Greater Trochanter. Individuals often describe this area as tender to the touch. The pain may radiate down the side of the thigh, though it rarely extends below the knee, and can range from a deep, aching sensation to a sharper pain with certain movements.
A distinguishing feature of this condition is the aggravation of pain by activities that compress the tendon against the bone. Lying on the affected side at night is a common complaint, often disrupting sleep. The pain also tends to intensify during functional movements that require single-leg balance, such as climbing stairs or standing on one leg.
Other provocative positions include sitting with the legs crossed or standing for long periods, which can increase tension on the tendons. Unlike the deep, groin-area pain associated with hip joint arthritis, gluteal tendinopathy pain remains focused on the lateral aspect of the hip. This pattern of pain and aggravation is often sufficient for a clinical diagnosis.
Common Causes and Risk Factors
Gluteal tendinopathy develops from a combination of mechanical overload and poor biomechanics rather than a single injury. The primary cause is repetitive compressive and tensile stress placed on the tendons beyond their capacity to heal. This can occur with a sudden increase in physical activity, such as starting a new running program or greatly increasing walking distance.
Faulty movement patterns, such as allowing the hip to drop inward (adduction) while walking or running, place excessive strain on the Gluteus Medius and Minimus tendons. This pattern is often linked to underlying weakness in the gluteal muscles themselves. Studies have shown that the symptomatic hip can exhibit a significant strength deficit compared to a healthy limb.
The condition is notably more prevalent in middle-aged women, a factor often attributed to wider pelvic anatomy, which increases the mechanical angle of the tendons and their tendency toward compression. Other risk factors include a leg length discrepancy, co-existing low back pain, or conditions that alter gait, placing uneven load on the hip stabilizers. Hormonal changes following menopause may also affect tendon health, increasing susceptibility to this chronic issue.
Pathways to Recovery and Treatment
Recovery from gluteal tendinopathy relies heavily on non-surgical management, with physical therapy considered the most effective long-term solution. The initial step involves activity modification to reduce direct compression and excessive loading on the irritated tendons. This means avoiding positions like sleeping on the affected side, sitting with legs crossed, or standing with weight shifted onto one hip.
Physical therapy focuses on a progressive loading program designed to strengthen the Gluteus Medius and Minimus muscles and improve the tendon’s tolerance to stress. Exercises begin with low-level static holds (isometrics) to reduce pain, gradually advancing to dynamic exercises that build strength and control throughout the hip and pelvis. This approach helps remodel the tendon and correct the underlying biomechanical deficiencies.
A physician may recommend short-term use of non-steroidal anti-inflammatory drugs (NSAIDs) to manage pain. Injection therapies, such as corticosteroids, may offer temporary pain relief but must be combined with a comprehensive rehabilitation program. Full recovery requires consistency and patience, often taking six to twelve months of dedicated rehabilitation to achieve sustained resolution of symptoms.