Hip pain can be a relentless companion, turning simple tasks like climbing stairs or getting a good night’s sleep into a daily challenge. While many potential causes exist, one culprit often hides in plain sight: gluteal tendinopathy.
This frequently misdiagnosed condition can leave patients trapped in cycles of discomfort and ineffective treatments. Let’s uncover what makes gluteal tendinopathy so elusive and, more importantly, how physiotherapy can guide you toward lasting relief.
What is gluteal tendinopathy?
Gluteal tendinopathy is a condition that affects the tendons in your hip. Tendons connect muscles to bones, and in this case, the tendons of two key muscles in your hip — called the gluteus medius and gluteus minimus — become irritated or damaged. These mucles work tirelessly to keep your pelvis steady during movement. But when their tendons experience excessive strain or repetitive stress, gluteal tendinopathy can develop.
This condition, often affecting women over 40, begins as a nagging discomfort on the outer side of the hip. Left unaddressed, it can escalate into chronic pain that disrupts your daily life.
Why is it so often misdiagnosed?
Lateral hip pain can be a diagnostic minefield, with symptoms that overlap with several other conditions. As a result, gluteal tendinopathy is frequently mistaken for:
- Trochanteric bursitis: Once the default diagnosis for outer hip pain, this involves inflammation of the bursa near the hip joint. However, research shows that gluteal tendinopathy is a much more common cause.
- Referred pain: The hip is a crossroads for signals from other areas, like the lower back or sacroiliac joint, which can cloud the true source of the pain.
- Hip osteoarthritis: While osteoarthritis can share symptoms, its underlying causes and treatment approaches differ significantly from gluteal tendinopathy.
Pinpointing the right diagnosis requires a detailed assessment, including a review of your movement patterns and sometimes imaging to identify the affected tendons.
Signs you shouldn’t ignore
Do these symptoms sound familiar?
- Pain on the outer hip, especially when lying on the affected side.
- Discomfort with activities like walking uphill, climbing stairs, or standing for long periods.
- Tenderness around the greater trochanter — the bony point on the side of your hip.
How physiotherapy can help
The good news? You don’t have to live with the pain. Physiotherapy offers evidence-based solutions to address both the symptoms and underlying causes of gluteal tendinopathy. Here is how:
- Personalised exercise programmes
For early-stage rehab, you might perform isometric hip abduction (pressing your leg against a wall without moving) to activate the gluteal muscles while minimising tendon strain. As strength improves, exercises like side-lying clamshells or resistance band walks are introduced to build tendon capacity. Eventually, step-down exercises or single-leg squats prepare you for higher-demand activities like running. - Movement retraining
If an assessment shows that excessive hip dropping during walking or running (known as a Trendelenburg gait) is contributing to tendon overload, a physiotherapist might prescribe mirror training to help you visually correct the issue. In addition, performing lateral band walks with proper form can help retrain your hip muscles to stabilise better during movement. - Manual therapy and adjunct treatments
Techniques such as soft tissue mobilisation or trigger point release around the hip muscles can help alleviate tightness that worsens pain. For chronic cases, adjunct treatments like shockwave therapy can stimulate tendon healing. An example might be a course of weekly shockwave sessions paired with a tailored exercise programme to maximise results.
Physiotherapy advice you can try at home
- Sleeping position: Sleep on your back with a pillow under your knees or on your unaffected side with two pillows between your legs.
- Sitting adjustments: Raise your seat height or take regular standing breaks to reduce hip strain.
- Walking tips: Track your steps, stay within a manageable distance, and gradually increase as symptoms improve. Shorter or faster steps can also help.
- Stair navigation: Use the railing opposite your painful hip or take stairs one step at a time, leading with your non-painful side.
Hip pain does not have to control your life. At Hein Viljoen Physiotherapy, we have world-class expertise right here in Cape Town to help you move better, feel stronger, and live pain-free. Your journey to recovery starts here.
