Gluteus Medius Tendinopathy: The Outer Hip Pain That Mimics Something Else

What is gluteus medius tendinopathy?

The gluteus medius is the primary hip stabiliser during single-leg stance - which is essentially every step of running. Its tendon attaches to the greater trochanter, the bony prominence you can feel on the outside of your hip.

When this tendon is overloaded or compressed, it degenerates. The result is a persistent ache on the side of the hip, sometimes radiating into the buttock or upper outer thigh.

It's often confused with hip bursitis (greater trochanteric bursitis), sciatica, or referred pain from the lumbar spine. A physiotherapist can distinguish between them.

What aggravates it

• Lying on the affected side in bed
• Crossing legs when seated
• Walking up stairs or hills
• Standing on one leg
• High mileage weeks
• Sudden return to running after a break

The compression of the tendon against the trochanter - in positions like leg crossing or lying on the hip - is as problematic as the tensile load of running.

What to change immediately

• Sleep with a pillow between your knees
• Don't cross your legs
• Avoid hip adduction stretches (crossing the affected leg across the body) - these compress the tendon
• Sit with feet hip-width apart

The exercises

1. Isometric hip abduction

Standing, press the affected foot outward into a wall. Hold 30–45 seconds, 4 sets. Pain relief through isometrics.

2. Side-lying hip abduction (slow)

Lying on the unaffected side, lift the top leg to 40°, lower over 3 seconds. 3 sets of 15. Progressive loading without compression.

3. Clamshell

3 sets of 20. Keep the pelvis stable - no rolling back.

4. Hip hike

Standing on the affected leg on a step, lower and raise the pelvis on the free side. 3 sets of 15. Directly trains the gluteus medius in its functional range.

5. Single-leg bridge

Glute bridge on the affected side. Progress to adding a resistance band above the knees. 3 sets of 12.

Running modifications

Avoid camber - running on a slope puts the uphill hip in a loaded adducted position. Run on flat ground. Reduce volume during the acute phase.

Timeline

8–12 weeks. Gluteal tendinopathy responds well to loading, but slowly. The key behaviours to change - sleep position, leg crossing, stretching patterns - matter as much as the exercises.