Hip tendonitis is pain over the bony point on the outside of the hip, coming from the gluteal tendons. Clinicians call it gluteal tendinopathy or greater trochanteric pain syndrome. The tendon is compressed rather than tight, which is why the stretches most people try first make it worse, and why load management plus exercise beats a steroid injection at one year.
Check one thing before reading further: does it hurt on the side of your hip, or in your groin? Two different conditions, two different treatments, and the search term does not separate them.
Side of the hip, or groin?
Side of the hip, or groin? The answer changes the diagnosis
Pain on the OUTSIDE of the hip
- Tender to press on the bony point.
- Worse lying on that side at night.
- Worse standing on one leg, or crossing the legs.
- This is gluteal tendinopathy, what people call hip tendonitis.
Pain in the GROIN
- Deep, hard to point at, felt in the crease.
- Worse putting socks on or getting out of a car.
- Stiff first thing, easing after 20 minutes.
- This is the hip joint itself, usually osteoarthritis.
If your answer is the groin, this is not your page. Those symptoms, worse putting socks on and stiff for the first 20 minutes of the day, come from the hip joint, and osteoarthritis is the usual cause.
What is actually going on
Two muscles, gluteus medius and gluteus minimus, attach by tendon onto the greater trochanter. Their job is to stop the pelvis dropping when you stand on one leg, which happens every second you walk.
Running over those tendons is the iliotibial band, a thick sheet of connective tissue. When the thigh crosses the midline, as it does when you cross your legs or sleep with the top knee dropping forward, that band presses the tendon hard against the bone.
Compression is the mechanism and it explains the rest: the night pain, why stretching the outside of the hip makes things worse, and why foam rolling the outer thigh grinds the band straight onto the sore spot.
The four habits that are the real causes
| Habit | Why it hurts the tendon | Change it to |
|---|---|---|
| Sleeping on the painful side | Eight hours of body weight compressing tendon against bone | Other side, pillow between the knees so the top knee does not drop |
| Standing with the hip pushed out | Hanging on one hip compresses the tendon under the iliotibial band | Weight evenly on both feet, feet hip width apart |
| Sitting with the legs crossed | Pulls the thigh across the midline, the compressing position | Both feet on the floor, knees apart |
| Stretching or rolling the outside of the hip | Figure-four stretches and the foam roller compress the tendon further | Stop both. This is the commonest self-inflicted setback |
What the evidence says about treatment
This condition has a good trial behind it, and almost no page ranking for hip tendonitis mentions it.
The LEAP trial: 204 people with gluteal tendinopathy, results at 52 weeks
Two things there. The injection group did well early and then stalled, the same pattern seen in tendon problems elsewhere in the body. And wait and see reached 52 per cent, so about half of people improve substantially with no treatment at all over a year. That is the baseline for judging anything anyone sells you.
The exercises that work
Strengthen the gluteal muscles without letting the thigh cross the midline. Each of these keeps the leg in line or out to the side.
Isometric hip abduction. On your back, a band around the thighs above the knees, push outwards and hold 30 seconds. 5 repetitions. Start here even if the hip is tender: it often reduces the pain immediately.
Side-lying abduction, hip slightly back. On your good side, top leg straight and a little behind the body, lift 20 to 30 centimetres and lower slowly. 3 sets of 10.
Standing hip hitch. On the painful leg on a low step, let the other side of the pelvis drop, then lift it with the standing hip. 3 sets of 10.
Every other day, 12 weeks before judging, the same horizon that Achilles rehabilitation needs.
Getting NHS health services involved
In most of England you can refer yourself to community musculoskeletal services without a GP, and every adult can now see a first contact physiotherapist at their own practice. American sites call it physical therapy, the NHS calls it physiotherapy; the work is the same.
See a GP if the hip gave way suddenly, if you cannot weight bear, if you have a fever or unexplained weight loss. Surgery is a late option for the few people with a genuine tendon tear, not a route out of the exercises.
Where a supplement fits
Nothing you swallow decompresses a tendon or strengthens gluteus medius. What a bioavailable anti-inflammatory can do is take the edge off the night pain that stops people sleeping and therefore stops them exercising. Broken sleep also feeds the background inflammatory load, which is why the two problems tend to move together. Our tendon support formulation is built for that, and the absorption problem behind it is on the bioavailable natural anti-inflammatory page.
Frequently asked questions
How to get rid of tendonitis in your hip?
Education about load plus a progressive exercise programme. In a randomised trial of 204 people published in the BMJ, 79 per cent of that group were at least moderately better at one year, against 58 per cent after a single corticosteroid injection and 52 per cent left to wait. Step one is stopping the things that compress the tendon.
What are the first signs of hip tendonitis?
Tenderness when you press the bony point on the outside of the hip, and pain lying on that side at night. Those two together are close to diagnostic. Standing on one leg to dress becomes uncomfortable, and so does crossing the legs. Groin pain instead points to the hip joint, which needs a different plan.
Is walking good for tendonitis in the hip?
Yes, with two adjustments. Walk on the flat rather than up hills, and keep your feet roughly hip width apart rather than one foot in front of the other. A narrow gait swings the thigh across the midline with every step, which is the compressing position. Distance matters less than those two details.
How long does it take for hip tendonitis to heal?
Around 3 months for a clear improvement and 6 to 12 for full recovery, which is longer than most people expect. The trial delivered its exercise programme over 8 weeks and the group was still improving at 52 weeks. Stopping when it merely feels better is the commonest reason the symptoms return.
Should I have a steroid injection for hip tendonitis?
Reasonable when pain stops you sleeping or prevents you starting the exercises, and a poor first move on its own. An injection works quickly and is then overtaken: by one year the exercise group was 20 percentage points ahead. Treat it as a way to get the exercises going.
What to take away
Tonight, sleep on the other side with a pillow between your knees. Tomorrow, stop every stretch aimed at the outside of your hip and start the isometric holds instead.
Those two changes reverse the mechanism. Expect the improvement to keep building for the best part of a year rather than arriving in a fortnight.
Sources
Mellor R., Bennell K., Grimaldi A. et al. (2018). Education plus exercise versus corticosteroid injection use versus a wait and see approach on global outcome and pain from gluteal tendinopathy: prospective, single blinded, randomised clinical trial. British Medical Journal, 361, k1662. DOI: 10.1136/bmj.k1662
Millar N.L., Silbernagel K.G., Thorborg K. et al. (2021). Tendinopathy. Nature Reviews Disease Primers, 7, 1. DOI: 10.1038/s41572-020-00234-1
Khan K.M., Cook J.L., Kannus P. et al. (2002). Time to abandon the “tendinitis” myth. British Medical Journal, 324(7338), 626-627. DOI: 10.1136/bmj.324.7338.626
Cook J.L., Purdam C.R. (2009). Is tendon pathology a continuum? A pathology model to explain the clinical presentation of load-induced tendinopathy. British Journal of Sports Medicine, 43(6), 409-416. DOI: 10.1136/bjsm.2008.051193
Sivrika A.P., Papadamou E., Kypraios G. et al. (2023). Comparability of the effectiveness of different types of exercise in the treatment of Achilles tendinopathy: a systematic review. Healthcare, 11(16), 2268. DOI: 10.3390/healthcare11162268
