Gluteal Tendinopathy: A Real Pain in the Bum

One of my super-fit gym friends recently told me that she hasn’t been able to run for months because of a lingering pain in her buttock and outer hip.

If that sounds familiar, you’re not alone. This kind of pain is surprisingly common, especially in active people in their 40’s and 50’s. It’s often caused by a condition called Gluteal Tendinopathy.

 

What’s Happening in the Muscles?

Our buttock muscles, the gluteals, are the power engines of the body. They propel us forward whether we’re walking, running, cycling, or training. 

They attach to the pelvic bones on either side via short, strong tendons.

When these tendons are put under too much strain, the delicate balance between wear and repair tips in the wrong direction. The tendon becomes irritated, inflamed, and painful. 

This is a condition called tendinopathy – the same type of injury that can affect the Achilles tendon, the Plantar Fascia, or cause Tennis Elbow.

Gluteal tendinopathy is most often felt on the outer hip and buttock, usually near a bony point called the greater trochanter, and sometimes higher up along the top of the muscle. 

Unlike arthritis of the hip joint, which usually causes pain deeper in the groin, this muscular type of hip pain tends to stay around the outside.

 

Why Does It Happen?

Several factors can make people more prone to gluteal tendinopathy:

• • Repetitive activity – Running, long walks and sports that put high demand on the glutes.

• • Tight IT band – The ilio-tibial band runs over the tendon and can compress it, especially if it’s tight from lots of exercise.
  • Posture – Habitual positions which stretch the IT band, such as sitting cross-legged, or if your knee crosses the midline when walking or running.

• • Body structure – Women often have a naturally greater “Q-angle” (wider hip-to-knee alignment), which increases the strain on the tendon.

• • Hormonal changes – Around midlife, shifts in collagen production and tissue resilience mean tendons may not repair as efficiently as before.

That’s why this condition is particularly common in active women around mid-life – even those who have been fit and strong all their lives, and sometimes more so, as the muscles are under high pressure to keep performing.

 

What Can You Do to Help Recovery?

Healing a tendon takes time and patience. On average, recovery can take 4 – 6 months – a long time! 

But there’s a lot you can do to encourage the process:

 

Reduce Strain and Inflammation:

 

• • Rest from activities that make the pain worse – if in doubt, do a little less.

• • Avoid lying on the painful side, and use a pillow between your knees if you sleep on the other side.

• • Avoid positions that overstretch or compress the tendon, such as sitting cross-legged, hitching your hip out, or stretching the leg across your body.

• • Use ice packs daily for acute pain, or gentle cold and heat packs in alternation if the issue has become long-standing. Always end on a cold application, to encourage natural blood flow to the region. 
  • Hands-on therapies such as massage, mobilisation, Shockwave Therapy (ESWT) and MSK Laser Therapy can improve blood flow and healing times.
  • Important: stretching is often unhelpful for tendinopathies, as further tension placed on the tendon can aggravate symptoms.

• Because pain causes the glute muscles to “switch off,” carefully rebuilding their strength is essential. 
• Exercises need to be progressive, controlled, and guided. 
• Pain during exercise should stay below 4/10, and should not flare up the following morning. With the right plan, you can gradually return to strength and activity safely.

 

How We Can Help at the Clinic?

A whole-person approach:

At Meadowside, we take a holistic look at how your body moves – not just your hips, but also your pelvis, knees, ankles, feet, and back. 

Often, subtle imbalances in movement patterns and muscle strength will place extra strain on the glutes on one or both sides, which may be the trigger to developing inflammation. 

By assessing and working on these patterns, we can change the circumstance that led to the problem in the first place, and help prevent it from recurring.

We will also discuss how you use your body at work and leisure, identify any possible culprits and make suggestions to support long-term resilience.

 

As part of our treatment strategy, we can:

 

• • Relieve tension in the muscles through massage, mobilisation and hands-on therapy.

• • Improve movement in stiff joints, and help stabilise joints who are hyper-mobile.

• • Use MSK Laser Therapy to reduce inflammation and accelerate the healing process – increasing the chance of faster repair to ‘win the race’ between wear and tear and repair.

• • We may also use Shockwave Therapy (ESWT) for more chronic cases, to stimulate a fresh, more effective healing response.
  • We will always support you with tailored strengthening exercises, which will be adapted to you as you progress through recovery and build your strength.

Moving Forward, Pain Free

Gluteal tendinopathy can be frustrating and slow to heal, but with the right support you can heal, regain strength, and get back to doing what you love – pain free. 

If you’ve been putting up with hip or buttock pain that just won’t go away, don’t ignore it.

Speak to us today to book an initial consultation and find out how we can help you move forward.