Hip tendonitis is a common source of discomfort that results in pain on the outer side of the hip, often limiting everyday activities. This condition involves the tendons connecting the gluteal muscles to the greater trochanter, the bony prominence on the side of the upper thigh bone. Healing requires a comprehensive and structured recovery plan focused on managing symptoms and restoring the tendon’s capacity to handle load.
Understanding the Condition
What is often called “hip tendonitis” is more accurately described as gluteal tendinopathy or greater trochanteric pain syndrome (GTPS). Gluteal tendinopathy refers to changes in the tendons of the gluteus medius and gluteus minimus muscles, which are important for hip stability and movement. When these tendons are repeatedly subjected to compression or excessive load, the tissue structure can begin to break down, resulting in pain and tenderness.
The problem is frequently caused by repetitive stress or a sudden increase in activity, such as a rapid jump in running mileage or starting a new exercise routine. Contributing factors include underlying muscle weakness or imbalance in the glutes, causing the tendons to work harder. Poor biomechanics, like standing with weight shifted to one hip or sitting with the legs crossed, also create compressive forces that aggravate the tendons. Successful treatment relies on understanding this is a load-management issue, not just simple inflammation.
Immediate Pain Management
In the acute phase, the primary goal is to settle the irritated tendon and reduce symptoms that interfere with daily life and sleep. This stage relies on passive strategies to decrease irritation and allow the tissue to begin recovery. Relative rest is vital, meaning you should avoid activities that specifically aggravate the tendon, rather than complete immobilization.
Activities to avoid include sleeping on the affected side and sitting with the legs crossed, as both positions compress the tendons against the underlying bone. When lying down, placing a pillow between the knees helps keep the hip in a neutral position, minimizing strain. Applying cold therapy, such as ice packs for 15 to 20 minutes several times a day, can help temporarily manage discomfort.
Over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, may provide short-term relief from pain. However, these medications are intended for temporary symptom control and should not be relied upon for extended periods. Long-term healing is driven by rebuilding strength, not by continuously masking pain signals. These initial steps are palliative measures intended to create a window for the active recovery phase.
The Core of Long-Term Recovery
The true path to healing involves a progressive, load-management approach centered on strengthening the gluteal muscles and increasing the tendon’s capacity. This active rehabilitation process is distinct from immediate pain relief and is necessary for lasting recovery. The first step often involves isometric exercises, where the muscle is contracted without changing the joint angle.
Isometric exercises, such as a simple side leg lift held briefly, are often well-tolerated and can provide an analgesic effect. After initial sensitivity subsides, the focus shifts to low-load, isotonic strengthening movements performed with controlled movement. Examples include the clam shell and the single-leg hip bridge, targeting the gluteus medius and maximus muscles. Start with low repetitions and loads, gradually increasing volume and resistance over several weeks to stimulate tendon repair without causing a flare-up.
As the tendon adapts, the progression moves toward more functional, weight-bearing exercises, such as mini-squats, step-ups, and single-leg deadlifts. These exercises mimic daily activities and build the strength and endurance needed to stabilize the hip. Flexibility work should be approached with caution, as deep stretching of the gluteal muscles can compress the irritated tendon against the bone, potentially worsening symptoms. Gentle mobility exercises for the hip flexors may be beneficial, but the sensitive gluteal tendons should not be aggressively stretched.
Consistency is paramount in this phase; strengthening exercises are typically performed two to three times per week, allowing for adequate rest days for the tendon to adapt. Recovery is often slow, taking several weeks to months. Steadily increasing the load on the tendon is the mechanism by which its structure is restored and long-term resilience is achieved.
When to Seek Professional Guidance
While many cases of hip tendon pain respond well to initial self-management and a structured strengthening program, professional input is sometimes necessary. Consult a healthcare provider immediately if the pain is severe, came on suddenly following an injury, or makes bearing weight difficult. These symptoms can indicate a more serious issue than simple tendon overload.
Seek professional help if self-care measures, including relative rest and initial strengthening attempts, do not lead to noticeable improvement after one to two weeks. A physical therapist or physician can provide an accurate diagnosis, distinguishing gluteal tendinopathy from other sources of hip pain, and create a personalized rehabilitation plan. If pain is accompanied by symptoms like fever, chills, or significant swelling, it could signal an infection requiring urgent medical attention. Advanced treatments, such as corticosteroid injections, may be considered for temporary relief in persistent cases, often used to create a pain-free window for physical therapy.