Hip tendonitis typically improves with a combination of rest, targeted exercises, and pain management over three to six weeks, though chronic cases can take longer. The key is identifying which tendon is irritated and adjusting your activity while you strengthen the surrounding muscles. Most people recover fully without surgery.
Where Hip Tendonitis Occurs
Several tendons around the hip can become irritated, and the location of your pain tells you a lot about which one is involved. The most common form affects the gluteus medius and gluteus minimus tendons, which attach to the bony bump on the outside of your hip (the greater trochanter). This causes pain and tenderness on the outer hip that sometimes extends down the outside of your thigh. It typically hurts most during single-leg activities like climbing stairs, walking, or even lying on the affected side at night.
The hip flexor tendon (iliopsoas) causes pain in the front of the hip or groin, especially when lifting your knee or getting up from a seated position. Adductor tendonitis shows up as inner thigh or groin pain, particularly common in athletes who do a lot of lateral movement. Proximal hamstring tendonitis causes deep pain at the base of the buttock, right where you sit, and worsens with prolonged sitting or running.
Distinguishing hip tendonitis from bursitis can be tricky because the structures sit so close together. One useful clue: if pushing against resistance while moving your leg outward reproduces the pain, that points toward tendonitis rather than bursitis. Bursitis typically won’t flare with resisted movement. An ultrasound can confirm the diagnosis by checking for fluid in the bursa or changes in the tendon tissue.
Rest and Activity Modification
The first step is reducing the load on the irritated tendon. This doesn’t mean complete rest, which can actually slow recovery by weakening the tendon further. Instead, temporarily avoid the specific movements that aggravate your pain. If stairs bother you, take them slowly or use a railing. If running is the trigger, switch to swimming or cycling for a few weeks. Side-sleeping on the affected hip compresses the outer tendons, so try sleeping on the opposite side with a pillow between your knees.
The goal is to find a pain level you can manage, not to eliminate all discomfort. Light activity that produces mild soreness (around a 3 or 4 out of 10) is generally fine. Sharp or worsening pain means you need to dial back.
Pain Relief With Medication
Over-the-counter anti-inflammatory medications like ibuprofen or naproxen are effective for managing acute tendon pain in the short term. The evidence supports using them for 7 to 14 days to get pain under control while you begin rehab exercises. They work best as a bridge, not a long-term solution, since they address pain without fixing the underlying tendon problem. Ice applied for 15 to 20 minutes several times a day can also help, especially after activity.
Exercise and Physical Therapy
Targeted exercise is the most effective long-term treatment for hip tendonitis. The approach follows a progression: start with isometric holds (contracting the muscle without moving the joint), advance to slow controlled movements with resistance, and eventually return to dynamic, sport-specific activity.
For gluteal tendonitis, the workhorse exercises include side-lying leg raises, clamshells, and single-leg bridges. For hip flexor tendonitis, gentle hip flexion against resistance and stretching of the surrounding muscles help restore function. The key principle is “progressive loading,” which means gradually increasing the demand on the tendon so it adapts and becomes stronger.
A physical therapist can tailor the program to your specific tendon and assess contributing factors like hip weakness, pelvic instability, or movement patterns that caused the problem in the first place. At least six weeks of structured physical therapy is a standard recommendation before considering other interventions.
Shockwave Therapy
Extracorporeal shockwave therapy (ESWT) uses targeted sound waves to stimulate healing in damaged tendons. It’s a non-invasive option for cases that haven’t responded to exercise alone. Most protocols involve three to four weekly sessions, with 2,000 to 3,000 pulses delivered per session.
The results are encouraging. Across multiple studies, ESWT significantly improved both pain and function for hip tendon problems. Success rates ranged from roughly 57% to 83% depending on the study and follow-up period, with some research showing continued improvement at 15 months. It’s not a guaranteed fix, but it’s a reasonable next step before considering injections or surgery.
Injections
When conservative treatment stalls, injection therapy is an option. Corticosteroid injections have long been used for quick pain relief, but platelet-rich plasma (PRP) injections are gaining ground based on newer evidence.
A randomized controlled trial comparing the two in people with chronic gluteal tendonitis (lasting more than four months) found that a single PRP injection outperformed a corticosteroid injection at 12 weeks. In the PRP group, 82% of patients achieved a meaningful improvement in symptoms, compared to 57% in the corticosteroid group. PRP works by concentrating your own blood’s healing factors and injecting them directly into the damaged tendon.
Corticosteroid injections still have a role for short-term relief, especially if pain is preventing you from doing your rehab exercises. But they don’t promote tendon healing the way PRP does, and repeated steroid injections may weaken tendon tissue over time.
When Surgery Becomes an Option
Surgery is reserved for cases that have exhausted all conservative treatments. The typical threshold is at least 12 weeks of treatment, including a minimum of six weeks of formal physical therapy, along with activity modification and anti-inflammatory medication. If those measures fail, surgical repair or debridement of the damaged tendon may be considered.
Surgical procedures vary depending on the tendon involved but often include cleaning up damaged tissue, reattaching the tendon to the bone, or releasing tight structures that are compressing the tendon. Recovery from hip tendon surgery generally takes several months and requires a structured rehabilitation program afterward.
Returning to Full Activity
Getting back to sports or high-impact exercise should be gradual and based on functional milestones, not just the calendar. Before starting a running program, you should be able to perform single-leg squats, front step-downs, and side-lying hip abduction for 10 repetitions each with good control and at least a 4 out of 5 strength grade in hip abduction.
For people recovering from more significant tendon injuries or surgery, clinicians look for at least 90% symmetry between the affected and unaffected leg on strength and performance tests. Functional tests like lateral agility drills, diagonal agility tests, and forward lunges onto a box help confirm readiness. Rushing back before hitting these benchmarks is one of the most common reasons hip tendonitis becomes a recurring problem.
Mild cases typically resolve in three to six weeks with consistent rehab. Chronic tendonitis, where the tendon has undergone structural changes from months of overuse, can take three to six months or longer to fully rehabilitate. Patience with the process makes a real difference in the outcome.