The two hallmark symptoms of hip tendonitis are pain and stiffness. Pain is typically the first and most noticeable sign, ranging from a dull ache to moderate or severe discomfort around the hip joint. Stiffness follows closely, limiting how freely you can move your leg during everyday activities and even at rest.
Pain: Where It Shows Up and What It Feels Like
Hip tendonitis pain varies depending on which tendon is irritated. When the tendons on the outer hip are involved, pain typically starts at the bony point near the top of your thighbone and radiates down the outside of your leg, sometimes reaching as far as your knee or lower leg. You may also feel it in your lower back or buttock. When the tendon at the front of the hip is affected, the pain centers in the front of the hip and groin. It tends to get worse when you extend your leg behind you or actively bend at the hip against resistance, like climbing stairs or getting out of a car.
The intensity can range from a mild ache after activity to sharp, moderate-to-severe pain that interferes with walking. Many people notice it worsens after sitting for long periods, then eases slightly once they start moving. Lying on the affected side at night is a common trigger, which can disrupt sleep and make the problem feel worse in the morning.
Stiffness and Reduced Mobility
Stiffness in the hip joint is the second defining symptom. It can be present both during normal activities and at rest, making it harder to take full strides, rotate your leg, or bend at the hip. Some people describe a tightness that loosens somewhat after a few minutes of gentle movement but returns after inactivity.
Along with stiffness, you may notice a grating or grinding sensation when the hip moves. In some cases, the irritated tendon can produce an audible or palpable snapping as it slides over the bony prominence on the outside of the hip during flexion and extension. This “snapping hip” isn’t always painful on its own, but it often accompanies the broader pattern of pain and stiffness.
Swelling and Other Secondary Signs
Some people develop mild swelling around the hip joint or the affected tendon. Unlike a swollen ankle, hip swelling is harder to see because the joint sits deep beneath muscle and tissue. You’re more likely to feel it as a sense of fullness or warmth in the area than to notice visible puffiness. Swelling tends to increase after prolonged activity and contributes to that stiff, restricted feeling.
How Hip Tendonitis Differs From Bursitis
Hip tendonitis and hip bursitis overlap so much that clinicians now often group them under “greater trochanteric pain syndrome.” Both cause pain on the outer hip, and both can radiate down the leg. The practical difference: tendonitis pain typically flares when the tendon is loaded, meaning when you actively push or pull against resistance (climbing stairs, standing from a squat). Bursitis pain is more reliably triggered by direct pressure, like lying on the affected side, and can be reproduced by pressing on the bony point of the outer hip.
In reality, many people have both at the same time, so the distinction matters less than understanding the overall pattern. If you have lateral hip pain that worsens with activity and pressure, the management approach is similar regardless of which structure is the primary source.
Activities That Make Symptoms Worse
Certain movements place extra load on the hip tendons and predictably aggravate symptoms:
- Stair climbing or hill walking, which demands repeated hip flexion under your body weight
- Sleeping on the affected side, compressing the irritated tendon against the bone for hours
- Prolonged sitting, especially in low chairs or with legs crossed, which keeps the tendon in a shortened or compressed position
- Running or brisk walking, particularly on uneven ground or with a sudden increase in distance
- Standing on one leg, even briefly, such as when putting on pants or shoes
Recognizing these triggers is useful because modifying them is often the first step in reducing pain. Switching to sleeping on your back with a pillow between your knees, avoiding deep squats temporarily, and gradually building up activity rather than pushing through pain can make a noticeable difference within a few weeks.
What to Expect From Diagnosis
A physical exam is usually enough to identify hip tendonitis. You’ll be asked to lie on your side with the painful hip facing up while the examiner presses on the outer hip to check for tenderness. They may also move your leg through flexion and extension while feeling for snapping or grinding over the tendon. Resisted movements, where you push your leg against the examiner’s hand, help pinpoint which tendon is involved based on where the pain reproduces.
Imaging isn’t always necessary, but an ultrasound or MRI can confirm tendon thickening or partial tears if symptoms don’t improve with initial management. These are typically reserved for cases that haven’t responded to activity modification and physical therapy after several weeks.