Gluteal tendinopathy and hip bursitis treatment in Edmonton

Pain on the outside of the hip that stops you lying on that side — and why calling it bursitis sends treatment the wrong way.

Book an appointment

Book an appointment

What causes pain on the outside of the hip?

Pain over the bony point on the outside of the hip is usually gluteal tendinopathy: a load-related problem of the gluteal tendons where they attach to the greater trochanter. For years this was called trochanteric bursitis, but when researchers looked, the bursa was inflamed far less often than the tendons were involved. The name matters because a bursitis diagnosis points to rest and injection, while a tendon problem responds to graded loading.

Gluteal Tendinopathy And Hip Bursitis Assessment And Treatment At Vertex Physiotherapy

The pattern

It is most common in women from around the mid-forties onward, and in runners increasing their load.

  • Pain over the bony point on the outside of the hip, sometimes running down the outer thigh
  • Lying on that side is painful — often the symptom that brings people in, because it disturbs sleep
  • Lying on the other side with the top leg dropping across is painful too
  • Standing on one leg, going up stairs and walking uphill provoke it
  • Sitting with legs crossed, or standing hanging on one hip, are uncomfortable

Why compression is the key idea

The gluteal tendons wrap over the bony point of the hip. Any position that brings the knee across the midline squeezes those tendons against the bone, and compression is what tendons tolerate least.

That is why the everyday advice for this condition is specific and slightly counter-intuitive: stop stretching the outside of the hip, stop crossing the legs, stop hanging on one hip when standing, and put a pillow between the knees at night. Several of the stretches people are commonly given for this pain make it worse.

What treatment usually involves

Removing the compressive positions first, which often changes night pain within a couple of weeks and makes everything else possible.

Then progressive loading of the gluteal muscles, starting with positions the tendon tolerates and building over weeks toward single-leg strength.

A randomised trial comparing education and exercise with corticosteroid injection and with a wait-and-see approach found outcomes favouring the education-and-exercise group at both eight weeks and twelve months. Injection can help in the short term, but it is not where the durable change comes from.

Questions people ask

Often that is what people are told. The iliotibial band passes over the same area, but the structure generating the pain is usually the gluteal tendon underneath. Rolling and stretching the IT band presses the tendon into the bone, which is why it tends not to help here.

Generally no, at least not the stretches that bring the knee across the body. Those compress the tendon. This is one of the conditions where the usual instinct works against you.

Night pain often improves within a few weeks once the compressive positions are removed. Building the tendon’s capacity takes longer — think three months of consistent loading rather than a handful of sessions.

Usually at reduced volume, with attention to hills and camber, which both increase the compressive load. That is worth planning rather than guessing at.

Most lateral hip pain that used to be called bursitis is actually gluteal tendinopathy, and the difference matters because the treatment is loading, not rest and injections. The assessment tests the tendon directly rather than relying on the label.

On the other side with a pillow between your knees, so the top leg does not drop across and compress the tendon. Lying on your back with a pillow under the knees also works. Avoid the sore side for now; it is one of the main aggravators.

No. Stretching or foam rolling the outer hip compresses the tendon against the bone, which is the thing that is irritating it. This is one of the conditions where the common advice makes it worse. Strengthening the hip abductors is the direction that helps.

Book a hip assessment

Vertex Physiotherapy is at 6958 76 Ave NW #205, Edmonton, AB T6B 2R2. Call (825) 525-2852 or book online.

Book an appointment

Written by Vertex Physiotherapy · Reviewed by Bipin Pokhrel, Provisional Physiotherapist · Last updated September 2026