Author: Mr Oliver Eaton BSc (Hons), PG.Cert – Orthopaedic Specialist
Reviewed by: Mr William Sharples BSc (Hons) – Pain Management Expert
Last Updated: September 2025
In this article, you will find out everything you need to know about gluteal tendinopathy and the most effective ways to treat it, including an advanced treatment called Prolotherapy.
Table of Contents
- What is Gluteal Tendinopathy?
- Symptoms of Gluteal Tendinopathy
- Causes & Risk Factors
- Diagnosis
- Treatment Options
- Prolotherapy for Gluteal Tendinopathy
- Prevention Tips
- Frequently Asked Questions
- Contact ProHealth Clinic
- Author Bio
- References
What is Gluteal Tendinopathy?
Gluteal tendinopathy is a common cause of lateral hip pain, affecting the tendons that connect your gluteal muscles (gluteus maximus, medius, and minimus) to the greater trochanter of the hip. Also known as Greater Trochanteric Pain Syndrome (GTPS), it affects 10–25% of the population and is three times more prevalent in women. These tendons are vital for shock absorption and hip stability during movement.
Symptoms of Gluteal Tendinopathy
- Tenderness on the outside of the hip (lateral hip pain)
- Pain when lying on the affected side
- Night pain and morning stiffness
- Referred pain to the outside of the thigh or knee
- Pain during walking, running, climbing stairs, or single-leg stance
- Relief when buttock muscles are stretched
- Lateral thigh pain after prolonged sitting
- Buttock weakness
- Pain with legs or knees crossed
Causes & Risk Factors
Pain over the greater trochanter often develops gradually and is linked to:
- Biomechanics: Weak gluteal muscles, tight iliotibial band (ITB), or altered hip alignment can increase tendon stress.
- Overuse: Excessive load or repetitive activities (especially hip adduction) can overwork the tendons.
- Alignment: Wider hips (higher Q-angle), pelvic misalignment, or previous lower back/pelvic pain increase risk.
- Weak hip ligaments: Lax ligaments force tendons to work harder, leading to pain.
- Trauma: Falls or direct impact can inflame the gluteal tendons, especially the gluteus medius.
- Excessive hip adduction: Increases compressive and tensile forces on the gluteal tendons.
Other risk factors include being an athlete (especially runners), inactivity, hip osteoarthritis, side-lying sleep position, and sitting with crossed legs.
Diagnosis
Diagnosis starts with a detailed history and physical exam. Your doctor or physiotherapist may assess your habits, posture, and hip alignment. Imaging (MRI or ultrasound) can confirm gluteal tendinopathy and rule out other conditions. Clinical tests like single-leg stance or external de-rotation test help identify tendon involvement.
Treatment Options
Treatment aims to reduce tendon load, pain, and inflammation, and restore hip function. Options include:
- Physical therapy (strengthening, isometric, and pelvic control exercises)
- Reducing hip adduction and correcting alignment
- Massage and soft tissue therapy
- Running gait analysis for athletes
- Corticosteroid injections (short-term relief, but may weaken tendons with repeated use)
- Prolotherapy (see below)
- Surgery (rare, for severe or persistent cases)
Prolotherapy for Gluteal Tendinopathy
The gluteal tendons have a poor blood supply, making healing slow with physiotherapy alone. Prolotherapy involves injecting nutrients directly into the gluteal tendons, providing what’s needed for healing and pain relief. It also strengthens hip ligaments, addressing the root cause and offering a potential permanent fix for gluteal tendinopathy.
Disclaimer: The information provided in this section is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Prolotherapy may not be suitable for everyone, and outcomes can vary. Always seek the guidance of a qualified healthcare professional regarding your specific medical condition or treatment options. Never disregard professional medical advice or delay seeking it because of information you have read here.
Prevention Tips
- Regular physical therapy and strengthening/stretching of gluteal and leg muscles
- Annual running gait analysis for athletes
- Monthly massage for those in weight-bearing sports
- Use a pillow between knees if sleeping on your side
- Avoid prolonged sitting with crossed legs
Frequently Asked Questions
How long does gluteal tendinopathy take to heal?
With physical therapy, healing can take 8 weeks to a year, depending on severity and adherence to treatment.
Is walking good for gluteal tendinopathy?
Walking can help if hips and pelvis are aligned. Poor alignment or weak buttock muscles can worsen symptoms.
Does gluteal tendinopathy go away?
Yes, with the right treatment and advice, most people recover fully.
Is gluteal tendinopathy degenerative?
Chronic inflammation can weaken tendon fibers, making the condition degenerative if left untreated.
Is tendinosis the same as gluteal tendinopathy?
Tendinosis is a degenerative tendon injury; gluteal tendinopathy is a broader term that includes both tendinosis and tendonitis.
Are there studies for the treatment of gluteal tendinopathy?
Yes, several randomized clinical trials (e.g., Mellor, Bennell, Grimaldi, BMJ) support physical therapy and injection therapies.
Which exercises are recommended for gluteal tendinopathy?
Single-leg squat and single-leg bridge are commonly recommended to strengthen the gluteus medius/minimus and reduce tendon compression.
What is the differential diagnosis of gluteal tendinopathy?
Includes femoral head fracture, lumbar spine degeneration, labral tears, metastasis, Achilles tendinopathy, and trochanteric bursitis.
Do gluteal tendinopathy and trochanteric bursitis often occur together?
Yes, increased compressive forces on the bursa from gluteal tendinopathy can cause both conditions to co-exist.
What are the triggering factors for greater trochanteric pain syndrome?
External rotation or lateral tilt of the legs, activating the ITB and increasing load on the gluteus medius, can trigger pain.
Contact ProHealth Clinic Today for Your FREE 15-Minute Discovery Call
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Author Bio
Having performed over 10,000 procedures, Mr Oliver Eaton is one of the UK’s leading practitioners in the field of treating Gluteal Tendinopathy, with patients travelling to see him from across the UK, Europe, and the Middle East.
With over 12 years of clinical experience, Oliver is dedicated to helping patients understand their symptoms associated with Gluteal Tendinopathy and providing effective treatment options to alleviate them.
He qualified in Prolozone Therapy and Prolotherapy in America with the American Academy of Ozonotherapy. He continued on to complete further qualifications at the Royal Society of Medicine, Charing Cross Hospital in London, Keele University’s Anatomy & Surgical Training Centre, and the medical department of Heidelberg University in Germany.
Mr Eaton’s expertise has been featured in many national news and media publications, including The Telegraph, The Daily Mail, The Daily Express, Women’s Health Magazine, and The Scotsman.
Over the years he has had the privilege of treating many elite-level athletes, including both Olympic and Commonwealth medallists.
LinkedIn profile
References
- Mellor R, Bennell K, Grimaldi A, et al. (2018). Education plus exercise versus corticosteroid injection use for gluteal tendinopathy: a randomized clinical trial. BMJ. https://www.bmj.com/content/361/bmj.k1662
- Grimaldi A, Fearon A. (2015). Gluteal tendinopathy: integrating pathomechanics and clinical features in its management. J Orthop Sports Phys Ther. https://www.jospt.org/doi/10.2519/jospt.2015.5822
- Reiman MP, et al. (2018). Diagnosis and treatment of gluteal tendinopathy: a systematic review. Phys Ther Sport. https://pubmed.ncbi.nlm.nih.gov/29549713/
- ProHealth Clinic. Prolotherapy for gluteal tendinopathy. https://prohealthclinic.co.uk/pain-and-injury-clinic/
- Case Study: Prolotherapy for chronic hip pain. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3659574/
Disclaimer: This article is for informational purposes only and does not substitute for professional medical advice. Always consult your healthcare provider before making treatment decisions.