From "Trochanteric Bursitis" to "Gluteal Tendinopathy"

Gluteal Tendinopathy

Why the Name (and Approach) Has Changed

"It's not just a change in terminology — it's a complete shift in understanding how hip pain really works."

🔍 What Is Gluteal Tendinopathy?

Gluteal tendinopathy refers to irritation or degeneration of the gluteus medius and/or gluteus minimus tendons where they attach to the greater trochanter — the bony point on the side of your hip.

It's one of the most common causes of outer hip pain, especially in women over 40, runners, and people who spend long hours sitting or standing on one leg.

Typical symptoms include:

Pain or tenderness on the outside of the hip
Discomfort when lying on that side
Pain when walking, climbing stairs, or standing from sitting
Night pain or difficulty sleeping on the affected side

🧠 Why the Term "Trochanteric Bursitis" Is Outdated

For years, any pain on the side of the hip was labelled trochanteric bursitis, implying inflammation of the bursa — the small fluid sac that cushions the hip joint.

But modern research and imaging tell a different story:

The bursa is rarely the main source of pain.
The gluteal tendons (particularly gluteus medius and minimus) are most often affected.
The bursa may become irritated secondarily, due to friction or compression, but it's not the root cause.

That's why the term "Gluteal Tendinopathy" has replaced "trochanteric bursitis" — it reflects what's actually happening at the tissue level.

🔄 How the Change Affects Management

Old Thinking: "Trochanteric Bursitis"	Modern Approach: "Gluteal Tendinopathy"
🔹 Assumed inflammation was the main problem	🔹 Recognizes tendon degeneration and overload as the true cause
🔹 Emphasis on rest, NSAIDs, and corticosteroid injections	🔹 Focus on graded loading, strength training, and patient education
🔹 Passive treatments (ice, ultrasound, heat)	🔹 Active rehabilitation (targeted gluteal loading, movement retraining)
🔹 Relief is often short-lived; pain may recur	🔹 Builds tendon capacity and long-term resilience
🔹 Avoids movement	🔹 Encourages smart, progressive loading

🏋️‍♀️ Key Principles in Treating Gluteal Tendinopathy

1. Load Management

Avoid positions that compress the tendon — like crossing legs, sitting with knees together, or lying directly on the sore side.

2. Strengthening

Progressive loading of the gluteus medius and minimus improves tendon strength and function. Exercises often start with isometrics and build toward functional loading.

3. Education

Understanding tendon recovery is crucial — tendons respond best to controlled load, not rest. Patience and consistency are key.

4. Adjunct Therapies

A single corticosteroid injection or shockwave therapy can help reduce pain temporarily, but should complement — not replace — structured rehab.

"Tendons don't like total rest — they recover best through smart, progressive loading."

💡 Quick Takeaways

"Trochanteric bursitis" is an outdated term — the issue is not primarily inflammation.
Gluteal tendinopathy describes what's really happening: tendon irritation and overload.
The best results come from education, load management, and progressive strengthening — not just medication or injections.

🩺 Clinician's Note — Bharath, M7LW Physiotherapy

In clinic, I often see patients who've struggled for months with "hip bursitis" that never quite settled. Once we shift focus from inflammation to tendon health, recovery begins to make sense.

The goal is not rest — it's rebuilding strength, balance, and movement confidence.

This updated understanding helps patients take an active role in their healing — and that's where real change happens.

Categories: Hip Pain, Tendinopathy, Evidence-Based Practice Tags: #glutealtendinopathy, #hippain, #tendinopathy