Struggling with Buttock Pain? Gluteal Tendinopathy Could Be the Cause - Here’s What to Do Next

Persistent pain around the side of your hip or deep in the buttock can be incredibly disruptive. If you’ve found it difficult to sleep on one side, walk for more than a few minutes, or even sit without discomfort, gluteal tendinopathy may be to blame.

At Perfect Balance Clinic in Moorgate, we work with people every day who are managing this frustrating condition. With targeted treatment, many experience relief within weeks - without needing injections or surgery. Whether it’s from running, walking, sitting too long, or standing all day, this form of tendon irritation can make even basic activities feel like a challenge. Fortunately, you don’t have to put up with it.

What Is Gluteal Tendinopathy?

Gluteal tendinopathy involves damage or irritation to the tendons that attach your gluteus medius and gluteus minimus muscles to the outer part of your thigh bone. Good hip support depends on these tendons doing their job.

The condition typically develops when the tendon is subjected to too much load, especially compressive stress, without enough recovery. With time, the tendon fibres break down and the spot where they attach gets sore.

Gluteal tendinopathy is also the most common cause of a condition known as Greater Trochanteric Pain Syndrome (GTPS) - a collection of symptoms affecting the outer hip and buttock, often confused with hip bursitis or sciatica.

Where Does It Hurt?

The hallmark symptom of gluteal tendinopathy is pain over the lateral hip, but it often extends further than that. You may feel:

• A dull ache or sharp pain on the outside of the hip, sometimes radiating to the buttock or thigh

• Increased discomfort when lying on the affected side, especially at night

• Pain that worsens when climbing stairs, standing for too long, or walking uphill

• A burning or stiff sensation after being still for long periods

• In some cases, groin pain or lower back discomfort due to compensation patterns

Pain is often worse with specific positions rather than random flares, and typically no numbness or tingling is present - which helps rule out nerve-based conditions.

It’s Commonly Misdiagnosed

Many people with gluteal tendinopathy are initially told they have:

• Sciatica

• Hip bursitis

• Piriformis syndrome

• Lumbar spine issues

This happens because buttock pain is a vague symptom that overlaps with several other conditions. However, key clues can help differentiate gluteal tendinopathy:

• Pain is worsened by pressure or movement, not prolonged sitting alone

• The pain is reproducible with pressure on the outer hip

• There’s no radiation of pain below the knee, unlike true sciatica

• Symptoms are load-dependent (e.g. worse after walking or climbing stairs)

Getting the diagnosis right is essential. It prevents unnecessary scans or medications and leads directly to a treatment plan that works.

What Leads to Gluteal Tendinopathy?

A mix of lifestyle habits, mechanical issues, and natural ageing can contribute. Common factors include:

• Overuse: Repetitive strain from activities like running, stair climbing, or hiking

• Underuse: Deconditioned glutes from long periods of inactivity

• Postural stress: Sitting with legs crossed, standing with hip “popped” to one side

• Sleeping positions: Lying on the affected side or without pillow support

• Hormonal changes: Particularly in post-menopausal women, where tendon tissue becomes more vulnerable

• Weak core or hip muscles: Poor control during movement leads to tendon overload

• Old injuries: Knee, ankle, or back issues that alter your walking pattern

Many people aren’t aware of how often they’re compressing the irritated tendon during daily life. That’s why education is a central part of treatment.

Typical Aggravators

Certain postures or movements commonly make the pain worse. These include:

• Crossing your legs while sitting

• Standing on one leg while doing daily tasks (e.g. brushing teeth)

• Walking with a narrow step width or toeing in

• Sitting in low chairs

• Climbing stairs or hills

• Side-lying without proper support

• Stretching the outer hip (e.g. pigeon pose)

At Perfect Balance Clinic Moorgate, we teach patients how to identify and reduce these movements early in rehab to calm the tendon before we gradually reintroduce more load.

How We Diagnose It

Our diagnostic process includes both hands-on testing and, when needed, referral for imaging:

Clinical Tests

• Palpation of the greater trochanter - pain reproduced on touch

• 30-second single-leg stance - pain increases during balance

• Resisted external de-rotation test - targets the specific gluteal tendons

Rule-Out Tests

We may also check lumbar spine motion, nerve tension, or perform hip impingement screening to exclude other causes.

Imaging such as ultrasound or MRI is rarely required but can be helpful in chronic or complex cases.

How It’s Treated - What Works

1. Load Management

Rest alone doesn’t resolve tendinopathy. It must be followed by gradual reintroduction of movement and strength. We begin by unloading the tendon where necessary (reducing aggravating behaviours), and then reloading it progressively.

We focus on movement patterns first - how you walk, sit, sleep, and stand.

2. Targeted Rehabilitation

Exercise is the key component of recovery. Our rehab programmes begin with isometric exercises to reduce pain and activate the tendon without irritating it. Then we guide you into concentric and eccentric loading to build long-term strength and resilience.

Common stages include:

• Isometric abductions: Side-lying or against a wall

• Step-downs: With a focus on hip control

• Glute bridges and single-leg bridges: As symptoms improve

• Walking retraining: Ensuring optimal stride length and glute activation

We also advise on what to avoid - such as deep lunges, hip stretching, or excessive uphill walking early in recovery.

3. Manual Therapy

Hands-on care such as joint mobilisation, soft tissue work, and guided movement helps reduce surrounding tension, especially in the TFL, piriformis, and QL regions. It’s also helpful for addressing coexisting pelvic imbalance or spinal stiffness.

4. Adjunct Treatments

At Perfect Balance Clinic Moorgate, we also offer:

• Shockwave therapy: Used in cases resistant to exercise alone. This non-invasive treatment can help stimulate tendon healing.

• Low-level laser therapy: Supports local circulation and healing for some chronic cases.

5. Education and Movement Coaching

You’ll learn how to:

• Position pillows for side-sleeping without irritating the tendon

• Sit without compressing the outer hip

• Climb stairs with better load sharing

• Choose the right footwear and insoles (if needed)

Education is one of the most powerful tools in preventing recurrence.

What About Injections or Surgery?

Injections, particularly corticosteroids, can offer temporary relief - but they do not repair the underlying issue. In fact, repeated injections may weaken tendon tissue.

Surgery is only considered in rare cases with tendon rupture or longstanding degeneration that hasn’t responded to rehab.

Most patients improve significantly through non-surgical care.

How Long Does Recovery Take?

Most cases respond well within 6 to 12 weeks with the right care. Chronic or long-standing cases may take several months, especially if movement habits need major retraining.

What slows down healing:

• Continuing aggravating activities

• Skipping rehab sessions

• Relying only on passive treatments

• Not understanding what’s driving the pain

Our role is to keep you on track and help you regain confidence in movement without overloading the tendon too soon.

Who Is Most at Risk?

We see gluteal tendinopathy most commonly in:

• Women aged 40-70

• Runners (especially those increasing mileage quickly)

• Office workers with prolonged sitting and poor posture

• People with a history of knee, ankle, or back pain

If you fall into one of these groups and notice outer hip pain - especially at night or after activity - seeking early intervention can make a big difference.

Hear from Others on Their Recovery Journey

Choosing where to go for treatment can feel overwhelming - especially when dealing with persistent pain. That’s why many of our patients say they found confidence after reading about others who had faced the same issues and found relief through our care.

A Smarter Way to Approach Persistent Buttock Pain

Gluteal tendinopathy is more than a sore hip - this condition can lower your comfort and confidence. Left untreated, it can lead to chronic pain or compensation patterns that stress the knees, back, or other areas.

The right approach is not just about reducing pain temporarily - it’s about correcting the way your body handles load, movement, and recovery.

At Perfect Balance Clinic Moorgate, our clinicians take the time to understand your body’s mechanics, tailor your rehab, and equip you with the tools needed to prevent re-injury. With a combination of clinical precision and practical support, we help people move better, feel better, and regain their independence.

If you’ve tried rest, stretching, or general exercises without lasting change, now is the time to get specific. Let’s uncover the root cause and give your tendon the chance to rebuild properly.

Book your assessment today - and take the next step toward lasting relief.

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Finding Us in Moorgate

Perfect Balance Clinic - Moorgate Centrally located near Moorgate and Liverpool Street stations. Easily accessible via public transport.

Please note: There is no on-site parking available at the Moorgate clinic. We recommend using public transport or nearby public car parks, such as:

• Finsbury Square Car Park

• London Wall Car Park

We offer early morning and evening appointments to accommodate your schedule.

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Perfect Balance Clinic, Moorgate