What is this Pain on the Outside of my Hip?

There may be a few causes for the pain you are experiencing on the outside of your hip such as referred pain from the back or the hip joint itself. However, Gluteal Tendinopathy is considered the primary cause of lateral hip pain. Lateral hip pain is thought to affect 1 in 4 women over the age of 50 and 10-25% of the population will experience this disorder. You may be experiencing pain at or around the outside of the hip. It may be provoked by:

Sitting with your legs crossed.
Sitting with the feet wide and knees together
Lying on the side of the painful hip.
Stretching the outside of the hip.
Going up and down stairs.
Running or Jogging.

This is due to poor movement and postural habits that lead to compression of the gluteal tendon over the hip. In turn, this causes extra stress on the lateral hip in these positions.

So What is a Gluteal Tendinopathy?

A Gluteal Tendinopathy is a moderate to severe pain affecting the gluteal tendon over the greater trochanter (lateral hip). It causes lateral hip pain, muscular stiffness and weakness of the hip muscles. In turn, the tendon becomes sensitive and painful to certain movements. Some common movements that aggravate the gluteal tendon involve bringing the hip across your body such as sitting with legs crossed or lying on the affected hip. However, the tendon is strong and resilient and can adapt given adequate time. The pain is due to a reaction to excessive load, not a sign of damage.

Why does it Occur – Common Causes?

Too Much Stretching – This creates a painful compressive load on the gluteal tendon over the hip and it tends to aggravate the symptoms. For example, doing lots of yoga poses in particular the pigeon pose can aggravate the tendon over the outside of the hip.

Postural Habits – These may be aggravating the painful tendon by compressing it e.g sitting with the legs crossed & sleeping on the painful hip.
Poor Ankle and Hip Stability. Knees coming together when jogging/running
Weakness and Poor Control of Hip Muscles.

How can Physio help my Lateral Hip Pain?

Reduce Pain : through activity modification, soft tissue therapy and low level activation exercises.
Accurate Diagnosis: of your lateral hip pain be it Gluteal Tendon pain or other causes. Gluteal tendon pain typically takes up to 12 weeks to see a significant resolution in symptoms depending on the severity.
Shockwave Therapy – and other manual therapy techniques to reduce pain levels and speed up healing. You can read more about Shockwave Therapy here.
Plan Treatment & Progressive Rehabilitation with you based on your current needs and goals. Long term positive outcome will only be achieved by addressing poor postural and movement habits, and correction of muscle dysfunction.
Stop Stretching for a period of time to let the tendon settle. We will then gradually re-introduce these movements if they are part of your goals – e.g Yoga Class.

Patient Example

50 year old lady with irritable Lateral Hip Pain. She had seen multiple clinicians for the same symptoms.
She was given Deep Tissue Massage and joint manipulation of the hip – made it much worse!
We provided a Second Opinion.
We advised her on activity modification and to stop stretching the hip initially.
She was shown some low level activation exercises for the hip to help with weakness and stiffness.
We coupled this with some Shockwave Therapy sessions to help with the pain and heal the area.
Within 3 weeks she was 80% better.
Her exercises were then reviewed and progressed to meet her goals of walking 8k a week.