Gluteal Tendinopathy

Common Symptoms

• Pain over the outer hip that can extend down the outside of the thigh
• Pain that's worse lying on the affected side
• Pain with single-leg activities: walking, stairs, standing on one leg to dress
• A limp or altered gait pattern in more significant cases
• Tenderness directly over the outer hip bone

Why It Happens

The gluteus medius and minimus tendons stabilize the pelvis with every step, especially during single-leg stance (which happens with every stride while walking). Cumulative compressive and tensile load on these tendons — worsened by certain postures and movement patterns — can outpace their capacity to adapt, leading to tendinopathy.

Why It Can Become Persistent

Because these tendons are loaded with essentially every step, and because common daily habits (standing with weight shifted to one hip, tight IT band stretching that compresses the tendon, crossing the legs) increase compressive load on the tendon, the area often keeps getting reirritated without the person realizing why.

Who Commonly Gets It

Gluteal tendinopathy is more common in women, particularly midlife and older adults, and in runners and other endurance athletes. It frequently overlaps with — or is the underlying cause of — greater trochanteric pain syndrome.

How It Is Usually Diagnosed

Diagnosis is typically clinical, including tenderness over the tendon insertions and specific tests such as single-leg stance provocation. Ultrasound or MRI can confirm tendinopathy or an associated partial tear when needed.

Traditional Treatment Options

• Load and position modification: Reducing tendon-compressive positions and habits (crossed-leg sitting, hip-hitched standing, certain stretches) is a key first step.
• Physical therapy: A progressive gluteal-strengthening program, often starting with isometrics, is a well-supported first-line treatment.
• NSAIDs: Sometimes used short-term for symptom control.
• Corticosteroid injection: Can offer short-term relief for some patients, considered case by case.

Why Someone Might Start Looking for Another Option

Gluteal tendinopathy can take months to improve with exercise therapy alone, and consistent adherence to a loading program is genuinely difficult for busy adults. This is a common point where patients look into additional non-invasive options alongside continued exercise therapy.

Where Shockwave Therapy May Fit

Because gluteal tendinopathy is now understood to be the primary driver of most greater trochanteric pain syndrome, the research on shockwave therapy for GTPS is directly relevant here as well — see What Research Says below.

How Shockwave Treatment Works for This Area

Acoustic pressure waves are directed at the affected gluteal tendon insertion over the outer hip. Treatment is typically used alongside, not instead of, a hip-strengthening program.

What the Treatment Feels Like

Most patients describe a firm tapping or pressure sensation over the outer hip, with some tenderness directly over the sore spot. Sessions are brief and most patients resume normal activity the same day per your provider's guidance.

What Happens During Your First Visit

Your visit begins with a provider evaluation focused on your history and a physical exam relevant to your complaint. If shockwave therapy is determined to be clinically appropriate, your first treatment can typically be provided the same visit. See our What to Expect page for the full walkthrough.

Who May Not Be Appropriate

• Suspected significant gluteal tendon tear with major weakness or gait deviation, which needs prompt orthopedic evaluation
• Active infection, open wounds, or certain bone conditions at the treatment site
• Certain circulatory, neurological, or bleeding-related conditions, per your provider's screening

This list is not exhaustive. Your provider will screen for contraindications during your evaluation.