The Real Cause of “Hip Bursitis” & How to Treat Outer Hip Pain Naturally
Outer hip pain is commonly diagnosed as bursitis.
However, modern research — including guidance aligned with institutions such as the Royal College of Surgeons in Ireland — shows that most cases are not primarily inflammatory bursitis.
Instead, the condition is now recognised as:
👉 Gluteal Tendinopathy
Also known as Greater Trochanteric Pain Syndrome (GTPS).
Understanding this shift is critical — because the treatment approach changes completely.
What Is Gluteal Tendinopathy?
Gluteal tendinopathy is a load-related tendon condition affecting the gluteus medius and gluteus minimus tendons at the outside of the hip.
Rather than acute inflammation, it involves:
• Tendon overload
• Degenerative change
• Reduced load tolerance
• Compression sensitivity
It is especially common in:
• Women over 40
• Perimenopause and menopause
• Runners and walkers
• Those who sit for long periods
• People who stand hanging on one hip
Symptoms of Gluteal Tendinopathy
You may experience:
• Pain on the outside of the hip
• Pain lying on your side
• Night pain
• Pain climbing stairs or hills
• Pain getting out of a car
• Tenderness when pressing the hip
• Pain standing on one leg
If this sounds familiar, it is likely not bursitis — it is tendon overload.
Why It Happens
The key mechanism is:
Compression + Load = Tendon Irritation
Common aggravators:
• Crossing your knees
• Sitting in low chairs
• Standing with hip dropped to one side
• Sudden increase in walking or exercise
• Weak hip stabilisers
• Hormonal changes affecting collagen quality
Evidence-Based Treatment for Gluteal Tendinopathy
Modern research strongly supports:
1. Education & Load Management
Simple changes can dramatically reduce pain:
• Stop crossing legs
• Avoid hanging on one hip
• Keep hips level when standing
• Sit with hips slightly higher than knees
• Avoid deep hip adduction stretches
• Use a pillow between knees at night
These reduce compressive load on the tendon.
2. Progressive Strength Training
This is the cornerstone of recovery.
Gentle, progressive gluteal strengthening improves tendon capacity and long-term resilience.
Exercise plus education has better long-term outcomes than injection alone.
3. Additional Medical Options (If Needed)
• Shockwave therapy
• Corticosteroid injections for short-term relief
• PRP in selected cases
• Rare surgical intervention
Most people recover fully with conservative management.
Integrative & Holistic Support at KINCORA Therapy
Alongside evidence-based rehabilitation, I support clients with integrative therapies that assist nervous system regulation and tissue recovery.
In-Clinic Therapies
• Bowen Technique
• Craniosacral Therapy
• Physical Therapy
• Reiki
These may help:
• Reduce muscular guarding
• Improve structural balance
• Calm pain sensitivity
• Support parasympathetic activation
• Address compensatory movement patterns
Pain is both mechanical and neurological — supporting both pathways enhances recovery.
Natural Anti-Inflammatory Supports
These can complement your rehabilitation plan:
• Cabbage leaf compress
• Castor oil packs
• Apple cider vinegar topical application
• Pernaton gel
• Epsom salt baths
These approaches may reduce discomfort and support recovery but should be used alongside strengthening, not instead of it.
Hormones & Tendon Health
Declining oestrogen during perimenopause and menopause affects tendon elasticity and collagen production.
If you are experiencing:
• Persistent hip pain
• New joint stiffness
• Multiple tendon issues
It may be worth discussing options with:
• Your GP
• A menopause specialist
• Women’s health clinics
Hormonal optimisation can be part of your recovery plan.
Watch: Gluteal Tendinopathy Explained
Can Gluteal Tendinopathy Heal?
Yes.
With:
• Education
• Load modification
• Progressive strengthening
• Nervous system support
• Patience
Most people return to walking, hiking, exercise, and pain-free sleep.
If you are struggling with persistent outer hip pain, I offer personalised assessments and integrative treatment plans at KINCORA Therapy.
Pain-free movement is possible.
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