Overview
Gluteus medius/minimus tendinopathy is an overuse and degeneration-type condition of the hip abductor tendons that attach to the greater trochanter, the bony bump on the outside of your hip. These tendons help stabilize your pelvis when you walk, stand on one leg, or move your hip. When they become irritated or overloaded, they can cause pain with sideways movements and swelling of the tendon/bursa region. This often leads to stiffness and weakness in hip abductor function, which can affect gait and climbing stairs.
Symptoms
Pain is usually felt on the outer side of the hip and may be sharp or achy, often worsening when lying on the affected side. Many people notice pain with walking, standing on one leg, climbing stairs, getting in and out of a car, or reaching the hip outward. Over time, hip abductor weakness can make your stride feel unstable or cause a noticeable limp. Some patients feel tenderness to touch over the greater trochanter, and discomfort may flare after increases in activity or prolonged sitting.
Causes
This condition commonly develops when the hip abductor tendons are repeatedly loaded beyond what they can tolerate, leading to micro-tears and tendon irritation. It can also follow a period of reduced strength or altered mechanics, so the tendons work harder to stabilize the pelvis. Less commonly, a sudden increase in activity, direct impact, or hip injury can trigger symptoms. Persistent irritation may cause ongoing pain even after the original trigger has passed.
Risk Factors
Risk is higher in people who rapidly increase walking, running, cycling, or stair use, or who have jobs or sports that involve frequent hip abduction and side-to-side loading. It is more common with age-related tendon changes, being overweight, and conditions that alter gait or pelvic mechanics. Tight hip flexors and reduced gluteal strength can contribute, as can sleeping predominantly on one side. Prior hip or low back problems that affect movement patterns can also raise the likelihood of developing gluteal tendinopathy.
Prevention
You can reduce risk by gradually increasing activity and avoiding sudden spikes in mileage, resistance, or time on inclines. Strengthening the hip abductors with a progressive program and improving hip mobility can help the tendons handle load more effectively. Practicing good mechanics during walking, squatting, and stair use, and limiting prolonged side-lying on the painful side, can reduce flare-ups. Maintaining a healthy body weight and addressing factors like footwear or training errors can further lower recurrence.
How the Diagnosis Is Evaluated
A clinician typically starts with a history focused on where the pain is felt, what movements trigger it, and how your walking or stair use has changed. The physical exam usually includes tenderness over the greater trochanter and tests that stress hip abduction, such as resisted abduction and functional single-leg tasks, often reproducing your typical pain. Imaging is not always needed initially, but ultrasound or MRI can help confirm tendon pathology and rule out other causes if symptoms persist, worsen, or the diagnosis is unclear. X-rays may be used to evaluate alternative structural issues, especially in older adults or if symptoms are atypical.
Nonsurgical Treatment Options
Treatment usually begins with activity modification to calm tendon overload while maintaining tolerance for walking and daily movement. Physical therapy is a cornerstone and typically focuses on progressive hip abductor strengthening, gait and movement retraining, and improving hip mobility and flexibility. Pain relief may include short-term use of anti-inflammatory medications if safe for you, along with ice or heat for symptom control. If pain limits progress, a corticosteroid injection around the affected region can provide temporary relief for some patients to better engage in strengthening, though results vary and repeated injections are used cautiously. For longer-lasting symptoms, some patients benefit from platelet-rich plasma (PRP) injections as an adjunct to rehabilitation. In selected cases with prominent muscle tenderness, trigger point-directed treatments or dry needling may help reduce associated myofascial pain.
When to Seek Medical Attention
Seek medical attention if pain persists beyond several weeks despite conservative care, keeps worsening, or significantly limits walking or daily activities. Get prompt evaluation if you cannot bear weight, have rapidly increasing swelling, or have fever or chills with hip pain. Contact urgent care or emergency services for sudden loss of hip function, severe new weakness, or any neurologic symptoms such as progressive numbness or bowel/bladder changes. If you had a significant fall or injury and symptoms are severe or your leg feels unstable, it is also important to be assessed promptly.
Frequently Asked Questions
In many cases, yes, but you should keep walking within a pain-tolerable range and avoid activities that cause a significant flare that lasts into the next day.
Corticosteroid injections can reduce pain temporarily and help you participate in strengthening, but they are not guaranteed to cure the underlying tendon overload.
Next Steps
If your pain is localized to the outside of the hip and worsens with abduction, start with activity modification and a targeted physical therapy program focused on hip abductor strengthening. If symptoms are not improving within a few weeks or you have significant functional limits, arrange an evaluation with a sports medicine or orthopedic clinician to confirm the diagnosis and discuss appropriate options. Early, consistent rehab is often the fastest path back to comfortable walking and stairs.