Persistent pain on the side of your hip can make everyday activities uncomfortable — especially walking, sleeping, climbing stairs, or exercising.

One common cause of lateral hip pain is Greater Trochanteric Pain Syndrome (GTPS), a condition affecting the gluteal tendons around the hip.

While the name sounds complex, GTPS is a very common condition that physiotherapists see regularly and can usually be managed successfully with the right rehabilitation approach.

What is GTPS?

GTPS is a condition involving irritation or overload of the gluteus medius and gluteus minimus tendons on the outside of the hip.

Tendons are strong tissues that connect muscles to bone. When these tendons are exposed to excessive load or repeated compression over time, they can become painful and sensitive.

While some people associate lateral hip pain with sciatica, GTPS is different and typically does not involve nerve symptoms such as tingling or numbness.

Why Does GTPS Develop?

GTPS often develops when the gluteal tendons are exposed to more load than they can comfortably tolerate over time.

Common contributing factors include:

  • Repetitive loading from walking, running, or stair climbing
  • Weakness in the hip muscles
  • Poor movement mechanics
  • Prolonged compression of the tendons
  • Age-related tendon changes

Women, particularly those over 50, are more commonly affected. Hormonal changes and pelvic anatomy can contribute to increased stress on the gluteal tendons.

Common Symptoms of GTPS

Symptoms usually develop gradually and may include:

  • Pain on the outside of the hip or upper thigh
  • Pain when lying on the affected side
  • Pain during walking, stairs, or prolonged standing
  • Tenderness over the bony part of the hip
  • Discomfort after prolonged sitting

Activities such as crossing your legs, sitting in low chairs, or bending deeply at the hips can often aggravate symptoms.

How is GTPS Diagnosed?

A physiotherapist will typically assess your symptoms, hip strength, movement patterns, and areas of tenderness around the hip.

Common clinical tests may include:

  • Resisted hip abduction testing
  • Single-leg stance testing
  • Movement assessment of the hip and pelvis
  • Special tests such as FADDIR and FABER

Imaging is not always necessary, but may occasionally be used to rule out other conditions.

Treatment and Management

The good news is that GTPS can often be managed successfully with conservative treatment and a structured rehabilitation program.

1. Load Management

Reducing aggravating activities is important early on.

This may involve temporarily modifying:

  • prolonged standing
  • stair climbing
  • running
  • sitting with crossed legs
  • deep hip bending positions

When sitting, it can help to keep your hips slightly higher than your knees.

2. Strengthening Exercises

Improving glute strength helps reduce stress on irritated tendons.

Exercises are usually introduced gradually and progressed based on symptoms and tolerance.

Common examples include:

  • Glute bridges
  • Isometric hip exercises
  • Standing hip strengthening
  • Resistance band exercises

A personalised exercise program is important, as every presentation is different.

3. Avoiding Tendon Compression

Certain positions can compress the tendons and worsen symptoms.

Helpful strategies include:

  • avoiding sitting cross-legged
  • avoiding standing with the hip “popped out”
  • using a pillow between the knees when sleeping on your side

4. Gait and Movement Retraining

Improving walking mechanics and lower limb control can help reduce stress on the gluteal tendons and improve long-term outcomes.

5. Manual Therapy

Massage, dry needling, and hands-on therapy may help provide short-term symptom relief.

However, these treatments should generally be viewed as adjuncts rather than the primary treatment approach, with exercise rehabilitation remaining the cornerstone of management.

Do’s and Don’ts for GTPS

Do:

  • Sit with hips slightly above knee level
  • Sleep with a pillow between your knees
  • Maintain regular gentle movement
  • Progress exercises gradually

Don’t:

  • Push through high levels of pain
  • Sit cross-legged for prolonged periods
  • Ignore worsening night pain
  • Suddenly increase activity levels

As a general guide, try to keep pain during exercise at 4/10 or below.

Can GTPS Be Prevented?

Maintaining good hip strength, gradually progressing exercise loads, and avoiding prolonged compressive positions can help reduce the likelihood of developing GTPS.

Regular strength training and attention to movement mechanics are often beneficial.

When Should You See a Physiotherapist?

If your lateral hip pain is:

  • persisting for several weeks
  • disturbing your sleep
  • limiting walking or exercise
  • not improving with rest

…an assessment with a physiotherapist can help identify the cause and guide an appropriate rehabilitation plan.

At Capital Clinic, our physiotherapists can assess your hip pain and develop an individualised treatment program to help you return to activity confidently.