The short answer
- Stand on the sore leg for 30 seconds. In a study using MRI as the reference, pain within those 30 seconds moved the probability of gluteal tendinopathy from 50% to 98%.
- If the bony point on the side of the hip is not tender to press, it is probably not this.
- It is not bursitis. The bursa was blamed for decades, and imaging and surgical findings pointed at the tendons instead.
- Stretching, crossing your legs and lying on that side all squash the tendon against the bone. Taking those out is a large part of the treatment.
- In a trial of 204 people, education plus exercise beat a corticosteroid injection at eight weeks and was still ahead at a year.
It starts as an ache on the side of the hip, on the bony point you can feel through your shorts. Then you notice you cannot lie on that side at night. Then someone tells you your glutes are tight, and you start stretching them, and it gets worse.
That sequence is so common it is almost diagnostic on its own.
Thirty seconds on one leg
There is a home test for this one with real numbers behind it.
Stand on the sore leg, let go of anything you are holding, and wait 30 seconds.
Two things worth knowing about that study. It was 65 people, so the precision around those numbers is limited, and the authors say so. And 20 of the 65 had gluteal tendinopathy on MRI while testing negative clinically, so a negative test does not close the case.
It is not bursitis
For decades this was called trochanteric bursitis, and people were treated for an inflamed bursa. Imaging and surgical findings moved the target: gluteal tendinopathy is now regarded as the primary local source of lateral hip pain, and the tendons of gluteus medius and minimus are what is actually involved2.
That matters because the two explanations lead different places. A bursa suggests something to calm down. A tendon suggests something to load.
Why stretching makes it worse
The gluteal tendons wrap over the bony point at the top of the thigh bone. Whenever the hip moves inwards across the midline, those tendons are pulled tighter against that bone and compressed.
That happens more often than you would think. Crossing your legs. Standing with your weight slumped onto one hip. Sitting low with the knees together. Lying on that side in bed. And the classic glute stretch, where you pull the knee across your body, which is compression held for thirty seconds on purpose.
What the trial found
This condition has one large, well-run trial, and its answer is unusually clear.
Two details are easy to miss. The injection did work, and faster than doing nothing, so this is not an argument that injections are useless. And the education and exercise group had 14 sessions over eight weeks, which is a lot of contact.
There is also a caution about the exercise part specifically. Two trials in postmenopausal women found that everyone improved when education was included, whether the exercise programme was the targeted one or a sham4,5.
What the profession actually does
Worth knowing what you may be offered.
Stretching being used by half of clinicians for a condition where stretching compresses the painful tendon is the part to take away from that.
How long it takes
The trial ran its main programme over eight weeks and followed people to a year, and improvement was still holding at 52 weeks. That is a reasonable frame: meaningful change inside a couple of months, and a plan you keep going well past the point where it stops hurting.
Where these findings stop is worth saying. The trials were done in people aged 35 to 70 with at least three months of pain, most of them postmenopausal women, not in runners mid-training-block. The mechanism transfers. The timelines are a guide rather than a promise.
When to get it looked at
Lateral hip pain is one of the running complaints most often managed as something else for months before it is named7, so a second opinion early is worth more here than in most places.