Hip Bursitis and Gluteal Tendinopathy Physiotherapy in West Perth
Pain on the outside of the hip is uncomfortable, persistent, and often affects sleep as much as activity. The good news is it responds well to physiotherapy when the contributing factors are properly identified and addressed — and that's exactly what we do at PhysioLogix.
What is Hip Bursitis?
The greater trochanteric bursa sits on the outer side of the hip, between the lateral hip tendons and the bony prominence of the greater trochanter. Its job is to reduce friction between these structures during movement. When the bursa is repeatedly compressed or irritated — through muscle weakness, habitual postures, or loading patterns — it can become inflamed and painful.
The classic presentation is pain on the outer side of the hip, often worse when lying on the affected side, rising from a seated position, climbing stairs, or walking for extended periods. It can radiate down the outer thigh and is frequently described as a deep aching or burning sensation.
Hip Bursitis and Gluteal Tendinopathy — Understanding the Relationship
Greater trochanteric bursitis and gluteal tendinopathy are closely related conditions that frequently present together — and understanding the relationship between them is important for effective treatment.
Greater trochanteric bursitis — inflammation of the bursa on the outer hip. The bursa becomes inflamed when it is repeatedly compressed, typically by the gluteal tendons passing over it under load or in positions of hip adduction such as crossing the legs, leaning on one hip, or side sleeping.
Gluteal tendinopathy — irritation of the gluteal tendons themselves, most commonly the gluteus medius and gluteus minimus tendons at their attachment point on the greater trochanter. These two conditions frequently coexist because the same mechanical factors — gluteal weakness, compressive loading habits, and altered hip mechanics — drive both simultaneously.
This is why treatment needs to address both the bursal irritation and the tendon loading issue together. Managing the inflammation alone without rehabilitating the gluteal tendons and correcting the load factors is why many hip bursitis presentations recur or fail to resolve fully.
At PhysioLogix, assessment identifies the contribution of each component before treatment begins so the program is built around what's actually happening rather than a generic hip bursitis protocol.
What Causes Hip Bursitis and Gluteal Tendinopathy?
Gluteus medius and minimus weakness — the lateral hip muscles are responsible for stabilising the pelvis during single leg loading activities like walking, running, and stair climbing. When these muscles are weak or fatigue quickly, the greater trochanter moves into positions that compress the bursa and tendons repeatedly. This is the most common underlying driver of both conditions.
Compressive load habits — certain postures place direct compressive load on the lateral hip structures. Sleeping on the affected side, crossing the legs, standing with weight shifted onto one hip, and sitting in low chairs with the hips in adduction all increase compressive load on the bursa and tendons. In sensitive presentations, even stretching the hip into adduction can aggravate symptoms.
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Training load changes — in runners and gym-based patients, sudden increases in training volume or a change in surface, footwear, or running mechanics can increase lateral hip loading beyond what the gluteal tendons can tolerate.
Trendelenburg gait — a pronounced side-to-side hip drop during walking is a visible sign of gluteus medius weakness and is both a consequence and a cause of lateral hip pain. The hip drops because the muscle is weak, and the drop further loads the tendons and bursa on the stance leg.
How We Treat Hip Bursitis at PhysioLogix
Assessment covers gluteal muscle strength and endurance, hip mechanics during functional movement, compressive load habits, and for active patients, gait and running mechanics where relevant. Understanding the full picture determines whether the primary driver is tendon loading, muscular weakness, habitual compression, or a combination.
Hands-on treatment includes soft tissue release to the lateral hip musculature and iliotibial band, and dry needling where deep gluteal trigger points are contributing to pain and slow to respond to manual release. Joint mobilisation to the hip and lumbar spine is included where restricted movement is contributing to altered hip mechanics.
Over-the-counter anti-inflammatory medication can be a useful adjunct in the acute phase to help settle the bursal irritation and make the rehabilitation process more comfortable. We'll advise you on this where appropriate.
Exercise rehabilitation is the central component of lasting resolution. Progressive gluteal loading — beginning with low-compression exercises and advancing systematically as the tendon and bursa's tolerance improves — rebuilds the capacity of the lateral hip structures to handle daily and sporting demands. Exercises such as isometric hip abduction, side-lying hip abduction, and progressive single-leg loading form the foundation of most programs. Load management advice — specifically around the compressive positions to avoid during the acute and mid-recovery phases — is essential and provided at the first appointment.
For runners, return to running is structured progressively within load tolerance parameters. For gym-based patients, training modifications during recovery are provided so that training can continue — modified where necessary — while the condition resolves.
Frequently Asked Questions
How long does hip bursitis or gluteal tendinopathy take to resolve?
This depends on how long it has been present and whether the compressive load habits have been identified and modified. Acute presentations that are caught and managed early can resolve within eight to twelve weeks. Chronic presentations that have been present for months or years take longer — but consistent engagement with a progressive loading program produces reliable results. Most patients notice meaningful improvement within the first few sessions.
Can hip bursitis resolve without surgery?
Yes — the vast majority of hip bursitis and gluteal tendinopathy cases resolve with conservative physiotherapy management. Cortisone injections can provide short-term relief but do not address the tendon loading and muscular weakness driving the condition. Surgery is rarely required and is typically only considered after extended conservative management has failed.
Can hip bursitis resolve without physiotherapy?
Some mild cases settle with rest and removal of the compressive habits. However, without addressing the gluteal weakness and load management factors, recurrence is common when activity resumes. For gluteal tendinopathy specifically — which requires progressive tendon loading to rehabilitate — passive rest alone is rarely sufficient for full resolution.
Should I stretch my hip if I have bursitis or gluteal tendinopathy?
With caution. Hip stretches that involve adducting the hip — crossing the leg over, pulling the knee to the opposite shoulder — directly compress the bursa and gluteal tendons and can aggravate symptoms in sensitive presentations. We will advise you specifically on which stretches are appropriate and which to avoid at your stage of recovery.
Can I keep running with hip bursitis?
In many cases yes, with load modification. Complete rest is not always necessary and can delay recovery of the gluteal tendons. The right approach depends on your presentation and how irritable the condition currently is — we will advise you specifically at your first appointment.
Where is PhysioLogix located?
6/567 Newcastle Street, West Perth WA 6005. We regularly see patients with shoulder bursitis and impingement from Subiaco, Leederville, North Perth, Nedlands, Mount Hawthorn, and across the inner Perth suburbs. Free street parking is available directly outside with no time limits during clinic hours.
Do I need a referral?
No referral is required. Book directly online using the button bellow Cliniko or call 0450 075 955.
Hip pain on the outside that's affecting your training or your sleep doesn't have to be something you just manage. Call us on 0450 075 955 and we'll work out what's driving it.