Gluteal Tendinopathy in Runners: Why Outer Hip Pain Isn’t Just “Tight Hips”
If you’re a runner dealing with pain on the outside of your hip, you’ve probably heard a few familiar explanations: tight hips, bursitis, just need to stretch more.
And maybe, at first, that advice seems reasonable. The hip feels stiff. Stretching feels productive. Foam rolling feels like you’re doing something.
But then the pain lingers. Or it gets worse with mileage. Or it starts waking you up at night when you lie on that side.
At our Atlanta-based running physical therapy clinic, this pattern almost always points to gluteal tendinopathy, not tightness and not something you just have to live with. To better understand tendinopathy in runners, check out this blog and then come back here.
What Gluteal Tendinopathy Actually Is
Your gluteus medius and gluteus minimus muscles in your outer hip play a huge role in running. Every time your foot hits the ground, these muscles stabilize your pelvis and control how your leg moves underneath you.
They do this thousands of times during a run.
The tendons that connect these muscles to the side of your hip are built to handle load but like any tendon, they have limits. When those limits are exceeded repeatedly, gluteal tendinopathy can develop.
It’s a load and compression problem that builds over time.
Why Runners Commonly Develop Lateral Hip Pain
Most runners with gluteal tendinopathy didn’t suddenly do something reckless. More often, it’s the result of small stressors adding up. Common contributors we see in Atlanta runners include:
Rapid increases in mileage or frequency
Running on cambered roads or consistently sloped surfaces
Fatigue late in runs leading to poor pelvic control
Weak lateral hip strength
Prolonged sitting with crossed legs
None of these are inherently “wrong,” but together they can overload the gluteal tendons.
How Gluteal Tendinopathy Feels to Runners
This injury often sneaks up on people. At first, it may just feel like mild discomfort on the outside of the hip. Over time, runners often notice:
Pain during longer runs or hilly routes
Discomfort when standing on one leg
Pain going up stairs or getting out of the car
Trouble lying on the affected side at night
Symptoms that worsen as fatigue sets in
Because the pain isn’t always severe, many runners keep training through it until consistency starts to suffer. Working with a running specialized physical therapist can help you manage this injury while still training for your big race.
Why This Pain Is Often Misdiagnosed as “Bursitis”
Lateral hip pain is frequently labeled as bursitis. While the bursa can become irritated, it’s often reacting to the same load issues affecting the gluteal tendons.
In runners, treating the bursa with passive treatments, such as anti-inflammatory medications, without addressing tendon load and strength usually leads to recurring symptoms.
The tendon is the driver. The bursa is the passenger.
What Can Runners Do to Help Gluteal Tendinopathy
The goal with gluteal tendinopathy isn’t to stretch more, it’s to reduce unnecessary compression while rebuilding strength and control.
That process typically includes:
Reducing compressive positions
Avoiding prolonged leg crossing, side-lying on the painful side, and aggressive cross-body stretches can significantly calm symptoms.Progressive lateral hip strengthening
Early-stage isometric exercises often help reduce pain. Over time, strength work becomes more dynamic and more specific to single-leg running demands.Improving single-leg stability
Running is a series of single-leg landings. When pelvic control falters, the gluteal tendons absorb extra stress.Addressing running mechanics
Excessive hip drop or trunk lean can increase lateral hip load. Small technique changes can reduce strain without altering pace or effort.
Why This Injury Can Be So Persistent
Tendons don’t respond quickly to change and gluteal tendons are no exception.
Runners often try to push through discomfort, assuming it will resolve on its own. Unfortunately, repeated overload without adequate strength adaptation can prolong symptoms.
Most runners start noticing meaningful improvement within 6–10 weeks when following a structured, progressive plan. Chronic cases may take longer, especially if sleep, sitting posture and training loads aren’t addressed together.
When to See a Running Physical Therapist in Atlanta
If you’re a runner in the Atlanta area and:
Your outer hip pain has lasted more than a few weeks
You can’t comfortably lie on the affected side
Your mileage or consistency is slipping
Stretching and rolling haven’t helped
A running-specific physical therapy evaluation can identify why your gluteal tendons are overloaded and how to rebuild their capacity safely.
At Tempo Physical Therapy & Performance, we specialize in running physical therapy for Atlanta runners with a focus on tendon injuries that don’t respond to generic rehab approaches. We help this kind of running injury every single day with a strength based approach to rehab to meet the demands of running.
The Bottom Line
Gluteal tendinopathy isn’t just tight hips and it’s not something you have to accept as part of running. It’s a signal that your lateral hip muscles and tendons need a better approach to load.
With the right combination of strength, movement control, and training adjustments, most runners return not just to pain-free running, but to better stability and confidence than before.
If outer hip pain has been holding you back, you don’t have to figure it out alone. Book a free consultation with us and work with a running specialized physical therapist to get back to running without pain.
