Health Library / Training
This content is for education only and is not medical advice. I'm a fitness coach, not a physician. Talk to your doctor before starting any medication, hormone, supplement, or new exercise program, especially if you have a medical condition or take prescriptions.
Pain on the outside of your hip. Worse lying on that side at night. Worse climbing stairs, getting out of the car, standing on one leg to put trousers on.
Around one in four women over 50 deals with this, and for decades almost all of them were told the same word: bursitis.
That word is mostly wrong, and the correction matters because it changes the treatment completely.
Bursitis means inflammation of a bursa, a small fluid-filled cushion. The logic was reasonable: the outside of the hip hurts, there's a bursa there, therefore an inflamed bursa. Treatment followed the logic — rest it, inject it with a steroid, wait.
When researchers actually imaged these hips, the bursa was frequently not the problem. What they found far more often was the gluteal tendons — the tendons of the smaller glute muscles that attach on the outside of the hip — degenerating and irritated where they attach. The current name is gluteal tendinopathy, or greater trochanteric pain syndrome.
That changes everything, because tendinopathy does not get better with rest. Tendons need progressive load to remodel. Rest them and they weaken, you do less, and the next attempt hurts more.
And a steroid injection, which helps briefly, doesn't fix the underlying tendon and may not serve you well repeated.
Tendons change with age, and in women that change accelerates through the menopause transition — connective tissue across the body remodels as estrogen falls, which is why hips, shoulders and feet so often start complaining in the same couple of years. People assume it's coincidence or "getting old." It's one underlying change with several addresses.
Add hip anatomy — a wider pelvis increases the angle those tendons work at — and weak glutes from years of sitting, and you have the standard picture.
Loading the tendon, progressively. That means strengthening the glutes, building slowly, and tolerating a bit of discomfort that settles rather than chasing zero pain.
Stop the positions that compress it. This one is oddly specific and it's the fastest relief most people get. That tendon gets compressed when your thigh crosses the midline. So: don't sleep on the painful side (and put a pillow between your knees if you sleep on the other), don't stand with your weight slung onto one hip, don't cross your legs, don't sit with knees together and feet apart. Aggressive IT band stretching and foam rolling directly on the sore spot usually compress exactly what's irritated.
Be patient. Tendons remodel on a timescale of months. The people who do badly are the ones who try something for two weeks and move on.
The outside of the hip is not the only thing that hurts around a hip, and these need different treatment:
Hip osteoarthritis usually shows as groin pain, not lateral pain, and often as stiffness and lost rotation. Different problem entirely.
Referred pain from the lower back can present at the hip.
And some things need prompt attention: pain after a fall, inability to bear weight, severe night pain that isn't positional, fever, or a hip that's suddenly lost range.
I'm not going to tell you which of these you have. The treatments diverge sharply and guessing costs months — which is exactly what happened to a generation of people treated for a bursa that wasn't the problem.
See a physical therapist, and ask specifically about gluteal tendinopathy and load management if your pain is on the outside. Ask your doctor about imaging only if it isn't responding, because scans in this area show degeneration in plenty of people who feel fine.
Then train your glutes, fix the sleeping and standing positions, and give it a real three months.
Last updated September 30, 2026