How to Fix Gluteal Tendinopathy in Runners

Pain on the outside of the hip is often mistaken for irritation of the greater trochanteric bursa, but research indicates that gluteal tendinopathy is the more common cause. This condition affects the tendons of the gluteus medius and minimus muscles, leading to discomfort, weakness, and difficulty with certain movements.

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What Causes Gluteal Tendinopathy?

Gluteal tendinopathy typically develops due to excessive compression or overload of the gluteal tendons. Some common contributing factors include:

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• Repetitive movements that strain the hip tendons
• Prolonged sitting with legs crossed
• Poor biomechanics in activities like walking or running
• Weak hip stabilizing muscles

Why Gluteal Tendinopathy Keeps Coming Back

Gluteal tendinopathy in runners is rarely just a “tendon problem.”

It’s usually the result of:

• Load management issues
• Strength deficits in the glutes and hips
• Running mechanics that overload the tendon

This is why rest alone or basic exercises don’t always fix it long-term.

The key is identifying what’s driving the overload.

Book an evaluation in Boulder by clicking here

Why Rest and Stretching Alone Don’t Fix It

Many runners are told to:

• Rest
• Stretch their hips
• Foam roll the area

While these can help temporarily, they often don’t address the underlying issue.

Gluteal tendinopathy is typically a load management and capacity problem—meaning:

• The tendon is being overloaded
• The surrounding muscles aren’t supporting it effectively

Without addressing these factors, pain often returns when running resumes.

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How Running Can Cause or Worsen Gluteal Tendinopathy

Running places significant stress on the gluteal tendons, and improper mechanics can increase the risk of developing tendinopathy or make existing symptoms worse. Some key factors include:

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• Excessive Hip Adduction: If the knees collapse inward while running, it increases compression on the gluteal tendons, leading to irritation over time.
• Overstriding: Landing with the foot too far in front of the body increases impact forces, putting additional strain on the hip stabilizers.
• Reduced Running Cadence: A slow step rate can result in increased ground contact time, which in turn exacerbates hip adduction and internal rotation.
• Weakness in Hip Abductors: If the glute muscles aren’t strong enough to stabilize the pelvis, other muscles compensate, leading to increased load on the tendons.
• Poor Footwear or Running Surface: Hard surfaces and improper footwear can alter running mechanics, increasing the likelihood of gluteal tendon irritation.

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Managing Gluteal Tendinopathy: Reducing Compression

The initial goal in managing gluteal tendinopathy is to minimize provocative activities. Some simple adjustments include:

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• Avoid sitting with legs crossed to reduce tendon compression.
• Use a pillow between your knees while sleeping to prevent excessive hip adduction.
• Modify running form by increasing cadence slightly and ensuring proper hip alignment.

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Strengthening Exercises for Gluteal Tendinopathy

A structured rehabilitation program is crucial for recovery. Strengthening the gluteal muscles helps reduce stress on the tendons and improves overall stability.

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1. Isometric Exercises

Isometric exercises involve holding a position to build tendon strength without excessive movement. A good starting point is the side plank, held for 30 seconds.

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2. Concentric-Eccentric Exercises

Once pain improves, controlled movements such as standing hip abductions with a resistance band and side-lying hip raises help further strengthen the gluteal muscles.

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3. Plyometric Exercises

For those returning to higher-impact activities, lateral hops and skater jumps are beneficial in the later stages of rehab.

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Returning to Running After Gluteal Tendinopathy

For runners recovering from gluteal tendinopathy, a gradual return to running is key. Here are some important considerations:

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• Increase Cadence: Aim for 170-180 steps per minute to reduce ground contact time and decrease strain on the gluteal tendons.
• Focus on Proper Form: Avoid excessive hip adduction and overstriding. Consider working with a specialist to refine your running mechanics.
• Use a Run/Walk Approach: Start with intervals, such as 1 minute of running followed by 1 minute of walking, and gradually increase running time as symptoms allow.
• Consider Alternative Activities: If running continues to cause discomfort, try lower-impact options like cycling, swimming, or elliptical training to maintain fitness while reducing tendon stress.

Gluteal Tendinopathy Treatment for Runners in Boulder, Colorado

If you’re a runner in Boulder, Longmont, Louisville, or Lafayette dealing with lateral hip pain, you’re not alone.

We commonly see runners who:

• Have pain on the outside of the hip when running
• Struggle with hills, speed work, or longer distances
• Have tried rest, stretching, or foam rolling without lasting relief

At Boulder Sports Clinic, we take a different approach by combining:

• Strength and load management strategies
• Run gait analysis to identify movement inefficiencies
• Shockwave Therapy to improve healing

This allows us to not just calm symptoms—but help you return to running without flare-ups.

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Seeking Professional Help

At Boulder Sports Clinic, we specialize in diagnosing and treating gluteal tendinopathy with evidence-based techniques, including:

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• Running gait analysis to address movement inefficiencies
• Shockwave Therapy, Dry Needling, and Class IV Laser Therapy to promote healing and pain relief
• Customized Rehabilitation Programs to restore strength and prevent future injury

Still Dealing With Hip Pain When You Run?

If your symptoms:

• Improve with rest but return when you run
• Flare up with hills or speed work
• Haven’t improved despite doing exercises

There’s likely a missing piece in your plan.

Schedule an evaluation to identify what’s being missed

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Ready to Get Back to Running Without Pain?

If you’re in Boulder, Colorado or surrounding area and dealing with persistent hip pain when running, the most important step is identifying what’s driving the issue.

Book a running evaluation at Boulder Sports Clinic and get a plan tailored to your goals.

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