Gluteal Tendinopathy: Why Strengthening Your Glutes Isn’t Always the Answer

If you’ve been diagnosed with gluteal tendinopathy, chances are you’ve already tried the usual: glute strengthening exercises, ice packs, maybe even a steroid injection. And yet… the pain lingers.

Sound familiar?

At Sevenoaks Chiropractic, we regularly see patients who’ve followed all the typical advice, sometimes for months or even years, only to discover they’ve been treating the symptom, not the root cause.

In this article, we’ll explore:

• What gluteal tendinopathy really is (and what it isn’t)
• Why common treatments often fall short
• How issues elsewhere in the body, like your foot, knee, or back, might be contributing
• What a full-body, root-cause approach looks like in practice

If you’ve been feeling stuck, you’re not alone, and there is another way forward.

What Is Gluteal Tendinopathy?

Gluteal tendinopathy refers to irritation or wear-and-tear in the tendons that connect your glute muscles (especially gluteus medius and minimus) to the outer hip, near a bony point called the greater trochanter.

You might notice:

• Pain on the outer hip or buttock
• Discomfort when lying on your side, especially at night
• Pain climbing stairs, walking, or rising from a chair
• Tenderness when pressing the outside of the hip

It’s a common condition, but also commonly misunderstood.

Didn’t This Used To Be Called Trochanteric Bursitis?

Yes, and for a long time, the pain was thought to come from inflammation in the bursa, a small fluid-filled sac near the tendon.

People were prescribed:

• Anti-inflammatories and ice
• Corticosteroid injections into the bursa
• Stretching and rest

But as research evolved, scans showed that many people didn’t have inflamed bursae at all, they had changes in the tendon itself. The condition was reclassified as “gluteal tendinopathy.”

Unfortunately, many treatments didn’t evolve. Instead of injecting the bursa, clinicians started injecting the tendon. And the exercises stayed much the same.

For some, this worked. But for many others, pain kept coming back.

So, What Causes Gluteal Tendinopathy?

Gluteal tendinopathy usually develops gradually due to chronic overload, when the glutes are asked to do more than they’re designed to handle.

This can happen when other parts of the body aren’t pulling their weight. For example:

• Your feet may not be supporting you properly (e.g. flat arches, bunions)
• Your hip joint may be stiff or restricted
• Your knees or lower back may not be moving as they should
• Old injuries may have altered your movement patterns

Over time, this extra demand can lead to:

• Microtears in the tendon
• Loss of flexibility
• Thickening or degeneration of the tissue
• Persistent, localised pain

It’s rarely a sudden injury. Instead, it builds slowly, starting as a minor ache, then worsening to the point it affects sleep or sitting. That’s why addressing the root cause early on is so important.

Why Glute Strengthening Isn’t Always the Answer

Yes, glute exercises can help. But only if weakness is the real issue.

For many people, the problem isn’t that the glutes are too weak, it’s that they’re doing too much to compensate for dysfunction elsewhere.

Your Glutes Might Be Overcompensating

We often see patients whose glutes are overloaded because other parts of their body aren’t contributing effectively. For example:

• Feet that don’t push off properly
• Limited toe or ankle mobility
• Hip stiffness or imbalance
• Poor lumbar spine coordination
• Previous injuries that changed how they walk or move

In these cases, your glutes are working overtime. They’re not failing, they’re doing too much.

Simply strengthening them in isolation can actually make things worse if you don’t fix the underlying movement issue.

A Diagnosis Is Just the First Step

Being told you have gluteal tendinopathy just means your glute tendon is irritated or painful, it doesn’t tell you why.

It’s a bit like being told you have a headache. That might be true… but is it from stress? Dehydration? A neck issue?

Treating only the pain, without understanding the bigger picture, often leads to short-term relief and long-term frustration.

Two Real-Life Cases From Our Clinic in Sevenoaks

Case 1: Misdiagnosed Hip Dysfunction

One woman came to us after months of trying glute exercises, stretches, even spinal adjustments, with limited results. She’d been diagnosed with gluteal tendinopathy and was doing everything right on paper. Her last chiropractor thought it was coming from her low back, but after several treatments she was no better.

But our assessment revealed the real issue: her hip joint capsule was restricted. It wasn’t just tight, it wasn’t moving properly. Her glutes were “fighting” a joint that wasn’t cooperating.

We performed gentle joint mobilisation, specifically to the hip (not the spine), and within a few sessions she could finally lie on her side and walk without pain, for the first time in six months.

Her glutes weren’t weak, but her back wasn’t the cause either. They were overworking to compensate for a joint that wasn’t moving well.

Case 2: Pain From the Ground Up

Another patient had been going to Pilates for years. She was strong, active, and consistent, but still struggled with hip pain.

The missing piece? Her foot mechanics.

She had collapsed arches and limited toe mobility, especially on one side. Each step she took placed more strain on her right glute, simply because her foot wasn’t absorbing or transferring force properly.

We fitted custom orthotics, released the overloaded soft tissue, and within 72 hours, six months of pain was gone.

Sometimes, the issue isn’t where you feel the pain. It’s how your whole body is working together (or not).

Signs You Might Be Missing the Real Cause

If this sounds familiar, don’t worry, it’s common. But it may be time to look deeper if:

• You’ve been doing exercises, but pain still returns
• Rest helps, but only temporarily
• One leg feels unstable or “different”
• You’ve had injections or therapy with no long-term change
• You’re starting to feel like you’ve “tried everything”

Our Approach: Treating the Whole You, Not Just the Tendon

At Sevenoaks Chiropractic, we take a root-cause approach, not just treating where it hurts, but investigating why it’s happening.

Our thorough assessment may include:

• Joint testing (hip, spine, foot, and knee)
• Gait and movement analysis
• Review of past injuries and compensation patterns
• Foot function (arches, toe mobility, bunions)
• Muscle activation and balance testing

We then tailor a plan that could involve:

• Targeted joint manipulation (not just standard “clicks”)
• Soft tissue release
• Orthotics (if needed)
• Coordination training and functional rehab
• Lifestyle advice to prevent repeat strain

Why Full-Body Assessment Matters

Focusing only on the painful area is like listening to a smoke alarm without checking for fire.

A true solution looks at how all the systems work together – feet, hips, spine, and everything in between. When we treat the whole body, we often see symptoms improve rapidly, and stay away longer.

FAQs About Gluteal Tendinopathy

Ready to Move Forward?

Resting and hoping won’t fix gluteal tendinopathy, especially if the problem lies somewhere else in your movement system. And strengthening alone may not be enough if your glutes are already overcompensating.

Don’t Settle for a Label. Find the Real Cause.

A diagnosis is helpful, but it’s just the beginning. If your current plan isn’t helping, we’d love to explore a new approach with you.