Hip & GroinTendinopathy / Lateral Hip PainModerate evidence
Greater Trochanteric Pain Syndrome (GTPS)
Lateral hip pain commonly associated with gluteal tendon pathology and compression sensitivity around the greater trochanter; isolated bursitis is an oversimplification.
Address safety, settle excessive irritability and maintain useful movement.
What to do
Reduce sustained hip adduction/compressive positions; modify side-lying with pillow support
Adjust walking/running load temporarily
Begin tolerable isometric abductor work
Exercise dosage
Hip abduction isometric: 4–5 x 20–30 seconds, tolerable effort
Avoid prolonged painful side-lying on affected side
Progress when
Daily function is stable or improving.
No new red flags or progressive neurological deficit.
Exercise response returns to baseline by the following day.
Phase 2 — Mobility, Strength & Capacity
Restore the specific strength, mobility and control required by the condition.
What to do
Progress gluteal tendon loading and hip abductor strength
Build pelvic control in functional single-leg tasks
Gradually restore stairs and longer walks
Exercise dosage
Hip abductor strengthening: 3 x 8–12, 2–3 days/week
Step-up/controlled single-leg tasks: 2–3 x 8–12
Progress when
Target movement and resistance are tolerated with good quality.
Functional capacity is improving without sustained symptom flare.
Progression is based on objective performance and patient goals.
Phase 3 — Functional Restoration & Return to Activity
Rebuild real-world, occupational or sporting capacity.
What to do
Progress running, hills, lateral movement and work demands
Increase single-leg load and speed gradually
Maintain strength and compression-management strategies
Exercise dosage
Progress heavier resistance 3–4 x 6–10
Walk/run volume progressed gradually; avoid simultaneous large increases in speed and distance
Progress when
Condition-specific return criteria are met.
Full task exposure is completed progressively.
No clinically meaningful deterioration during the following 24 hours.
Manual Therapy — Role & Application
Manual therapy may address coexisting hip or lumbar mobility limitation but is not a primary tendon treatment.
Avoid aggressive direct compression over greater trochanter in irritable cases.
Modalities — Use / Avoid
Pillow positioning and load modification may reduce compression.
Passive modalities do not replace progressive tendon loading.
Return / Discharge Criteria
Side-lying and stair tolerance improved
Single-leg loading and walking tolerated
Hip abductor strength appropriate for target activity
Common Clinical Mistakes
Calling all lateral hip pain bursitis
Aggressive ITB stretching/compression
Ignoring lumbar and hip OA differential
Progressing running volume too quickly
Clinical Pearls
Education about compression plus progressive loading is central.
Pain on palpation alone is insufficient to identify a specific tendon lesion.
Continue learning
Connect assessment with management
Use the related PNA learning pathways to explore examination techniques and structured rehabilitation. A test result should always be interpreted alongside the history, full examination and clinical presentation.
Use these sources as a starting point for clinical learning. A reference being listed here does not, by itself, establish that every recommendation on this page is strongly supported. Check the original publication, study design, population and limitations before applying findings to an individual patient.
Educational resource only. Tests and treatment plans must be adapted to the individual patient, irritability, comorbidities, surgical restrictions and local scope-of-practice requirements.
