Gluteal Bursitis or Gluteal Tendinopathy?

Here’s What’s Really Causing Your Pain

Still in Pain After a Bursitis Diagnosis?

If you’ve been told you have gluteal bursitis, but the pain isn’t shifting, there’s a strong chance that diagnosis has missed the real problem. Most people with pain at the side of their hip are actually dealing with gluteal tendinopathy—an irritation or degeneration of the tendons that attach the gluteal muscles to the hip bone.

Misdiagnosing it as bursitis is common, and it leads to the wrong treatment plan—often involving rest, ice, or medication, none of which will solve the underlying issue. This article helps you understand and the difference between Gluteal Bursitis vs Tendinopathy and take your first steps toward effective relief.

Table of Contents

What Exactly Is Gluteal Bursitis?

Gluteal bursitis refers to inflammation of the trochanteric bursa—a small fluid-filled sac that sits over the bony point of your hip. It’s designed to reduce friction between muscle and bone. When inflamed, it can cause sharp or burning pain on the outside of the hip.

This sounds plausible, but in practice, true bursitis is far less common than it’s diagnosed. It’s typically short-lived and often secondary to another issue—most often, gluteal tendinopathy.

What Is Gluteal Tendinopathy?

Gluteal tendinopathy is a condition where the tendons of the gluteus medius and gluteus minimus muscles become irritated, overloaded, or structurally weakened. These tendons are critical for stabilising your pelvis during walking, standing, and climbing stairs.

It typically develops over time due to poor loading habits (too much or too little), poor movement mechanics, or a sudden increase in demand—like taking up hill walking, a new workout routine, or even just spending more time on your feet

Why the Two Get Confused

There’s two main reasons why the pain from Gluteal bursitis and Tendonitis get confused. The first and most obvious is they are in a similar places.

The second is that the sensitivity and pain of bursitis is a problem secondary to the tendon pain. This means that the bursitis settles when it’s treated, but the tendon can still cause problems as it’s not been addressed or treated and everything gets worse.

Primary Source of Pain

Gluteal Bursitis

Inflamed trochanteric bursa

Gluteal Tendinopathy

Overloaded or degenerated gluteal tendons

Worsens With

Gluteal Bursitis

Lying on side, direct pressure

Gluteal Tendinopathy

Laying on side, direct pressure/compression, walking, stairs, standing, increased activity

Response to Load

Gluteal Bursitis

May tolerate light load

Gluteal Tendinopathy

Often aggravated by excessive or rapid load, classic "too much too soon"

Response to Rest

Gluteal Bursitis

Often improves

Gluteal Tendinopathy

Stagnates or worsens if rest is prolonged

Response to Injection

Gluteal Bursitis

May help short-term

Gluteal Tendinopathy

Usually temporary or ineffective

Best Treatment

Gluteal Bursitis

Anti-inflammatories, short-term rest

Gluteal Tendinopathy

Load management and progressive rehab

Role of Massage

Gluteal Bursitis

May reduce superficial sensitivity

Gluteal Tendinopathy

Useful as a settling modality to support rehab

Gluteal tendinopathy is usually the primary problem, and any inflammation of the bursa is often secondary or incidental.

Why the Right Diagnosis Matters

Treating bursitis with anti-inflammatories, ice, or rest can help short-term if inflammation is present, but this won’t solve tendinopathy. Worse, it may delay proper care. Tendinopathy needs graded loading—controlled, targeted strengthening exercises that rebuild tendon tolerance and capacity.

The earlier this is recognised, the easier it is to resolve. If you’ve been chasing relief with minimal results, rethinking the diagnosis is the first step.

Self-Check: (60-Second Quiz)

Is It Really Bursitis?

1. Have you had this pain for more than 6 weeks?
2. Does it hurt during or after walking, stairs, or standing?
3. Is the pain worse the day after activity?
4. Have you had a cortisone injection that didn’t help?
5. Have you been told it's bursitis, but it keeps coming back?
6. Are you stretching regularly without real improvement?
7. Is it painful to lie on the affected side at night?

🟡 What Do Your Answers Suggest?

4 or more “Yes” answers: You may be dealing with gluteal tendinopathy, not bursitis. That’s more common than people realise—and it’s treatable.

Fewer than 4 “Yes” answers: Less likely—but if pain is ongoing, a proper assessment still matters.

Still unsure? Download our free guide or Get advice

Score 3 or more? There’s a strong chance you’re dealing with gluteal tendinopathy, not bursitis.

Why Stretching Might Make Things Worse

Stretching is often the first thing people try when they feel tight or sore. But with gluteal tendinopathy, stretching actually increases compression on the irritated tendon, especially if you cross your legs or pull the knee across your body.

That compression is exactly what the tendon can’t handle in its sensitised state. Instead of improving flexibility, stretching often prolongs or worsens symptoms.

Early Treatment: Calming the System First

Before you can start building strength, you need to reduce the tendon’s sensitivity. This is where hands-on treatment like massage can play a key role.

Massage doesn’t “fix” the tendon, but it helps calm down protective muscle tone, desensitise the area, and make early loading more comfortable. It’s an effective part of stage-one care—especially for people who can’t tolerate even light exercises without pain.

Combined with education and postural changes (like avoiding long periods of standing with your hip dropped out to the side), massage can be a helpful first step.

The Real Long-Term Fix: Progressive Loading

Once the tendon calms down, the goal is to gradually reintroduce load in a way the tendon can tolerate and adapt to. This means structured exercises that target the gluteus medius and minimus with careful progression.

You’ll typically start with isometric (static) holds and low-load movements, then move into more dynamic exercises over time. Recovery isn’t instant, but with the right loading strategy, most people see a dramatic improvement in 8–12 weeks.

Local? Book a Soft Tissue Therapy Session

I work with people every week who’ve been told they have bursitis and gluteal tendinopathy —but haven’t responded to standard treatment. My approach combines targeted soft tissue work with guidance on early rehab and loading.

If you’re near me, I’d be happy to help you get started on the right track.

Want a Clearer Plan? Start Here

Free guide: Bursitis or Tendinopathy?

7 Signs You’ve Been Misdiagnosed—and What to Do About It”

Inside you’ll find:

  • Visual breakdown of bursitis vs tendinopathy
  • The mistakes most people make in early rehab
  • A checklist to help you talk to your clinician or therapist
  • Simple steps you can take today to feel better faster

Summary

If your outer hip pain hasn’t improved with rest, anti-inflammatories, or stretching, it may not be bursitis at all. Gluteal tendinopathy is the more common and persistent cause—and needs a very different approach.

Correct diagnosis leads to correct treatment. And with the right strategy, even long-standing pain can change.