Lateral Hip Pain in Runners: Gluteal Tendinopathy (Not Just a Tight ITB)
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The ACL Comeback Program
A structured 28-day knee rehab program designed for people stuck in the "almost better" phase after ACL or meniscus injury. Rebuild strength, restore confidence, and bridge the gap between feeling okay and being fully back.
Side-of-hip pain is a load problem
Runners often call it ITB or “bursitis.” In clinic we frequently find gluteal tendinopathy — the glute medius / minimus tendons struggling with compressive and tensile load at the greater trochanter. Stretching and foam rolling the side of the hip rarely fixes the capacity gap.
Common triggers
- Sudden mileage or hill spikes
- Long strides / low cadence
- Crossing midline when fatigued
- Side-sleeping on the sore hip
- Weak single-leg strength relative to running volume
What rehab looks like
- Calm compression — sleep position, avoid aggressive adduction stretches, temporarily ease hills.
- Isometrics — side-lying or standing holds that load the tendon without flaring next-day pain.
- Heavy-slow strength — hip abduction, hip hinge patterns, single-leg squat control.
- Return to run — flat first, then gentle undulation, then hills — using the same principles as our return-to-running guide.
Related reading
ITB syndrome · runner’s knee · stress fractures
Buy The ACL Comeback Program or request an online consult
The ACL Comeback Program is our paid 28-day lower-limb strength and confidence block ($50). We use it for ACL and meniscus rehabs — and for athletes stuck in the “almost better” phase after knee sprain, giving-way, or a long layoff from running and court sport. It is built for the whole lower limb, not only post-op ACL.
Purchase The ACL Comeback Program →
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Free progressive home loading: Knee Pain Mastery Guide. In Cabramatta / South West Sydney? Book an in-clinic physio assessment.
Frequently Asked Questions
Is lateral hip pain the same as bursitis?
Often what’s labelled “bursitis” is actually gluteal tendinopathy (glute med/min) with or without bursal irritation. Treatment still centres on tendon loading and reducing compressive positions — not endless rest or stretching.
Why does it hurt more at night or on my side?
Side-lying compresses the tendon against the greater trochanter. Hills, long strides and crossing the legs do a similar job. We modify those positions while we rebuild tendon capacity.
Should I stretch my ITB and glutes hard?
Aggressive stretching into adduction can compress the tendon further. Prefer isometrics and progressive heavy-slow strength, then running load rebuild.
How long until I can run hills again?
Many runners settle day-to-day pain in 4–8 weeks with consistent loading; hills return later once flat running and single-leg strength are solid. Timelines vary with severity and training age.
Do I need a scan?
Usually not first-line. We image if red flags appear, symptoms don’t follow expected timelines, or you’re considering injection after a failed loading program.
Which program should I buy?
For a paid 28-day lower-limb strength block that rebuilds hip-to-knee control, purchase The ACL Comeback Program. Use the free Knee Pain Mastery Guide for day-to-day progressions.
