Physiotherapy - 15/08/2026
Pain on the outside of your hip that bites on the stairs, aches after a long walk, and is at its worst when you lie on that side at night. If you are a woman somewhere between 40 and 60, this is one of the most common problems we see, and one of the most treatable. It is usually the tendons on the outside of the hip rather than the joint itself, which is better news than it sounds, because tendons respond well to the right kind of work.
The likely culprit is your gluteus medius tendon, and often the gluteus minimus alongside it, where they attach to the bony point on the outside of your hip called the greater trochanter. The structure of the tendon changes, and loading it, stretching it or compressing it against that bone becomes intolerable. That is what the pain is. The clinical names for it are gluteal tendinopathy, or greater trochanteric pain syndrome.
You may have heard this called trochanteric bursitis. A bursa is a small fluid-filled sac that sits under the tendons to reduce friction, and it can become irritated and add to the discomfort. But the bursitis label has largely been retired, because when researchers looked properly they kept finding tendon change rather than an inflamed sac. That matters for what you do next: a tendon problem is a loading problem, and loading problems get better with the right amount of the right work, not with rest and anti-inflammatories.
It also helps to know what this is not. It is not your hip joint wearing out. It is not damage you have caused. Tendons are living tissue that adapt to what you ask of them, and a tendon that has become sensitive can become tolerant again.
People say “hip pain” and mean three completely different problems. Before anything else, put a hand on the sorest spot. Where it sits is the single most useful clue you can bring to an appointment.
Outer hip, over the bony point. Tender to press, worse lying on that side, worse on stairs and after standing still for a while, and it can spread down the outside of the thigh without usually going past the knee. That is gluteal tendinopathy, and it is what the rest of this page is about.
Groin, or deep at the front. This is more often the hip joint itself. In this age group that commonly means osteoarthritis: stiffness first thing in the morning, trouble getting socks and shoes on, a pinch when you turn or pivot, and sometimes a referred ache into the front of the thigh or even the knee. In younger women a labral irritation can feel similar, and so can a hip that moves further than the muscles around it can control, which is where joint hypermobility comes into it.
Buttock, or pain that travels down the back of the leg. This one frequently is not the hip at all. Pain referred from the lower back or the sacroiliac joint sits in the buttock, can run down the leg, and sometimes brings pins and needles or numbness with it. A good tell is that it changes with what your back is doing, sitting, bending, getting out of the car, more than with what your hip is doing.
Be honest about the limits of this though. Location is a guide, not a diagnosis, and two things happily coexist: a stiff hip joint and irritated glute tendons keep each other company all the time. An assessment for hip pain is what confirms it, and it is quick. If the pain arrived with a fall, if you cannot put weight through the leg, or if you feel generally unwell with it, have it looked at promptly rather than working through this page. One other pattern is worth naming. If the pain came on with a jump in walking or running, hurts every time you put weight on it rather than in particular positions, and does not settle with rest, that is worth having checked promptly rather than loaded, particularly if your bone density is low or unknown.
Lateral hip pain has a recognisable shape. An aching or burning pain on the outside of the hip. Pain that builds with prolonged standing, walking or climbing stairs. Real discomfort lying on the affected side, which is why so many people first mention it as a sleep problem. And often a spread of pain down the side of the leg.
As for what started it, it is usually one of a short list, or several of them at once. A sudden increase in activity, the new walking habit, a big weekend, a return to running after years off. Repetitive hip movements that add up over time. A sedentary stretch where the glutes quietly stopped being asked for much. Straightforward glute muscle weakness. And hormonal change through perimenopause, which gets its own section below because it explains so much of the timing.
There is one more ingredient people rarely suspect: compression. The tendon runs over the bony point, so anything that squashes it against that bone winds it up. Sitting with your legs crossed. Standing with your weight slung onto one hip. Sleeping on the sore side. None of these are dramatic, and all of them are things you might do for hours a day without noticing.
The timing is not a coincidence, and it is not in your head. Gluteal tendinopathy peaks in women between about 40 and 60, which is exactly the window when oestrogen starts to fall away. Tendon tissue carries oestrogen receptors, and oestrogen appears to influence the collagen that tendons are built from and how much load they tolerate before they complain. Around the same time, muscle and bone begin needing deliberate upkeep rather than looking after themselves, which is the wider story behind perimenopause and strength training.
Two honest caveats. First, this is an association with a plausible biological mechanism behind it, not a settled chain of cause and effect. Nobody can look at your hip and say the oestrogen did that. Second, hormones are rarely the whole story: the sudden new walking habit, the desk job, the years the glutes spent unbothered, all still count.
What we can say with more confidence is the useful part. This is common, it is treatable, and it is not simply ageing that you now have to accept. The best-evidenced treatment for gluteal tendinopathy is unglamorous and effective: manage the load that is irritating the tendon, then build strength progressively over months rather than weeks. That is true whatever your hormones are doing, and it is the same work whether you are 38 or 58.
If you are weighing up menopausal hormone therapy, that conversation belongs with your GP, and it is a good one to have for its own reasons. It is not a treatment for a sore tendon, and starting it will not remove the need for the strength work. Our job is the hip. For a lot of women that work lands best in a room built for it, which is what Midlife Strength classes are.
Contrary to popular belief, complete rest is not the answer for tendon pain. Tendons do not like total inactivity, and a few weeks of doing nothing tends to leave you with the same pain and less muscle to meet it with. What settles a tendon is less compression and more graded load, in that order.
Conservative treatment is where this starts, and it works. The strongest evidence is for education about load plus progressive strengthening, which is what physiotherapy for this hip looks like. For additional pain relief along the way, oral medication options are worth discussing with your doctor.
Two questions come up so often they are worth answering here. Should I get a scan? Usually it changes nothing. Imaging finds tendon changes in plenty of hips that have never hurt a day, so the scan rarely decides the plan. What about a cortisone injection? An injection can quieten things in the short term, but when it has been compared with education plus exercise, the exercise group was doing better a year later. That is why an injection is at most a support act for a stubborn case, not the plan itself.
We talk first. How long it has been going on, what aggravates it, what your nights are like, what you have already tried, and what you are trying to get back to. The everyday detail is where most of the diagnosis lives.
Then we watch you move. Squatting, standing on one leg, walking, and specific hip positions that load or compress the tendon in predictable ways. Gluteal tendinopathy has a fairly clear signature, so this part is usually quick and it is what separates it from a hip joint or a lower back.
Hands-on treatment where it helps. Gentle work through the glute muscles, away from the bony point itself, can take the edge off and make the exercise more comfortable to start.
You leave with something to do. Before you go, a short set of home exercises pitched at what your hip will actually tolerate this week, plus the load changes that stop you stirring it up between appointments. That is what physiotherapy for this looks like: not a mystery, and not a lifetime commitment.
Tendons do not want rest. They want the right amount of work.
Home exercises get you started. The thing that finishes the job is progressive strength, and that is easier to keep up when someone is watching your technique and adding load for you. Clinical Pilates classes are physio-taught and capped small, so your hip gets adjusted around every week.
Strengthening. Targets the gluteus medius and the muscles around it so the hip has support that does not depend on the tendon holding on.
Movement without provocation. Hip movement is kept in ranges the tendon tolerates, which is why this is a better home for the work than a general stretching class.
Pain relief. Controlled, low-impact movement gives the tendon load it can handle, which is what turns the sensitivity down over time.
Everyday positions. Practical work on how you sit, stand and load the hip through the day, so you are not undoing the strength work between classes.
If you want the same work with heavier weights and a midlife focus, Midlife Strength classes run the same principles with a barbell in your hands.
Stop sitting cross-legged. It pulls the thigh across the body and presses the tendon into the bone. Feet flat, knees apart, for as long as you can remember to.
Sleep on the non-affected side, with a pillow between your knees. Without the pillow the top leg drops across and compresses the sore side anyway. If both hips are sore, a pillow between the knees and a second under the top ankle keeps things reasonably level.
Avoid glute stretching. Pulling your knee across your body feels like exactly what a tight hip needs, and it is the single most reliable way to make this worse. Stretching compresses the tendon against the trochanter. Leave it alone.
Stop standing on one leg. Putting on shoes, socks or pants while balancing, and hanging your weight on one hip while you wait, both load the tendon in the position it likes least. Sit down to dress, and stand evenly on two feet.
These four take the pressure off. They are not the treatment, and on their own they will only get you so far, but they stop you undoing your own progress while the strength work does the rest.
Lateral hip pain can ease within a few weeks if it is moderate and you follow the right steps. If you have had it for months, expect longer, often a few months of consistent work, because tendons adapt slowly and there is no way to hurry that part. Do not be disheartened by the timeline. Progress here is measured in weeks rather than days, and most women notice the nights improving well before the stairs do.
Keeping it away is mostly about not stopping. Regular exercise that keeps the hip and glute muscles strong is the whole prevention strategy in one line, and the part people skip is continuing it once the pain has gone, which is the same habit that decides how the decade from 36 to 46 plays out for the rest of your health. Warm up properly before anything demanding rather than going straight into it. Look at how you sit and stand through the day, including the standing desk you perch on one hip at, and vary it. And eat well enough to support the repair, with adequate protein in particular, because tendon and muscle are being rebuilt on whatever you give them.
The other quiet piece of prevention is not waiting. Outer hip pain caught early, while it is still a niggle after long walks, is a far shorter job than outer hip pain that has been keeping you awake since autumn.
Our physiotherapists treat lateral hip pain at Yarraville in the inner west (03 8319 9945), Hampton East in the bayside south east (03 9086 3740), and Kensington in the inner north west (03 8319 9946). Clinical Pilates and Midlife Strength classes run at Yarraville and Hampton East. HICAPS on the spot, Medicare Care Plans welcome, no referral needed.
Book a physiotherapy appointment at whichever studio suits, or call and tell us where the pain sits and how long it has been there. That is usually enough for us to know where to start.
The most common cause of pain on the outside of the hip in women over 40 is gluteal tendinopathy, an irritation of the glute tendons where they attach to the bony point on the outside of the hip. It is usually set off by a combination of a sudden increase in activity, glute weakness, positions that compress the tendon such as sitting cross-legged, and the hormonal change of perimenopause. Pain in the groin more often comes from the hip joint itself, and buttock pain is frequently referred from the lower back.
It is common, and there is a plausible reason for it: tendon tissue responds to oestrogen, and falling oestrogen appears to affect how much load a tendon tolerates. That is an association rather than a proven cause, and it does not mean the pain is something to accept. Gluteal tendinopathy responds well to load management and progressive strengthening at any age, so being in perimenopause changes the explanation rather than the treatment.
Sleep on the side that does not hurt, with a pillow between your knees so the top leg does not drop across your body and compress the sore hip anyway. If both hips are sore, try a pillow between the knees plus one under the top ankle, or sleep on your back with a pillow under your knees. Getting the nights right often brings the first noticeable improvement.
Almost always tendinopathy. The older term trochanteric bursitis has largely been replaced by gluteal tendinopathy, or greater trochanteric pain syndrome, because tendon change turns out to be far more common than an inflamed bursa. A bursa can be irritated alongside it, but treating this as a tendon loading problem is what makes the difference.
Generally no. Pulling the knee across the body presses the tendon into the bone, which is the exact position that irritates it, so glute stretching is one of the few things that reliably makes lateral hip pain worse. It often feels like relief in the moment and hurts more later. Strength work rather than stretching is what settles this.
If it is moderate and recent, a few weeks of the right load changes and exercise is often enough. If it has been going on for months, expect a few months of consistent work, because tendons adapt slowly. Most people notice sleep improving first, then stairs and longer walks.
Usually neither. Scans commonly show tendon changes in hips that have never been painful, so imaging rarely changes the plan. A corticosteroid injection can reduce pain in the short term, but studies comparing it with education plus exercise found the exercise group doing better at twelve months, so it is a support for a stubborn case rather than the first move.
Yes, and you should. Complete rest tends to leave the tendon just as sensitive and the muscles weaker. What changes is the type and amount: less of what compresses the tendon, more graded strength work, adjusted as it settles. Physio-taught Clinical Pilates is built for exactly this kind of progression.
All for One physiotherapists treat lateral hip pain at Yarraville in the inner west, Hampton East in the bayside south east, and Kensington in the inner north west. No referral is needed to book, and HICAPS is available on the spot.
Physiotherapy - 15/08/2026
Prefer to talk? Yarraville (03) 8319 9945 · Hampton East (03) 9086 3740 · Kensington (03) 8319 9946
Please don’t include medical or health information in this form. For clinical questions or appointments, call your studio or book online. Your message goes straight to the studio you choose.
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Specialist care from physios who truly understand women’s bodies.
Senior Women’s Health Physiotherapist
Emily has a deep passion for empowering women to take control of their pelvic health. She creates a warm, judgement-free space where you can talk openly about what’s really going on.
With advanced training in pelvic floor rehabilitation, Emily treats a wide range of conditions including incontinence, prolapse, pelvic pain, and pregnancy-related concerns. She takes the time to really listen, explain what’s happening in your body, and build a treatment plan that fits your life. Whether you’re preparing for birth, recovering postpartum, or navigating menopause — Emily is here to help you feel strong and confident again.
Women’s Health Physiotherapist
Tori is passionate about helping women feel heard and supported through every stage of life. She combines clinical expertise with genuine empathy to deliver care that makes a real difference.
Tori brings a holistic, evidence-based approach to treating pelvic floor dysfunction, pregnancy-related pain, and postnatal recovery. She has a special interest in helping women return to exercise safely after having a baby and supporting those with persistent pelvic pain. Tori believes every woman deserves to understand her body and feel empowered in her recovery — no topic is too awkward, and no concern is too small.