Hip pain · Trochanteric bursitis · Physiotherapy in Booragoon
Does your hip ache when you lie on your side, walk up stairs or stand on one leg?
Maybe you’ve started sleeping on the other side because the outside of your hip is too tender. Or walking, running and even getting out of the car have become uncomfortable.
Pain around the outside of the hip is often called hip bursitis or trochanteric bursitis. However, the painful area may also involve the gluteal tendons, which is why clinicians often use the broader term greater trochanteric pain syndrome (GTPS).
At Adaptive Physiotherapy & Massage in Booragoon, we assess your symptoms, activity demands and goals before deciding what will be most useful. Treatment may include changes to aggravating activities, progressive strengthening and hands-on care when appropriate.
What is trochanteric bursitis?
The greater trochanter is the prominent bony point on the outside of your upper thigh. Small fluid-filled bursae help reduce friction around this area, while the gluteal tendons attach nearby and help control your hip during walking, running and standing on one leg.
Trochanteric bursitis refers to irritation or inflammation of a bursa. But not every case of lateral hip pain is caused by an inflamed bursa. Gluteal tendinopathy is frequently part of the picture, and several sources of pain can overlap. Together, these presentations are often described as GTPS.
Why this matters: Knowing whether your symptoms are related to the bursa, gluteal tendons or another hip or back condition helps guide the right treatment. More massage or stretching isn't necessarily the answer.
Common causes and contributing factors
There isn't always one identifiable cause. Symptoms can develop after a change in exercise, following a fall or gradually over time. Possible contributors include:
- Changes in activity load: Increasing running distance, hills, walking or repeated single-leg tasks faster than the hip can comfortably tolerate.
- Direct pressure or compression: Spending long periods lying on the painful side, standing with one hip pushed out or sitting with legs crossed.
- Hip muscle capacity: Reduced strength or tolerance of the gluteal muscles and tendons for repeated loading.
- Previous injury: A fall onto the hip, changes in activity after an injury or altered walking patterns.
- Other conditions: Hip osteoarthritis or referred pain from the lower back may produce symptoms that need to be distinguished from GTPS.
Posture, leg length and movement patterns may be relevant to an individual assessment, but they should not be assumed to be the cause of every person's pain.
Symptoms of hip bursitis or greater trochanteric pain syndrome
Pain on the outside of the hip
Aching or tenderness near the bony point of the outer hip, sometimes spreading into the outer thigh.
Discomfort when lying on your side
Pressure on the affected hip can make sleep uncomfortable.
Pain with stairs or walking
Long walks, hills, climbing stairs or standing on one leg may bring on symptoms.
Reduced activity tolerance
Running, training and everyday movements may become more difficult as symptoms persist.
At Adaptive, an assessment considers the hip and surrounding regions, including whether symptoms could be coming from the hip joint or lower back. Imaging isn't always required; it depends on the clinical presentation and whether it would change management.
How severe can lateral hip pain become?
Symptoms vary between people, and there isn't a universally accepted mild-to-severe staging system for trochanteric bursitis. A useful way to describe how it affects daily life is:
Occasional discomfort
Pain mainly after longer walks or training, with limited impact on day-to-day activity.
Persistent activity-related pain
Stairs, walking or sleeping on the affected side regularly bring on symptoms.
More limiting symptoms
Pain interferes with sleep, work, exercise or ordinary tasks and may need closer assessment and a modified plan.
Symptoms from another cause
Severe or unusual symptoms may require assessment for joint, spinal, traumatic or medical causes rather than assuming bursitis.
Evidence-based treatment for trochanteric bursitis and GTPS
For many people with gluteal tendon-related lateral hip pain, education about managing load and progressive exercise form an important part of treatment. A randomised trial found that education plus exercise provided better overall improvement than a corticosteroid injection at both eight and 52 weeks in people with gluteal tendinopathy.
Initial pain management and activity modification
The first step is usually to settle symptoms without stopping all movement. Depending on your presentation, that may mean temporarily reducing hills, running volume, prolonged single-leg standing or other activities that trigger pain.
Simple changes can help: try not to sleep directly on the painful side, use a pillow between your knees when side-lying, and avoid prolonged positions that compress the outside of the hip. Ice or warmth may offer comfort if you find them helpful.
Manual therapy when appropriate
Hands-on treatment may help with associated muscular discomfort or restricted movement, but it's not essential for everyone and does not directly repair a gluteal tendon. We avoid applying excessive direct pressure to the painful outer hip.
Where appropriate, remedial massage can be considered for surrounding muscle discomfort, alongside—not instead of—assessment, activity advice and progressive exercise.
Exercise rehabilitation: rebuild hip capacity
Your exercise program should match your symptoms and starting point. Not every exercise is right for every stage, particularly if it increases compression over the outer hip.
Early loading: comfortable hip abductor isometrics, supported standing exercises or gentle bridges may be considered.
Developing strength: suitable variations of glute bridges, controlled squats, banded walks, step-ups and other hip strengthening can be introduced as tolerated.
Single-leg control: supported single-leg balance and functional stepping drills can help prepare you for walking, stairs and higher-level activity.
Exercises such as clamshells or side-lying movements may be modified or avoided if lying on the hip aggravates symptoms. The aim is to build strength and tolerance, not force a particular movement pattern.
Return to walking, running and sport
As symptoms and strength improve, rehabilitation progresses towards your own goals—longer walks, stairs, gardening, gym training or running.
Runners and athletes may add gradual impact, plyometrics or lateral movement drills when appropriate. Progression is based on how your hip responds during activity and afterwards, rather than a fixed recovery timetable.
For more demanding activity goals, sports rehabilitation can support a structured return to training.
What about stretching, foam rolling and hip mobility?
It's common to feel tight around the outer hip and assume you need to stretch it harder. But stretches that move the leg across the body, some ITB stretches and aggressive foam rolling over the painful area can increase compression of sensitive gluteal tendons.
Mobility work can still be useful when an individual restriction is present. Your physiotherapist can help choose movements that improve comfort without unnecessarily aggravating the lateral hip.
Practical tip: If a stretch or exercise leaves your hip noticeably more painful later that day or the next morning, that may be a sign to change the position, load or amount—not necessarily stop exercising altogether.
Managing flare-ups and reducing recurrence
- Keep building capacity: Continue an achievable strength program rather than stopping as soon as pain settles.
- Manage changes in activity: Increase walking, running, hills and resistance training gradually.
- Reduce unnecessary compression: Be mindful of prolonged side-lying, leg-crossing or standing with your weight hanging on one hip if these aggravate symptoms.
- Respond to flare-ups: Temporarily adjust activity and then progress again when symptoms allow.
- Reassess when needed: Persistent symptoms or changes in how pain behaves may call for further investigation.
No program can guarantee that symptoms won't return. The aim is to improve what your hip can tolerate and give you practical strategies to manage your activities.
When should you seek an assessment?
Book a physiotherapy assessment if your outer hip pain keeps returning, affects your sleep or makes walking, stairs, work or exercise difficult. Seek prompt medical assessment after a significant fall, if you're unable to bear weight, or if the hip is acutely hot or swollen with fever or you feel unwell.
At Adaptive, we assess the person before deciding what they need. This may involve physiotherapy in Booragoon, a progressive exercise plan, advice about activity or collaboration with another healthcare professional when appropriate.
Get your hip pain assessed in Booragoon
If pain on the outside of your hip is affecting sleep, walking, training or everyday movement, a physiotherapy assessment can help clarify what's contributing and what to work on next.
Adaptive Physiotherapy & Massage · 27 Shields Crescent, Booragoon WA 6154 · Free onsite parking
References
- Mellor R, Bennell K, Grimaldi A, et al. (2018). Education plus exercise versus corticosteroid injection use versus a wait and see approach on global outcome and pain from gluteal tendinopathy: randomised clinical trial. BMJ, 361:k1662. Read study.
- International Society for Hip Preservation (ISHA) Physiotherapy Agreement (2022). Consensus on assessment and treatment of greater trochanteric pain syndrome. Read consensus.
- Healthdirect Australia. Greater trochanteric pain syndrome (GTPS). Patient information.