Greater Trochanteric Pain Syndrome: Why This Lateral Hip Pain Happens, Why Women Are More Affected, and What Actually Helps
If you’ve been told you have bursitis on the outside of your hip, or you’ve been struggling with persistent pain around the side of your hip that won’t seem to settle, you may be suffering from an uncomfortable but also very common condition known as Greater Trochanteric Pain Syndrome.
Greater Trochanteric Pain Syndrome (GTPS) is one of the most common causes of lateral hip pain, particularly in women over the age of 40, when it often appears ‘out of nowhere’ and for seemingly no reason. GTPS can make walking uncomfortable, disturb sleep, make stairs feel challenging, and leave you wondering why movements such as lying on your side suddenly hurt.
One of the things I hear most often in clinic is, ‘I’ve tried resting it, but as soon as I become active again, the pain comes straight back.’ However, GTPS is usually not a condition that improves by avoiding movement altogether. In fact, tendons, for which this is predominantly a tendon issue, need the right amount of load to stay healthy. The challenge is finding the sweet spot between doing too much and doing too little.
The good news is that while recovery can sometimes be frustratingly slow, these tissues do heal. I promise! Perhaps more importantly, recovery doesn’t necessarily require hours in the gym or complicated exercise programmes. Often, the most effective starting point is much simpler and less time consuming than people expect.
In this article, we’ll explore why GTPS is so common in women, particularly during perimenopause and menopause, why stretching is often unhelpful, and what you can start doing to help your hip recover.
What Is Greater Trochanteric Pain Syndrome?
The greater trochanter is the bony prominence on the thighbone on the outside of your hip . Attached to this area are the tendons of the gluteus medius and gluteus minimus muscles, two muscles which play an important role in pelvic stability when walking, standing and moving.
For many years, pain in this region was commonly labelled as “trochanteric bursitis”. While a bursa can occasionally become irritated, research now shows that the vast majority of people with persistent lateral hip pain have changes within the gluteal tendons rather than an inflamed bursa.
This is why the term Greater Trochanteric Pain Syndrome is now preferred. It recognises that the condition is often more complex than simple bursitis. That said, you may hear the terms Gluteal Tendinopathy, Trochanteric Bursitis and Hip Bustitis used interchangably with the updated term of Greater Trochanteric Pain Syndrome.
Why Are Women More Commonly Affected?
Around three out of four people diagnosed with GTPS are women.
There are several reasons for this. Women’s pelvises tend to be wider, creating slightly different loading patterns through the hip. However, one of the biggest factors appears to be hormonal change.
Oestrogen plays an important role in tendon health. Tendons are living tissues that continually repair and remodel themselves. Oestrogen influences collagen production, tissue hydration, blood flow and the ability of tendons to recover from load.
As oestrogen levels begin to fluctuate during perimenopause and decline after menopause, tendons can become less resilient and slower to repair. This doesn’t mean damage is inevitable and we will all end up with a hurty outer hip if assigned female at birth, but it does mean that tissues which previously tolerated activity without issue may become more sensitive to everyday loading.
Many women notice the onset of hip pain during their 40s, 50s and 60s, often alongside other symptoms associated with hormonal transition. This is also a time when many women are torn between family duties, careers and caring for ageing parents, making stress levels high and time and motivation to stay fit and healthy low.
This is why hormones and hip health are often part of the conversation when helping you to find women’s health and menopause support in my Southsea and Hayling Clinics. Along with realistic approaches and time commitments for self care strategies, that fit in around your life.
Why Does It Hurt So Much at Night?
One of the hallmark symptoms of GTPS is pain when lying on your side.
This is partly because the body’s natural anti-inflammatory chemicals are lower at night. However, there is also a mechanical reason.
When lying on the affected side, body weight compresses the irritated tendon directly against the greater trochanter. Even when lying on the opposite side, the top leg often drops across the body into adduction, the action of pulling the leg across the midline, creating further compression through the painful tendon.
This is why many people find that side sleeping becomes one of the biggest aggravating factors.
A simple pillow placed between the knees and ankles can make a significant difference by keeping the top leg supported and reducing compressive load through the hip.
The Stretching Myth
One of the most common pieces of advice people receive is to stretch their hips more.
Unfortunately, this can sometimes make symptoms worse.
Unlike muscles, irritated tendons often dislike repeated compression. Many traditional stretches for the outer hip place the leg into adduction, which pulls the tendon tightly around the greater trochanter and increases compression.
This doesn’t mean staying flexible in the hips is bad. It simply means that aggressively stretching into pain is often not the answer during an irritated phase. And this is a misinformed error that I see with many people who come to see me for clinical massage for hip pain in Southsea.
If stretching consistently aggravates symptoms, it may be worth stepping away from it temporarily and focusing on reducing irritation instead.
A Better Starting Point: Isometric Loading
One of the most useful early-stage interventions for GTPS is often isometric exercise.
An isometric contraction occurs when a muscle works without changing length. Think of gently pressing your leg outwards against a wall or holding a controlled side-lying leg lift.
These exercises can help calm pain, improve tendon tolerance and begin rebuilding strength without excessively aggravating symptoms. And they are often a starting point for tendinopathy treatment.
Importantly, they don’t require a gym membership, expensive equipment or high levels of fitness. Just some initial guidance from a trained professional.
For many people, recovery starts with small, consistent movements performed regularly a few times a week, rather than intense workouts.
Here is an interesting study for more information around this subject – https://pmc.ncbi.nlm.nih.gov/articles/PMC6797310/
Lifestyle Habits That Can Help
The little things you do every day can have a surprisingly large impact on symptoms.
Avoid “hanging” into one hip
Many people naturally stand with their weight dropped onto one leg. While it feels comfortable, this position places a prolonged compressive load through the gluteal tendons.
Try standing with your weight distributed more evenly between both feet.
Be mindful of crossing your legs
Sitting cross-legged repeatedly places the hip into adduction and can increase compression around the tendon attachment.
Where possible, keep both feet on the floor, or use props to elevate your feet if needed.
Modify side sleeping
Use a pillow between your knees and ankles when sleeping on your side.
Some people also find that placing a mattress topper on the bed helps reduce pressure.
Pace walking and hills
Walking is usually beneficial, but long walks, steep hills and uneven ground can sometimes temporarily exceed the tendon’s current capacity.
Finding the right amount of movement often works better than complete rest or pushing through significant pain. Its all about gradual exposure to increased time and challenge of terrain.
Consider Hormone Therapy alongside Conservative Management
Whilst HRT isn’t a direct treatment for tendinopathy, some women report improvements in musculoskeletal symptoms after addressing declining oestrogen levels, alongside hip rehab and lifestyle modifications.
Emerging research suggests that maintaining healthier hormone levels may support collagen turnover and tendon health, although HRT should always be discussed with a suitably qualified healthcare professional as part of a wider conversation about menopausal health.
What About Dietary Changes for Tendinopathies?
There is no single diet that cures tendinopathy, but nutrition does play a role in tissue healing.
Tendons require adequate protein to support repair and remodelling. Many people, particularly as they get older, simply don’t consume enough.
Prioritising protein-rich foods throughout the day can help provide the building blocks needed for recovery.
Bone broth, slow-cooked meats on the bone, collagen-rich cuts of meat, oily fish, eggs and adequate dietary protein may help provide some of the raw materials required for connective tissue repair. Whilst no food will “fix” a tendinopathy on its own, good nutrition can support the healing environment that tendons need.
A diet rich in colourful fruits and vegetables, omega-3 fats and minimally processed foods will also support overall tissue health and help manage persistent inflammation. As will a diet rich in fibre and hydration.
While no food can magically heal a tendon, giving your body the resources it needs to repair itself is an important part of the bigger picture.
Recovery Takes Time—But Tendons Can Adapt
One of the most difficult aspects of GTPS is that recovery rarely follows a straight line.
Tendons generally heal more slowly than muscles because they have a more limited blood supply. Progress is often measured in months rather than days.
This can be frustrating, particularly if you’ve already tried stretching, injections or periods of rest without lasting success.
However, tendons are remarkably adaptable tissues. With the right combination of load management, gradual strengthening, movement modification and patience, symptoms often improve significantly. My role as your women’s hip pain specialist in Southsea and Hayling is to help you navigate this combination.
The goal isn’t to avoid using your hip. It’s to help the tendon gradually become stronger and more tolerant again.
Long-term recovery isn’t just about strengthening one painful tendon. It’s about creating a hip that can share load effectively. This may involve improving the strength of the glutes, deep hip stabilisers and surrounding muscles, or in some cases improving the timing and coordination of how those muscles work together. A strong muscle that switches on at the wrong time isn’t always much use.
The ultimate goal is to build a hip that feels capable, resilient and confident again.
How Clinical Massage and Rehabilitation Can Help
Persistent hip pain is rarely just about one structure.
Reduced movement confidence, altered walking patterns, muscle guarding, pelvic floor tension, lower back sensitivity, hormones and stress can all contribute to how symptoms are experienced.
Clinical massage and hip rehabilitation can help by reducing protective tension around the hip and pelvis, improving movement options and creating an individualised plan that gradually rebuilds tendon capacity without overwhelming sensitive tissues.
At Ocean Flow Therapies, I regularly work with clients experiencing persistent lateral hip pain, gluteal tendinopathy and Greater Trochanteric Pain Syndrome from clinics in Southsea and Hayling Island. Treatment combines clinical massage, rehabilitation and movement-based approaches to help reduce pain, improve confidence and gradually restore function.
If you’ve been struggling with persistent lateral hip pain, support is available at my Southsea and Hayling Clinic.
To find out more or to book, head to:
https://www.oceanflowtherapies.com/clinical-massage-southsea/
https://www.oceanflowtherapies.com/
