Pain guide · Hip pain
Pain over the bony point on the outside of the hip, sometimes spreading down the outer thigh. It hurts to lie on that side, climb stairs, stand on one leg, or get up after sitting with your legs crossed. It is most common in mid-life and in women, especially after menopause.
It used to be called trochanteric bursitis. Reviews now see the gluteus medius and minimus tendons as the main source, which changes what helps: the first job is to stop squeezing them.
Exercise is for pain that has been checked or is clearly mild and settling.
The gluteal tendons wrap round the bony point of the hip. When the thigh moves across the midline, the band of tissue down the outer thigh presses them against the bone. Reviews suggest that squeezing combined with high pulling load is the hardest mix for a tendon.
This is the leading explanation rather than a proven fact, but it explains why crossing your legs, standing on one hip and outer-thigh stretches tend to keep this pain going.
In the LEAP trial (204 people with more than 3 months of outer hip pain), 51 of 66 in the education-plus-exercise group reported success at 8 weeks, against 38 of 65 after a steroid injection and 20 of 68 with wait-and-see. At a year it still led the injection on overall improvement, though pain had become similar.
About half of the wait-and-see group had also improved by a year, so this often settles slowly on its own; exercise gets there faster and more reliably.
Source 4
In a trial of 132 postmenopausal women, everyone was taught to avoid compressing the tendon and to manage load. Tendon-specific exercise was no better than sham exercise on top of that advice: all groups improved. The LEAP authors also thought much of their benefit came from the education.
A 2025 network meta-analysis of 19 trials ranked exercise therapy highest for pain and function, while noting there are few trials to compare.
Source 7
Of 12 common exercises measured in healthy adults, side-lying hip abduction produced the highest gluteus medius activity. Do it lying on your good side, once the pain allows.
Source 9
The LEAP programme accepted no increase in outer hip pain during squats, bridges and side-stepping, because pain there suggested the tendon was being squeezed. During heavier strengthening, pain up to about 5 out of 10 was fine if it eased afterwards and was no worse that night or the next morning.
Source 5
Start at the first stage. Each move opens a full guide with a 3D demo.
Week 1, daily. Static holds and small movements with the knees apart, plus the habit changes in the table.
3D demoSupine isometric hip abduction (belt press)Beginner · A band3 to 5 holds of 5 to 10 s, twice a day · LEAP trial dose
Harder: Lateral band walk
Standing wall-press hip abductionBeginner · A wall3 to 5 holds of 5 to 15 s each side, twice a day · LEAP trial dose
Harder: Lateral band walk
3D demoGlute bridgeBeginner · No equipment10 slow reps, once a day
Easier: Pelvic tilt into bridge · Harder: Glute kickback (quadruped hip extension)
3D demoSit squat (partial squat)Beginner · No equipment10 slow reps, once a day, knees over toes
Harder: Bodyweight squat
3D demoLateral band walkBeginner · A band10 steps each way, no band yet
Easier: Hip abduction machine · Harder: Side-lying leg raise
Move on when: None of these raise outer hip pain, and nights are no worse.
From week 2 to about week 6.
3D demoStaggered-stance bridge (offset bridge)Beginner · No equipment5 slow reps each side, building to 2 sets of 5 to 10 · LEAP trial progression
Easier: Pelvic tilt into bridge · Harder: Glute kickback (quadruped hip extension)
3D demoSplit squatIntermediate · No equipment5 slow reps each side, short range, building to 2 sets of 5 to 10
Easier: Bodyweight squat · Harder: Reverse lunge
3D demoLateral band walkBeginner · A band10 to 15 steps each way with a band
Easier: Hip abduction machine · Harder: Side-lying leg raise
3D demoSingle-leg standBeginner · A wall3 holds of 10 to 30 s, pelvis level
Easier: Tandem stance and heel-to-toe walk · Harder: Single Leg Reach Matrix
3D demoStep-upBeginner · A step2 sets of 8 each side, low step, pelvis level
Harder: Dumbbell step-up
Move on when: You can stand on the sore leg for 30 seconds with the pelvis level and no outer hip pain.
From about week 6. Expect weeks to months; one NHS trust tells patients recovery can take 6 to 12 months.
3D demoSingle-leg glute bridgeIntermediate · No equipment2 to 3 sets of 8 each side
Easier: Glute bridge · Harder: Alternate-leg bounding
3D demoSide-lying leg raiseBeginner · No equipment2 to 3 sets of 8 to 12 on the good side · Leg slightly behind the body line, never dropping below level
Easier: Lateral band walk · Harder: Step-up with knee raise
3D demoStanding band hip abductionBeginner · A band + An anchor point3 sets of 10 to 12 each side · A standing band hip abduction
Easier: Hip abduction machine · Harder: Side-lying leg raise
3D demoPatrick step-downIntermediate · A step3 sets of 8 each side
Easier: Bodyweight squat · Harder: Skater squat
3D demoSingle-leg Romanian deadliftAdvanced · A dumbbell2 to 3 sets of 6 to 8 each side
Easier: Dumbbell Romanian deadlift · Harder: Full Nordic curl
Move on when: Progress the side plank to the full version and add load to the step and hinge work, one change at a time.
| Habit or position | Why it matters | Instead |
|---|---|---|
| Sitting with your legs crossed | The thigh crosses the midline and compresses the tendons. | Knees hip-width apart, hips a little higher than the knees. |
| Standing hanging on one hip | The hip drifts out sideways under your weight. | Weight even on both feet. |
| Lying on the painful side | Direct pressure on the bony point for hours. | On your back with a pillow under the knees, or on the good side with pillows between the knees. |
| Lying on the good side with the top knee dropped | The top hip falls across the body. | A pillow or two between the knees so the top leg stays level. |
| Low chairs and car seats | Deep bending plus the thigh drifting in. | A higher seat or a cushion. |
| IT band and outer hip stretches | The stretch position is the compression position. | Leave the outer hip unstretched while it is painful. |
| Knee across the body stretch | Pulls the thigh across the midline. | A gentle back stretch that keeps the knees apart. |
| Foam rolling the outer thigh | Direct pressure over the sore area (untested either way). | Skip it while it is painful. |
Not while it hurts. Pulling the thigh across the body is the position that squeezes the gluteal tendons, and an NHS hospital's patient advice warns it can irritate them if repeated.
Try not to. Sleep on your back with a pillow under your knees, or on the other side with pillows between your knees so the top leg stays level.
Usually, yes. Walk with your weight even on both feet, shorten the distance if it builds pain, and avoid long steep hills early on.
They can ease pain for a few weeks, but in the LEAP trial education plus exercise did better at 8 weeks and on overall improvement at a year.
Outer hip tendon pain is most common in women in mid-life and after menopause. A trial testing hormone therapy found the education and exercise did the work; talk to your doctor about hormone therapy for its own reasons.
Exercise education, not a diagnosis or treatment plan. It is written from the guidelines and studies listed above; review by a clinician is pending. If your pain follows an injury, is severe, is getting worse, or comes with any warning sign listed on this page, get it assessed. Health disclaimer.
