When you live with glute tendon pain, you often learn which positions to avoid the hard way. Lying on your side, crossing your legs or standing with your weight on one hip all seem to set it off. Knowing why these positions bother the tendons, and how to build their strength back, can help you move with less discomfort.

What glute tendon pain is

Your glute muscles, in your buttocks, attach to the bony point on the outside of your hip through strong tendons. These tendons help keep your pelvis level when you walk, climb stairs or stand on one leg.

Glute tendon pain means these tendons have become sensitive. It usually causes pain on the outside of your hip, sometimes spreading into your buttock or down the side of your thigh. It is very common, especially in midlife, and it often develops after a change in activity or a period of extra load.

Why some positions hurt

Glute tendons are sensitive to being squashed against the bone. This happens when your leg crosses towards or past the middle of your body, especially when you put weight through it. That is why these positions often bring on pain:

• Lying on the sore side, or on your other side with your top leg dropping across your body.
• Sitting with your legs crossed or in very low chairs.
• Standing with your weight shifted onto one hip.
• Stretches that pull your leg across your body.

Positions to avoid for now

Easing these positions for a while gives the tendons a chance to settle while you build their strength:

• Sit with your legs uncrossed and both feet on the floor.
• Choose higher chairs, or add a cushion to low seats.
• Stand with your weight even on both feet.
• Sleep on your other side with a pillow between your knees and ankles, or on your back with a pillow under your knees.
• If you lie on the sore side, a soft mattress topper can ease the pressure.
• Leave out stretches that pull your leg across your body. Feeling tight does not mean the tendon needs stretching.

These changes are usually needed for a while, not forever. As the tendons get stronger, you can gradually return to more positions.

Why strength is the key

Tendons get stronger when they are loaded gradually, and they lose some of their ability to cope when rested. That is why rest alone tends to help only for a while.

Research supports a combination of easing compression and building strength. In a large trial of people with this kind of hip pain, those who had education about daily habits plus a gradual strength programme did better over the following year than those who waited to see.

If you have been given a programme by a physiotherapist, keep following that.

Gradual strengthening

A good programme starts with holds, then builds to movement and heavier work over weeks. Something to try three or four times a week:

• Standing side press. Stand side-on to a wall, with the sore side furthest away. Bend the knee nearest the wall and press it gently into the wall for 30 to 45 seconds. Repeat a few times.
• Bridges. Lie on your back with your knees bent, lift your hips, then lower slowly. Progress to single-leg bridges.
• Sit to stand. Rise from a chair without using your hands, keeping your knees in line with your toes.
• Step-ups. Step up onto a low step, keeping your pelvis level, then step down slowly.

If you would like to follow along, VIDA has short videos of bridges and sit to stands you can use at your own pace.

Getting the amount right

Check how your hip feels later that day and the following morning. A mild ache that settles by the next day is usually fine. If it is sorer the next morning, ease back a little rather than stopping.

Once an exercise feels easy, you could add a few repetitions, slow down the lowering or move from two legs to one. Changing one thing at a time, every week or two, gives the tendons time to adapt.

Walking and staying active

Walking is part of your strength work. If longer walks bring the pain on, you could split them into shorter ones and build up gradually. Shorter strides, flatter routes and taking stairs one at a time can all help for now.

Managing a flare-up

Flare-ups are common with tendon pain, often after a busy week or a long walk. Dropping back to an easier level for a few days, rather than stopping, usually helps it settle.

When to get it checked

If your pain is not easing after several months of steady strengthening, your GP or a physiotherapist can talk through other options with you.

Your VIDA pain check-in can help you notice how your hip changes as you build strength.

What to take away

• Glute tendons are sensitive to being squashed across the body.
• Avoid crossing your legs and sleep with a pillow between your knees for now.
• Leave out stretches that pull your leg across your body.
• Build strength gradually, starting with holds.
• Drop back to an easier level during a flare-up, rather than stopping.

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