Gluteal Tendinopathy in Amsterdam: Why the Side of Your Hip

Does the outside of your hip ache when you lie on that side at night? Does it hurt after climbing the stairs of a narrow Amsterdam canal house, standing at a party, or walking a long loop through the Vondelpark? Maybe you were told it was “hip bursitis”, got some stretches or even an injection, and it still keeps coming back.

There is a good chance the real problem is gluteal tendinopathy, an irritation of the tendons of the gluteal muscles where they attach to the bony point on the side of the hip. It is one of the most common causes of lateral hip pain, and one of the most often misunderstood. This article explains what it is, why typical advice can make it worse, and what a structured physiotherapy plan looks like.

What is gluteal tendinopathy?

On the outside of each hip is a bony bump called the greater trochanter. Two important hip muscles, gluteus medius and gluteus minimus, attach there through their tendons. These muscles keep your pelvis level every time you stand on one leg, which happens with every step you take.

Gluteal tendinopathy means those tendons have become overloaded and sensitive. It is part of a wider group of problems called greater trochanteric pain syndrome (GTPS). For many years this pain was simply labelled “trochanteric bursitis”, but imaging studies have shown that tendon changes are much more common than true inflammation of the bursa (the small fluid sac in the area). Treating it as a tendon problem changes how you manage it.

Who gets it?

Lateral hip pain is common. In a large US cohort, about 1 in 4 women and about 1 in 12 men aged 50 to 79 reported greater trochanteric pain on at least one side (Segal et al., 2007). It is most common in women around and after menopause, but we also see it in:

Runners who increased their distance quickly, or run on cambered roads
People who stand for long periods with their weight on one hip
People returning to exercise after pregnancy
Anyone with a sudden increase in walking, stairs or hill work (moving house in Amsterdam counts)

Typical symptoms

Pain on the outside of the hip, sometimes spreading down the side of the thigh toward the knee
Pain when lying on the affected side, and often also when lying on the other side with the top knee dropping down
Pain and stiffness when getting up after sitting, especially from low chairs or a car
Pain climbing stairs, walking uphill or standing on one leg (for example putting on trousers)
Pain when crossing your legs

Pain in the groin, or pain that is mostly in the buttock with numbness or tingling, points more toward other problems such as the hip joint itself or the lower back. That is why a proper examination matters.

Why it often keeps coming back

Many people with gluteal tendinopathy have already tried something, and it helped for a while. Here are the most common reasons it returns.

1. Stretching the wrong way

Tendons on the side of the hip are sensitive to compression. Positions that pull the thigh across the midline (crossing your legs, the classic “IT band” or piriformis stretch with the knee pulled across the body, sitting with knees together and low) squeeze the tendon against the bone. Well-meant stretching can keep the tendon irritated.

2. Rest alone

Tendons need load to adapt. Complete rest may calm the pain briefly, but the tendon and muscles lose capacity, so the pain returns as soon as you go back to normal life.

3. Injection without a loading plan

A corticosteroid injection can reduce pain in the short term. However, in a well-known randomised trial (the LEAP trial), education plus a specific exercise programme gave better results at 8 weeks and at one year than an injection, and both were better than a “wait and see” approach (Mellor et al., 2018, BMJ). The injection helped early on, but the benefit did not last as well as the exercise group.

4. Daily habits nobody looked at

Standing with your hip pushed out to one side, sleeping on the painful side without support, or a sudden spike in steps per day all add load to the tendon. Without changing these, even good exercises struggle.

How physiotherapy helps

Current evidence supports a combination of education about load and compression plus progressive strengthening of the hip muscles (Grimaldi et al., 2015, Sports Medicine). At Alter Physio, a typical plan includes the following.

Assessment first

We check whether the pain really comes from the gluteal tendons, or from the hip joint, the lower back, or a combination. We look at how you stand, walk, climb a step and balance on one leg, and we ask about sleep, work and training.

Calming the tendon

Avoiding compressive positions: no leg crossing, a pillow between the knees at night, sitting with hips slightly higher than knees.
Load management: temporarily reducing hills, long stairs or long runs rather than stopping activity completely.
Isometric exercises: holding a gentle muscle contraction without movement can often be done with little or no pain and is a safe starting point.

Rebuilding strength and control

Over the following weeks we progress to exercises that strengthen the hip abductors and improve control of the pelvis in standing: bridges, side-stepping, step-ups and single-leg work. The aim is not just a stronger muscle but a tendon that tolerates the real demands of your life, whether that is walking around the city, running the Amsterdamse Bos or carrying a toddler on one hip.

Tendons adapt slowly. Most people need around 8 to 12 weeks of consistent work for a meaningful change, sometimes longer if the problem has been there for years. That timeline matches what the LEAP trial used, and it is honest to say so from the start.

Hands-on treatment

Manual therapy and soft-tissue work can reduce pain and stiffness around the hip and lower back, making it easier to do the exercises. We use it to support the programme, not to replace it.

Shockwave and other options

Some research suggests radial shockwave therapy can help in persistent cases (Rompe et al., 2009), usually alongside exercise. If you are not improving after a well-performed programme, we discuss further options or referral to a sports physician.

Where does Japanese acupuncture fit in?

Many of our clients combine physiotherapy with Japanese acupuncture. The research on acupuncture specifically for gluteal tendinopathy is limited, so we do not present it as a cure. What we see in practice is that gentle, thin-needle Japanese acupuncture and moxibustion can help some people with pain, muscle tension around the hip and lower back, and poor sleep, which can make it easier to stick with the exercise plan. If you are curious, we will tell you honestly whether it makes sense for your situation.

When to see a physiotherapist

Book an assessment if:

Side hip pain has lasted more than 2 to 3 weeks
It wakes you at night or stops you lying on your side
It limits walking, stairs or sport
You already had treatment (stretching, an injection, or physio) and it keeps returning

See your GP (huisarts) promptly if you have fever, a hot swollen joint, severe pain after a fall, unexplained weight loss, or pain in the groin that makes it hard to put weight on the leg.

In the Netherlands you can see a physiotherapist directly without a GP referral. If you have already had treatment that did not work, our second opinion service is designed for exactly that situation. You can also read our broader guide to hip pain physiotherapy in Amsterdam, and runners may find our article on running injuries from the Vondelpark to the Amsterdamse Bos useful.

Frequently asked questions

Is gluteal tendinopathy the same as hip bursitis?

Not exactly. Both are part of greater trochanteric pain syndrome, but imaging shows that tendon changes are far more common than true bursitis. Treating the tendons with the right kind of load usually works better than treating it as inflammation alone.

Should I stretch my hip if it hurts on the side?

Be careful with stretches that pull your leg across your body, such as many IT band or piriformis stretches. They compress the tendon and can keep it irritated. A physiotherapist can show you which movements are helpful for you.

How long does recovery take?

Most people need around 8 to 12 weeks of consistent, progressive exercise to see a clear improvement. Long-standing cases can take longer. Pain at night often improves earlier once compressive positions are avoided.

Can I keep running or going to the gym?

Often yes, with adjustments. We usually reduce hills, speed work or long runs for a while and modify gym exercises, rather than stopping completely.

Do I need a scan?

Usually not. The diagnosis is made with a clinical examination. An ultrasound or MRI may be useful if you are not improving or if another problem is suspected.

Book an assessment in Amsterdam Zuid

If the side of your hip hurts at night or every time you climb the stairs, you don’t have to keep guessing. At Alter Physio & Acupuncture in Amsterdam Zuid, our English-speaking physiotherapists will find out what is really driving your pain and give you a clear, step-by-step plan, with Japanese acupuncture available if it suits you. Contact us or book your first session.

References: Segal NA et al. (2007) Greater trochanteric pain syndrome: epidemiology and associated factors. Arch Phys Med Rehabil. Grimaldi A et al. (2015) Gluteal tendinopathy: a review of mechanisms, assessment and management. Sports Med. Mellor R et al. (2018) Education plus exercise versus corticosteroid injection use versus a wait and see approach on global outcome and pain from gluteal tendinopathy: prospective, single blinded, randomised clinical trial. BMJ. Rompe JD et al. (2009) Home training, local corticosteroid injection, or radial shock wave therapy for greater trochanter pain syndrome. Am J Sports Med.

This article is for general information and does not replace a personal assessment.