Outer Hip Pain in Women: Why It’s Often Called Hip Bursitis

Pain on the outside of the hip is often diagnosed as lateral hip bursitis.

Many women in their 40s, 50s and early 60s are told the pain is caused by inflammation of the bursa on the outside of the hip.

But in reality, the bursa is rarely the true cause of the problem.

At Penrith Physiotherapy Sports Centre, we regularly see patients who have been told they have bursitis when the real issue is something different — gluteal tendinopathy.

Understanding this difference is important, because treating the wrong structure often leads to persistent hip pain that keeps returning.

Why Outer Hip Pain Is More Common in Women Aged 40–60

Lateral hip pain most commonly affects women between the ages of 40 and 60.

This pattern is well recognised in physiotherapy and sports medicine.

Several factors make this group more prone to developing the condition.

Changes in tendon capacity

As we move through our 40s and 50s, tendons can become less tolerant to sudden increases in load. They still respond well to strengthening, but they may become irritated more easily if overloaded.

Pelvic structure

Women generally have a wider pelvis, which can increase the load placed on the gluteal tendons during walking and single-leg activities.

Hormonal changes

Hormonal changes around perimenopause and menopause may influence tendon health and recovery.

Activity patterns

Many women in this age group remain active with walking, exercise classes, running or gym training, and sudden increases in activity can irritate the tendons.

This is why we frequently see women presenting with persistent pain on the outside of the hip.

The Bursa Often Gets the Blame

A bursa is a small fluid-filled sac that helps reduce friction between tissues.

On the outside of the hip sits the trochanteric bursa, which allows the gluteal tendons and the iliotibial band to move smoothly over the bone.

Historically, pain in this region was diagnosed as trochanteric bursitis.

However, modern research has shown that the bursa is often not significantly inflamed in people with lateral hip pain.

Instead, the most common finding is irritation of the gluteal tendons.

This is why the condition is now more accurately referred to as:

Greater Trochanteric Pain Syndrome (GTPS).

The Real Cause of Most Outer Hip Pain: Gluteal Tendinopathy

The gluteus medius and gluteus minimus tendons attach to the outside of the hip.

These muscles are essential for stabilising the pelvis when you:

• walk

• run

• climb stairs

• stand on one leg

• carry weight

Every step you take requires these muscles to control the pelvis and prevent it dropping sideways.

When these tendons become irritated or overloaded, they develop gluteal tendinopathy.

This tendon irritation is usually the primary cause of lateral hip pain.

The nearby bursa can become irritated as a secondary effect, which is why it often gets blamed.

But in most cases, the tendon overload is the real driver of the symptoms.

The Three Things That Commonly Make Lateral Hip Pain Worse

For people with gluteal tendinopathy, there are three key aggravators.

Understanding these can help reduce symptoms significantly.

1. Overload

Tendons become irritated when the load placed on them exceeds what they can tolerate.

Common triggers include:

• sudden increases in walking or running

• increasing hills or stairs

• starting new exercise programs

• high volumes of single-leg activities

Because the gluteal tendons work hardest when standing on one leg, even everyday walking can aggravate symptoms.

2. Compression

Compression is one of the biggest irritators of the gluteal tendons.

This occurs when the tendon is pressed against the bone on the outside of the hip.

Common compression positions include:

• lying on the painful hip

• standing with your weight shifted onto one hip

• crossing your legs

• sitting with knees together for long periods

This is why many people with this condition say their pain is worse when lying on their side at night.

3. Stretch

Stretching the outside of the hip might seem helpful, but it often makes gluteal tendinopathy worse.

Many common hip stretches place the tendon under both stretch and compression, which increases irritation.

Stretches that can aggravate symptoms include:

• crossing the leg across the body

• deep glute stretches

• pigeon stretch

• aggressive ITB stretching

While stretching may feel relieving temporarily, it often prolongs the problem.

Physiotherapy for Lateral Hip Pain in Penrith

At Penrith Physiotherapy Sports Centre, our physiotherapists regularly assess and treat conditions such as:

• lateral hip pain

• hip bursitis

• gluteal tendinopathy

• greater trochanteric pain syndrome

Treatment focuses on improving the strength and load tolerance of the gluteal tendons through structured physiotherapy and targeted rehabilitation.

If you are experiencing persistent outer hip pain, an assessment with a physiotherapist can help identify the cause and guide the right treatment plan.

For people living in Penrith and Western Sydney, our team at Penrith Physiotherapy Sports Centre provides expert assessment and treatment for hip pain and tendon injuries.