There are two completely different problems that both get called “hip pain”, and telling them apart takes about thirty seconds.
Point to where it hurts. If you point to your groin, that is the hip joint. If you point to the bony bump on the outside — the one you land on if you fall sideways — that is almost never the joint, and treating it as though it were sends people down the wrong path for months.
The outside one is usually tendon
Gluteal tendinopathy is the most common cause of pain over that bony point. It gets called bursitis constantly, including on scan reports, because the bursa often shows changes. But the bursa is rarely the driver; the tendon is.
That distinction is not academic. Cortisone into a bursa gives relief that fades. Loading the tendon changes it.
The symptom that gives it away
You cannot lie on that side. People describe it as the thing that finally made them book, and it is characteristic enough to be diagnostic on its own. Standing on one leg hurts, stairs hurt, and sitting with your legs crossed makes it worse afterwards.
What changes it fastest is not exercise
It is compression. The gluteal tendons get squashed whenever the knee comes across the midline of your body — sitting cross-legged, standing with one hip dropped, and above all sleeping with the top leg falling forward across the bottom one.
So the first thing we change is how you sleep: on your back, or on the unaffected side with a pillow between your knees so the top leg cannot drop across. This one adjustment frequently produces more improvement in the first fortnight than anything else we do.
Then the loading
Progressive gluteal strengthening, which takes months rather than weeks because tendon adapts slowly. Where it has been stubborn, shockwave therapy is well supported for this particular tendon and is available on site.
And if you did point at your groin
Groin pain with walking, stiffness after sitting, and trouble putting on socks points at hip osteoarthritis instead. Different problem, different program — and one where strength work is genuinely the best-supported treatment available, despite how the diagnosis usually gets described.
Why this happens around menopause
Gluteal tendinopathy is notably more common in women in their fifties, because tendon tissue is sensitive to hormonal change. It is not inevitable, it is not something to wait out, and it responds to loading like any other tendon.
Forge West End is at Unit 4, 249 Montague Road, West End. Book online or call 07 3844 0686 — we are open from 6am Monday to Friday.