Hein Viljoen
Physiotherapy
Do you struggle with aching pain on the side of your hip, especially when you are lying on it, climbing stairs, or sitting? You might have gluteal tendinopathy, a common tendon issue affecting the hip muscles, often misdiagnosed as "bursitis". A landmark 2025 study, "Gluteal Tendinopathy Masterclass: Refuting the Myths and Engaging with the Evidence," breaks down outdated beliefs about this condition and explains what works.
Fact: While bursitis (inflammation of a small fluid sac) can happen, most pain comes from the gluteal tendons — a condition known as gluteal tendinopathy. Bursitis may sometimes contribute to the issue, but it is not the primary cause.
Fact: Short rests or anti-inflammatory medications may help briefly, but long-term relief comes from education and guided exercise. We teach you how to load the tendon.
Fact: Imaging sometimes shows tendon changes in people who feel no pain. That is why clinical examination (physical tests and talking through symptoms) is more reliable.
Fact: While more common in post-menopausal women, gluteal tendinopathy can affect anyone, including young active people and men.
Fact: Pain on the side of the hip can come from different tissues. That’s why we do tests like palpation (gentle pressing), single-leg balance, and resisted movements to confirm it’s the tendon.
Fact: The iliotibial band is very tight and does not stretch easily. These stretches may even compress the tendon, making things worse.
Fact: Clamshells may activate the smaller glute muscles, but they offer little tendon load and often involve a compressive position. Weight-bearing exercises, such as single-leg stands or squats, provide a significantly better tendon stimulus.
Fact: Injections may relieve pain in the short term, but for lasting results, exercise and education win every time. Additionally, injections may pose a long-term risk to the tendon.
Fact: Even a partial tendon tear often heals well with conservative care, like tailored rehab and load management. Surgery is rarely needed.
We focus on patient-reported pain, functional limitations, gait mechanics, muscle activation patterns, posture, and load history to arrive at an accurate diagnosis of the tendon, avoiding overreliance on imaging or assumptions.
We begin patients with isometric holds (e.g., static hip abduction) for pain relief and tendon modulation, then gradually progress to eccentric and resistance exercises, such as single-leg squats and step-downs, to promote tendon adaptation.
We help patients modify aggravating positions and habits — especially those causing tendon compression (e.g., lying on the affected side) — and introduce gradual exposure rather than avoidance.
We empower patients with strategies to manage exercises, posture, sleep positioning, and daily activity progression at home, fostering long‑term recovery and prevention.
Hip hip hooray! A few sessions with one of our Cape Town physiotherapists could help you with your hip pain.
