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Lateral hip pain is an incredibly common condition, particularly in women and runners. It is the sharp pain on the outside of the hip bone (trochanter). It makes lying on your side in bed impossible. It makes walking up hills agony. It makes standing on one leg to put on trousers a balancing act of pain.
For decades, this was diagnosed as “Trochanteric Bursitis” (inflammation of the fluid sack). Patients were given cortisone injections into the bursa. While this helped temporarily, the pain almost always returned.
Modern research has shown that in the vast majority of cases, the bursa is not the primary problem. The issue is Gluteal Tendinopathy. The tendons of the Gluteus Medius and Minimus muscles are degrading. They are failing to cope with the loads placed upon them.
At Breakthrough Pain & Performance, we treat the tendon, not the bursa. We understand that tendons do not just wear out; they fail because the neurological control of the muscle has failed. By restoring the brain’s control of the hip, we can unload the tendon and allow it to heal.
Tendons hate compression. In the hip, the Gluteal tendons wrap around the bony bump of the thigh bone (Greater Trochanter). When the hip drops into adduction (crossing the midline), the tendons are compressed against the bone.
This happens when you:
This compression squeezes the blood supply out of the tendon and causes structural breakdown. We educate you on Position Management. We teach you how to sit, stand, and sleep to stop strangling the tendon. Removing the compression is often enough to reduce pain significantly within a week.
Why does the hip drop into adduction when you walk? Because the Gluteus Medius muscle is failing to stabilise the pelvis.
This is rarely because the muscle is small or atrophied. It is because it is Inhibited. The nerve signal from the brain is weak. This can be due to lower back issues (the nerve supply comes from L5) or reciprocal inhibition from tight inner thigh muscles (Adductors).
If the Glute Medius is asleep, the tendon takes all the strain. It is being pulled and compressed with every step. We use P-DTR and activation drills to wake up the muscle. We increase the neural drive. Once the muscle is firing strongly, it holds the pelvis level. The compression on the tendon stops, and the pain cycle is broken.
Many of our clients have had steroid injections. While cortisone creates a powerful anti-inflammatory effect that kills pain quickly, it is toxic to tendon cells. Repeated injections actually weaken the collagen structure of the tendon, increasing the risk of tears in the future.
We offer a regenerative alternative. We use Isometric Loading. Research shows that heavy static holds (isometrics) are analgesic for tendons. They reduce pain immediately by calming the brain’s threat perception. They also stimulate the tendon cells to lay down new, healthy collagen. We teach you exactly how to dose this exercise as if it were medicine.
We analyse how you walk. Many people with hip pain walk like a runway model, placing one foot directly in front of the other (narrow step width). This forces the hip into adduction with every step, compressing the tendon.
We use Gait Re-education. We teach you to widen your stance slightly. This simple mechanical change opens up the hip angle and instantly takes the pressure off the painful tendon. It is a small tweak that makes a massive difference to your daily pain levels.
Sleep is the biggest complaint for patients with this condition. You can’t lie on the painful side because of direct pressure. You can’t lie on the good side because the top leg drops over, stretching the painful tendon.
We provide specific advice on pillow placement. The goal is to keep the top leg parallel to the bed, preventing the adduction that strangles the tendon. Improving sleep quality is vital because it lowers your systemic inflammation and pain sensitivity.
1. Decompress: We identify and stop the habits that are crushing the tendon (crossing legs, hanging on hip).
2. Activate: We wake up the Glute Medius muscle fibre to take the load.
3. Load: We use isometric exercises to reduce pain and stimulate healing.
4. Integrate: We fix your walking pattern to prevent the hip from dropping.
This clinic is for you if:
We provide a long-term solution for healthy tendons.
