Outer Hip Pain: exercise plan
Your gluteal tendons hate being squashed and love being strengthened. Stop squashing, start loading, and give it a couple of months.
- Pain rules: up to about 3–4/10 during strength work is OK if it doesn’t increase that night or the next morning. Everyday movements should not increase pain.
- How often: isometric holds daily; strength work every second day.
- How long: in the LEAP trial, people did better than with an injection by 8 weeks, and the gains lasted to a year.
- Progress when: a level feels easy and next-morning pain is no worse. Add a band, hold longer or move up a level.
Your exercises
- Standing hip push (isometric)Stand side-on to a wall, sore side away. Bend the knee nearest the wall and press it gently into the wall, so the sore side’s glute works to keep you level. Start at gentle effort; progress to firmer pushes.5 holds of 30–45 seconds, once a day
- Lying hip push (isometric)Lie on your back, knees bent, band around your thighs. Push your knees gently apart against the band and hold. Progress with a stronger band.5 holds of 30 seconds, once a day
- BridgeLie on your back, knees bent, feet hip-width. Squeeze your bottom and lift your hips. Progress to a band around the knees, then single-leg bridges.3 sets of 10, every second day
- Sit to standStand up from a chair without using your hands, keeping knees apart and pelvis level. Start with a higher chair; progress lower or holding a weight.3 sets of 10, every second day
- Side-step with bandBand around your knees, small steps sideways keeping your pelvis level and toes forward. Progress with a stronger band or band around the ankles.3 sets of 10 steps each way, every second day
- Step-upsStep up onto a low step leading with the sore leg, keeping your pelvis level (no hip dropping out sideways). Progress to a higher step or holding weights.3 sets of 10, every second day
Avoid squashing the tendon: don’t cross your legs, hang on one hip when standing, sit in low chairs, or lie on the sore side (or on the good side with the top knee dropped: put a pillow between your knees). Skip clamshells and deep side stretches for now.
Stop and see your GP or physio if
- Pain in the groin or deep in the hip joint, or a limp that is getting worse
- Back pain with leg pain, numbness or weakness
- Night pain that wakes you and doesn’t ease with changing position
- No improvement after 3 months of regular exercise
Want a supervised program?
A physio can guide you through a LEAP-style program (education plus progressive exercise, about 14 sessions over 8 weeks), which beat a cortisone injection in the trial. If you also have hip osteoarthritis, the GLA:D program is a good supervised option. If you have a chronic condition, ask your GP about a GP Chronic Condition Management Plan (GPCCMP): it gives a Medicare rebate for up to 5 allied health visits a year (physio, exercise physiologist or podiatrist).
Evidence and more information
- Running Physio: LEAP trial summary
- Mellor et al, BMJ 2018: LEAP trial (education plus exercise vs injection)
maladywise.com/hip-pain/exercises/