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Hip and gluteus medius (tendinopathy): returning to sport step by step

Pain on the outer side of the hip, aggravated by sleeping on that side, on stairs or standing for a long time.

Outer side of the hip

Why it happens

Increase in volume, weak glutes, cambered surfaces, long periods of standing.

Coming back in four stages

  1. 1

    Flat walking for 20 to 30 minutes, avoid sleeping on the painful side if possible.

  2. 2

    Glute strengthening prescribed or approved by your physiotherapist.

  3. 3

    Alternating walking and running on flat ground, without camber.

  4. 4

    Easy continuous running, then slopes and speed gradually.

Move on to the next stage after 2 sessions in a row with discomfort of 2 out of 10 or less and no pain the next day. Each stage usually lasts 1 to 2 weeks, depending on your healthcare professional’s advice. For the hip, pain when lying on your side at night is a good guide: if it increases, stay at this stage.

Movements to postpone

  • côtes et descentes from stage 4
  • changements de direction et pivots from stage 3

Strengthening exercises

  • 12

    Clamshell

    from stage 1 of the plan

    Lying on your side, knees bent, feet together: open the top knee without moving the pelvis. Add a band later.

    To start: 3 sets of 15 per side, every other day.

    Variations, mistakes and progression
    Easier
    Smaller opening, no band.
    Harder
    Band around the thighs, then a 2-second hold at the top.
    Common mistakes
    • Rolling the pelvis back to open wider.
    • Going fast and feeling it in the back rather than the buttock.
    Moving on
    When 3 × 20 with a band is easy: move on to the side plank or band walks.
  • 12

    Glute bridge

    from stage 1 of the plan

    Lying on your back, knees bent, lift the hips squeezing the buttocks, hold 2 seconds, lower slowly. Later: on one leg.

    To start: 3 sets of 12, 2 seconds at the top, every other day.

    Variations, mistakes and progression
    Easier
    Smaller range, feet closer to the buttocks.
    Harder
    On one leg, then with your shoulders on a sofa.
    Common mistakes
    • Arching the lower back instead of squeezing the glutes.
    • Letting the knees drift apart or together.
    Moving on
    When 3 × 12 on one leg is easy, with the pelvis staying level.

  • Side plank

    from stage 2 of the plan

    On your elbow, knees bent (later legs straight), hold 20 to 30 seconds with the pelvis aligned.

    To start: 3 holds of 20 seconds per side, every other day.

    Variations, mistakes and progression
    Easier
    Knees bent on the floor.
    Harder
    Legs straight, then lifting the top leg.
    Common mistakes
    • Letting the hip sag towards the floor.
    • Leaning the trunk forward.
    Moving on
    When you can hold 45 seconds with straight legs and the pelvis aligned.
  • 12

    Lateral band walk

    from stage 2 of the plan

    Band around thighs or ankles, knees slightly bent, take 10 steps sideways each way.

    To start: 3 rounds of 10 steps each way, every other day.

    Variations, mistakes and progression
    Easier
    Band above the knees, short steps.
    Harder
    Band around the ankles, deeper knee bend, or a stronger band.
    Common mistakes
    • Letting the knees cave in.
    • Swaying the trunk at each step.
    Moving on
    When 3 × 15 steps with the band at the ankles is easy.
  • 12

    Low step-up

    from stage 3 of the plan

    Step up onto a 10 to 20 cm step with the affected leg, come down slowly, pelvis steady.

    To start: 3 sets of 10 per leg, slow on the way down, every other day.

    Variations, mistakes and progression
    Easier
    10 cm step, one hand on the rail.
    Harder
    Higher step (20 to 30 cm), then with weights in your hands.
    Common mistakes
    • Pushing off with the leg on the floor.
    • Knee drifting inwards.
    Moving on
    When 3 × 12 on a 20 cm step is clean and causes no discomfort the next day.

  • Single-leg balance

    from stage 3 of the plan

    Stand 30 seconds on one foot, knee slightly bent. Then with eyes closed, then on a cushion or unstable surface.

    To start: 3 holds of 30 seconds per leg, every day.

    Variations, mistakes and progression
    Easier
    One hand on a chair, or the tip of the free foot on the floor.
    Harder
    Eyes closed, then on a cushion, then throwing a ball against a wall.
    Common mistakes
    • Knee straight and locked.
    • Looking at your feet instead of a point ahead.
    Moving on
    When you can hold 30 seconds without putting the other foot down, as on the healthy side.

The doses are starting points. Stay at 2 out of 10 discomfort at most, during and the next day; otherwise switch to the easier version or go back to the previous exercise.

When to stop and see a professional

Pain in the groin with limping, pain after a fall or intense night pain: see a doctor.

Rehab’s advice

Avoid cambered surfaces, crossed-leg positions and prolonged standing at first.

What the Rehab plan does for this injury

The plan starts at 35% of your previous training volume and builds up to 85%, with a consolidation week every three weeks. If your discomfort reaches 5 out of 10, it stops and refers you to your doctor or physiotherapist.

In which sport?

General information, currently being reviewed by healthcare professionals. It replaces neither a diagnosis nor the advice of your doctor or physiotherapist.