Gluteal tendon tears

What is a gluteal tendon tear?

The gluteus medius and minimus are muscles on the side of your hip. They attach by tendons to a bony point on the upper thigh bone, called the greater trochanter. They are often called the hip abductors. Their job is to keep your pelvis level each time you stand on one leg, which happens with every step.

These tendons can wear down, fray, and tear. People sometimes call this a “rotator cuff tear of the hip,” because it behaves much like a tear in the shoulder. Most tears are partial, and tears involve the gluteus medius in almost all cases (Longstaffe, 2021). They usually build slowly with age, though a fall can cause one too.

Is my outer hip pain trochanteric bursitis?

Maybe not. For years, pain on the outside of the hip was simply called trochanteric bursitis. A bursa is a small fluid sac that reduces rubbing, and it can get irritated. But in many people the true source is the tendons, not the bursa.

Today, doctors often use a wider name: greater trochanteric pain syndrome. It covers a range of problems, from an irritated bursa, to worn tendons (called gluteal tendinopathy), to partial and full tears.

Common symptoms include:

• Pain on the outer hip that may spread down the side of the thigh
• Pain lying on that side at night
• Pain with stairs, standing on one leg, or getting up after sitting
• A limp, or a feeling that the hip is weak

Groin pain points more toward a problem inside the joint, such as a labral tear or arthritis. An exam comes first. An MRI or ultrasound can show the tendons and how much muscle remains.

Do I need surgery for lateral hip pain?

Usually not at first. Most people start with non-surgical care, and the evidence for this is better than for surgery.

The key trial followed 204 people with lateral hip pain from gluteal tendinopathy. They had 14 sessions of education and exercise, or one corticosteroid injection, or no treatment. At eight weeks, 77% of the exercise group reported success, compared with 58% after injection and 29% with no treatment. At one year, the exercise group still did better on overall improvement than the injection group, at 78% vs 57%, though pain scores did not differ between those two (Mellor, 2018).

Education usually means learning to reduce the loads that squeeze the tendon. Examples are crossing your legs and hanging on one hip when standing.

A later review of randomized trials concluded that exercise and education can be cautiously recommended as the core approach. Corticosteroid injections had a small, short-term effect on pain. Shockwave therapy and platelet-rich plasma had some promising results, but firmer trials are needed (Bremer, 2025). You can read more in the PRP guide.

One caution applies. These trials studied tendinopathy. A recent review of gluteal tendon tears found no studies at all of non-surgical treatment for tears (Spencer, 2026). So we know much less about how well therapy works once a tendon has truly torn. It is still a common first step, but the proof for it in tears is missing.

When is repair considered?

Repair may be discussed when pain and weakness last despite a good try at therapy, especially if you have a persistent limp or an MRI shows a clear tear. A long-standing tear with a lot of muscle wasting can be harder to repair, so the condition of the muscle matters as much as the tear.

The evidence for surgery is real but limited. One review of 22 studies found improvements in function after repair. Among those with a limp before surgery, about 70% saw it resolve, and the repeat tear rate was 3.8% (Longstaffe, 2021).

A larger review of 1,584 people also found improvement in pain and quality of life after surgery. But it found no randomized trials, and it rated the certainty of the evidence as very low (Spencer, 2026). In plain terms, people tend to improve after repair, but we can’t be sure how much of that is due to the operation itself.

How is a gluteal tendon repair done?

The surgeon reattaches the tendon to the bone with anchors and stitches. There are two main approaches. An open repair uses one larger incision. An endoscopic repair uses a camera and small incisions, similar to hip arthroscopy. In one review, both improved function and repeat tear rates were similar. Complications were lower with endoscopic repair, at 0.7% vs 7.8% (Longstaffe, 2021). The size of the tear and the tissue quality help decide which fits.

Risks include infection, blood clots, nerve irritation, stiffness, a repair that does not heal, and ongoing pain or weakness. Results vary from person to person, and no surgeon can promise a certain outcome.

Should I get a second opinion?

It can help if you have had “bursitis” for a long time that has not improved, or if you have been told there is nothing more to do. Here’s how a second opinion works.

Where can I see Dr. Pareek?

Dr. Pareek sees patients with lateral hip pain at HSS in New York and at HSS in New Jersey. Bring any MRI images and reports you already have, and a list of the treatments you have tried.

What does recovery look like?

These are typical ranges. Your surgeon’s plan comes first, and recovery varies from person to person.

• Weeks 0-2: Protect the repairAfter a repair, many people use crutches, with limits on weight and on lifting the leg out to the side. Early therapy focuses on swelling and gentle movement.
• Weeks 2-6: Keep it protectedCrutches usually continue while the tendon heals to bone. Therapy adds gentle motion and light muscle activation, without loading the repair.
• Weeks 6-12: Walk normallyWeight on the leg builds up, and most people work off crutches toward a normal walking pattern. A limp can take time to settle.
• Months 3-6: Build strengthTherapy moves toward strengthening the hip muscles and building stamina for walking, stairs, and daily life.
• Months 6-12: Keep improvingStrength and comfort can keep improving for many months. Recovery from this repair is often slow. These are typical ranges, and your surgeon's plan governs.

Related reading

• Do I need surgery for a labral tear?

Sources

1. Mellor R, et al. Education plus exercise versus corticosteroid injection use versus a wait and see approach on global outcome and pain from gluteal tendinopathy: prospective, single blinded, randomised clinical trial. BMJ 2018;361:k1662.
2. Bremer T, et al. The efficacy of gluteal tendinopathy treatments: a systematic review. Clin Rehabil 2025;39:600-617.
3. Spencer T, et al. Low quality evidence supports surgery for gluteal tendon tears, no non-surgical evidence was identified: a systematic review. BMC Musculoskelet Disord 2026;27:191.
4. Longstaffe R, et al. Both open and endoscopic gluteal tendon repairs lead to functional improvement with similar failure rates: a systematic review. J ISAKOS 2021;6:28-34.