Why are your hips hurting??
That aching outer hip isn't just "getting older" — here's what's really going on (and how to fix it)
If you're a woman in your 40s, 50s, or beyond and you've been dealing with persistent pain on the outside of your hip — especially when you lie on that side at night, climb stairs, or sit for too long with your legs crossed — there's a good chance your gluteus medius tendon is involved.
Gluteus medius tendinopathy is one of the most under-diagnosed causes of lateral hip pain in women, and menopause is one of the biggest reasons it develops. At Sharp Ortho & Pelvic Physical Therapy, we treat this condition every week — and the good news is that with the right approach, it responds very well.
What is the gluteus medius, and why does it hurt?
The gluteus medius is the muscle on the outer part of your pelvis that keeps you from wobbling side to side when you walk. Its tendon attaches to the bony point on the outside of your hip (the greater trochanter). When that tendon becomes overloaded or compressed, it becomes painful and irritated — a condition called tendinopathy.
Why menopause makes this so much more common
This isn't random timing. After menopause, estrogen — which directly supports tendon strength and collagen production — drops dramatically. That means the tendon becomes less resilient, more vulnerable to overload, and slower to recover. Combine that with natural muscle loss (sarcopenia), changes in body composition, and shifts in how we move, and the gluteus medius tendon is under real stress.
As a Women's Health Coach and pelvic PT with 30 years of orthopedic experience, I also see something many providers miss: the connection between hip pain and the pelvic floor. The muscles and fascia that surround the hip are directly linked to the pelvic floor. When the hip isn't working well, the pelvic floor often isn't either — and vice versa. That's why our treatment always looks at the whole picture.
Signs you may have gluteus medius tendinopathy
Aching or sharp pain on the outside of one or both hips
Pain that worsens when lying on your side — or on the opposite side
Discomfort when sitting with your legs crossed or in low chairs
Hip pain going up stairs, walking hills, or standing on one leg
Pain that seems to come and go but never fully resolves
What does treatment actually look like?
Contrary to what many women are told, rest is not the answer. Tendons need the right kind of movement to heal. Our evidence-based program progresses through three stages:
Phase 1: Gentle isometric exercises that calm pain without aggravating the tendon — no stretching, no compression
Phase 2: Progressive strengthening to restore hip and pelvic control, including retraining how your body moves in daily life
Phase 3: Functional loading — building tendon capacity for walking, stairs, exercise, and everything you want to do
We also address posture habits, sleep positions, and — because this is a postmenopausal issue — nutritional factors like protein intake, collagen support, and vitamin D that directly affect how well your tendon can heal.
You don't have to just live with this
Lateral hip pain is incredibly common in women after menopause, but it isn't inevitable — and it's very treatable. Most of our patients see meaningful improvement within the first 3–4 weeks when they commit to the program.
If you're dealing with outer hip pain and want answers, we'd love to help. Sharp Ortho & Pelvic Physical Therapy serves women at every stage of life from our Hoover, AL clinic. Call us at (205) 515-0258 or visit sharpphysicaltherapy.com to schedule your evaluation.
Tags: lateral hip pain, gluteus medius, menopause and hip pain, pelvic floor physical therapy, women's health Hoover AL, postmenopausal pain, hip tendinopathy
