Healing Hip Tendonitis and Returning to Running
Watch the video or read the full breakdown below — both cover the same ground.
Timestamps: 0:00 Overview 1:08 Anatomy lesson 2:02 Why lying on your side at night hurts 3:30 Why stretching can make it worse 5:34 Why rest doesn’t fix it 6:45 Why injections aren't a long-term solution 7:10 Why time off can make it worse 9:00 The 2 Things Your Plan Must Have 9:55 Resistance training - The Ladder Effect 13:03 How to know if you're ready to run
Why everything you've been told might be making this worse
Stretching is probably not helping. It may be hurting.
This is the one that surprises women most.
If you've been doing figure-four stretches, pigeon pose, or anything that pulls your knee across your body — and your pain keeps coming back — there's a specific clinical reason why.
The pain in lateral hip pain comes from the gluteal tendons — the connective tissue attaching your glute muscles to the outside of your hip. When you stretch into positions that bring your knee across your body, you're placing direct compression on that tendon against the bone.
That area feels tight — but the tightness isn't because the muscle is short. It's because there's inflammation and fluid in the tendon. Stretching doesn't release it. It compresses an already irritated structure.
Sometimes stopping the stretching alone contributes significantly to pain improving. Not the whole solution — but one of the most important things to understand first.
Complete rest isn't fixing it either.
Rest makes intuitive sense. Take six weeks off, let it heal, try running again.
The problem: this isn't the type of injury that responds to rest. And the research is specific about why.
Studies have looked at three groups of women with this exact condition — one group did resistance training, one received injections, one rested completely. The resistance training group got more pain relief, faster, with better long-term outcomes than either of the other groups.
There's also a specific reason why rest backfires. Research shows that if a tendon goes without movement or resistance for more than 14 days, it starts to decondition — changes happen at a cellular level that make it more sensitive to load when you return. This is why so many women rest, feel better, go back to running, and find the pain is just as bad or worse.
The rest didn't fix anything. It reduced the irritation temporarily while the tendon lost capacity.
Injections aren't a long-term solution.
Corticosteroid injections can offer short-term relief — but research now shows repeated injections over time have a detrimental effect on bone density. For a woman who plans to be running and hiking at 70, that tradeoff matters.
What actually works: the two-bucket system
Getting back to running with lateral hip pain requires two things working together. Most approaches focus heavily on one and neglect the other — which is one of the most common reasons women stay stuck for months or years longer than necessary.
Bucket 1: Strengthening — with the right progression
Research is clear: resistance training works better than rest or injections for this condition. But strengthening without the right progression is where most programs fail.
Think of it as a five-rung ladder. At the bottom: a banded clamshell. Working up through single-leg glute bridges, walking lunges, bodyweight deadlifts, to heavy loaded exercises at the top.
This is what I call the Goldilocks effect. Start too high on the ladder — too heavy, too soon — and the tendon flares for one to four days after. Start too low and you fail to make progress. The goal is finding the rung that's right for where your hip is right now, and progressing every two to four weeks as your capacity builds.
This doesn't require hours in the gym. Most women make significant progress with two to three 20-minute sessions per week.
Bucket 2: Return to running — with progression gates
This is the piece that's most often missing — and for some women it matters even more than the strengthening.
Most women are told "just go for a run and see how it feels." That's not a system. It's a guess. And it leads to the exact cycle of running, flaring, resting, and starting over that keeps women stuck.
Research has identified specific progression gates — criteria your hip needs to meet before running is reintroduced:
Before running: complete a 45-minute walk without a flare-up in the 24 hours after.
Before increasing load: meet specific jumping benchmarks — because jumping tests the tendon's capacity for impact, which is exactly what running demands.
Once those gates are cleared: begin run-walk intervals, progress to continuous running, then — if your goals include it — add speed work, hills, and back-to-back training days.
Two ladders running simultaneously. Strength progressing. Running progressing. Each one informed by where your hip actually is — not where a generic protocol assumes you should be.
What this means for you
If you've been stuck in the cycle of trying to return to running and having it flare every time — that's not your body failing you.
It's what happens when the approach doesn't start where you actually are.
The tools exist. The research is clear. Getting back to running with lateral hip pain is entirely possible — and it doesn't require giving up the sport that makes you feel like yourself.
Want to understand the anatomy behind why this happens? Jump to [1:08] in the video above — I walk through exactly which structures are involved and why they respond the way they do.
Chelsea Matthews - Doctor of Physical Therapy, Running Specialist and Running Coach
