Your greater trochanter hurts because the gluteal tendons that attach to this bony prominence are irritated or degenerating, or because the bursa that cushions these tendons is inflamed. The greater trochanter is a high-stress area where multiple structures converge, making it susceptible to overload injuries. Understanding the specific causes reveals effective treatment strategies. Research published in the British Journal of Sports Medicine demonstrates that greater trochanteric pain syndrome affects 10-25% of the general population (PMID: 28626999). The study found that gluteal tendinopathy, rather than bursitis, is the primary pathology in most cases, with tendon changes visible on imaging in up to 80% of affected individuals. This article explains why your greater trochanter hurts and provides exercises that address the underlying causes. Understanding the Greater Trochanter The greater trochanter is a critical anatomical landmark: Location: The greater trochanter is the bony bump on the outer upper femur that you can feel when you place your hand on your hip. Muscle attachments: The gluteus medius and gluteus minimus tendons attach here, making the trochanter a high-load area during walking, running, and standing. Bursa location: Multiple bursae surround the trochanter to reduce friction as tendons glide over bone. These bursae can become inflamed. ITB crossing: The iliotibial band passes over the greater trochanter and can contribute to compression and friction in this area. Causes of Greater Trochanter Pain Gluteal tendinopathy: The most common cause. The gluteus medius and minimus tendons undergo degenerative changes from overload or age, creating pain at their trochanteric attachment. Trochanteric bursitis: Inflammation of the bursae at the trochanter. Often occurs secondary to tendinopathy or from direct compression. Hip abductor weakness: Weak gluteal muscles create abnormal loading at the trochanter with every step. This weakness both causes and perpetuates trochanteric pain. Compressive loading: Hip adduction positions, such as side sleeping or crossing legs, compress trochanteric structures and cause irritation. Repetitive friction: Activities involving repeated hip flexion-extension create friction of structures over the trochanter. Who Gets Greater Trochanter Pain Certain populations have higher risk: Women over 40: Hormonal changes and wider pelvis anatomy increase risk. Women are 3-4 times more likely to develop this condition. Runners: Repetitive hip loading with inadequate hip strength creates overload at the trochanter. Sedentary individuals: Prolonged sitting weakens hip abductors and may directly compress trochanteric structures. Those with lower back pain: Altered movement patterns from back pain often increase stress at the hip. Primary Exercises for Greater Trochanter Pain These exercises address the weakness and imbalances causing trochanteric pain. 1. Side-Lying Hip Abduction Why it works: Strengthening the gluteal muscles that attach to the trochanter builds tendon capacity to handle load. Start with limited range to avoid provocation. JME 125 Holding onto a wall or your chair, extend one leg to the side. 2. Glute Bridge Why it works: Bridges strengthen gluteal muscles without the compressive forces of standing exercises. This makes them appropriate early in rehabilitation when the trochanter is sensitive. JME 137 With your toes rotated toward your other leg, lift your leg up at your knee. As you lift, tuck your chin. When you return your foot to the floor, untuck your chin. 3. Clamshell Why it works: Clamshells strengthen hip external rotators with minimal trochanteric compression. The side-lying position keeps load off the affected side. JME 128 Staying steady on one leg, follow the diagram for the path of your leg. Stay controlled with your movement and find your end range at every location. 4. Figure Four Stretch Why it works: Addressing piriformis and deep rotator tightness reduces tension on structures crossing the trochanter. JME 133 Bring one ankle up to rest on your knee. As you sit in this cross-legged position, rotate your upper body toward the floor to feel a gentle stretch. Don't force your end range - do what works for you. Supporting Exercises Additional exercises support trochanteric healing. 5. Standing Hip Extension Why it works: Hip extension builds gluteus maximus strength, contributing to overall hip function and reducing compensatory load on the trochanter. JME 127 Holding onto the wall or your chair, lift one leg to 90 degrees, return to the ground, then do the same with the other leg. 6. Hip Circles Why it works: Gentle mobility maintains hip range and promotes blood flow to the trochanteric region without aggressive loading. JME 122 Keeping your feet in the same position, rotate your hips in a circle. 7. Hamstring Stretch Why it works: Posterior chain flexibility affects hip mechanics. Balanced flexibility reduces abnormal stress at the trochanter. JME 141 Sitting in your chair, extend one leg in front. Once extended, bend your upper body over that leg to fell a gentle stretch in your hamstring. Don't force anything - find what works for you. 8. Knee to Chest Why it works: Hip flexion mobility affects overall hip function and may reduce compensatory patterns that stress the trochanter. JME 121 Sitting in your chair, grab onto one leg and pull it toward your chest for a gentle stretch. Activity and Position Modifications Avoid side sleeping on the affected hip: Direct compression worsens trochanteric pain. Sleep on your back or opposite side with a pillow between knees. Avoid crossing legs: Hip adduction compresses the trochanter. Sit with knees apart or parallel. Modify running: Reduce mileage and avoid cambered surfaces. Wider step width reduces trochanteric load. Use cushioning: If you must sit on hard surfaces, use a cushion to reduce direct trochanter pressure. Stand evenly: Avoid standing with weight shifted onto the affected hip. Distribute weight evenly. When Greater Trochanter Pain Requires Evaluation No improvement after 8-12 weeks: Consistent rehabilitation should produce improvement. Lack of progress may indicate need for imaging or other intervention. Severe pain: Pain greater than 6/10 that limits daily activities warrants assessment. Night pain: Pain that wakes you from sleep or prevents sleeping needs evaluation. Weakness: Significant hip weakness or giving way requires investigation. Common Treatment Mistakes Aggressive stretching: Stretches that pull the leg across the body compress the trochanter. Avoid adduction stretches. Deep tissue massage: Direct pressure on the painful trochanter irritates inflamed structures. Only passive treatment: Injections or medications alone do not address underlying weakness. Active rehabilitation is essential. Too much too soon: Aggressive strengthening early on can flare symptoms. Progress gradually. Expected Timeline for Recovery Greater trochanter pain typically requires patience. Early improvements may appear in 4-6 weeks with appropriate management. Significant tendon adaptation requires 12-16 weeks of gradual loading. Full resolution of chronic cases may take 6-12 months. Consistent, progressive strengthening produces the best long-term outcomes. Start Moving Better Today Your greater trochanter hurts because gluteal tendons and bursae at this bony prominence are irritated from compression, weakness, or overload. Addressing hip abductor weakness while avoiding compressive positions creates lasting improvement. These eight exercises target the causes of trochanteric pain. simplmobility provides joint-specific hip programs designed for trochanteric pain. Each routine takes 2-3 minutes and progressively builds the strength needed for healthy trochanteric function. Try simplmobility Free for 14 Days Frequently Asked Questions Is greater trochanter pain the same as hip arthritis? No. Greater trochanter pain involves structures on the outside of the hip, while hip joint arthritis affects the ball-and-socket joint itself. Arthritis typically causes groin pain and stiffness, while trochanteric pain is localized to the outer hip. Both conditions can coexist. Do cortisone injections help greater trochanter pain? Cortisone injections provide temporary relief for some people, but evidence shows they do not improve long-term outcomes compared to exercise alone. Injections may help manage pain while beginning rehabilitation, but they do not address the underlying weakness causing the problem. Can I exercise with greater trochanter pain? Yes, appropriate exercise is essential for recovery. Avoid exercises that compress or stretch the trochanter. Focus on low-load strengthening exercises like bridges and clamshells initially, progressing to standing exercises as pain allows. Why does my greater trochanter hurt more at night? Night pain often results from side sleeping, which compresses the trochanter for hours. Additionally, reduced movement at night allows inflammation to accumulate. Sleeping on your back or with a pillow between knees when side sleeping can help.