Best sleeping positions for gluteal tendinopathy and hip bursitis
- Alison Gould
- Feb 20
- 4 min read
If you have gluteal tendinopathy or hip bursitis, sleep can become frustrating and painful – especially if your hip hurts regardless of which side you’re lying on! Here are a few simple sleeping tips you can try to make nights more comfortable while you continue your rehab.
Remember, if you need help with an injury, you're welcome to consult one of our physios online via video call.
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In this article:
We've also made a video about this:
Why sleeping positions can aggravate gluteal tendinopathy / hip bursitis symptoms
Many people with gluteal tendinopathy or hip bursitis notice that their symptoms flare up at night, especially when sleeping on their side. This is usually linked to pressure or stretch placed on the irritated tissues.
Two common positions tend to irritate symptoms:
Lying directly on the painful side – this puts pressure onto the sensitive tendon and bursa, similar to pressing on a bruise.
Letting the top leg drop forward across your body when lying on the opposite side. This movement (called adduction) stretches the gluteal tendons, pulling them tighter over or against the hip bone, which can also increase pressure on the already irritated tissue.
A useful way to think about it is the “bruise” analogy: pressing on a bruise hurts, but does not necessarily cause further damage, and taking the pressure away helps it to calm down. The aim of adjusting your sleep position is simply to reduce that pressure on those areas so the pain settles.
Adduction is a normal movement – it’s not “bad” – but while your hip is irritated and symptoms are flared up, reducing prolonged time in that position can help things to calm down.
These tips are not a cure on their own – they’re meant to make you more comfortable so you can continue with your rehab exercises, which are an important part of managing tendon problems.
Tips for sleeping more comfortably with outer hip pain
The main aims are to reduce any direct pressure over the injured area and to keep your hip in a more neutral alignment rather than allowing it to drop into positions that stretch the outside hip.
You might still wake up during the night – that’s normal. The goal of these strategies isn’t to be a miracle fix, but to make it easier to get comfortable again and fall back asleep.
Everyone’s preferences differ, so you might need to experiment to find what works best for you.
1. Side lying with pillows between your knees
If you prefer lying on your non-painful side, placing pillows between your knees can help prevent your top leg from dropping forward into adduction.
Use enough pillows to keep your hips in a neutral line – some people need one pillow, others two.
The key is that your top leg shouldn’t fall across your body.
Experiment with different pillow orientations to find a setup that feels stable and comfortable, or try out this ergonomically designed side sleeping knee pillow available on Amazon.
2. Resting the top leg on pillows in front of you
Another variation of lying on your non-painful side is to place pillows in front of your body and rest your top leg on them. This helps to support the leg, so it doesn’t drop into adduction, while still allowing you to lie comfortably on your side.
The height of the pillows matters – you want enough support to keep the hip aligned rather than letting the leg sag forward.
I demonstrate the positions in this video clip:
3. Half-side position with a line of pillows
If side lying feels uncomfortable, you could try placing a line of pillows lengthways down your bed and lying partly on them, either on your front or your back.
This position allows you to lie:
neither fully on your side nor fully on your back, or
partly on your front if that feels better.
Some people find this reduces pressure on the outside hip while still feeling stable enough to sleep. Here’s how to do that:
What these sleep tips can – and cannot – do
These strategies aim to:
reduce pressure on the irritated tissues,
help calm symptoms at night, and
make it easier to stay comfortable.
They don’t treat the underlying tendon problem by themselves. They work best alongside a structured rehab programme aimed at improving tendon health and capacity.
How we can help
Need help with an injury? You’re welcome to consult one of the team at SIP online via video call for an assessment of your injury and a tailored treatment plan.
We're all UK Chartered Physiotherapists with Master’s Degrees related to Sports & Exercise Medicine or at least 10 years' experience in the field. But at Sports Injury Physio we don't just value qualifications; all of us also have a wealth of experience working with athletes across a broad variety of sports, ranging from recreationally active people to professional athletes. You can meet the team here.
About the Author
Alison Gould is a chartered physiotherapist and holds an MSc in Sports and Exercise Medicine. You can follow her on LinkedIn, Facebook, Instagram or Twitter.