How to sit and stand with gluteal tendinopathy / hip bursitis
- Maryke Louw
- Feb 20
- 6 min read
If you have gluteal tendinopathy or hip bursitis, you might notice that sitting and even relaxed standing positions can quietly aggravate your symptoms. In this article, I’ll explain why this is and show you a few simple posture tweaks you can try right away to make sitting and standing more comfortably and to help calm things down 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.
In this article:
We’ve also made a video about this:
Why sitting and standing can increase outer hip and thigh pain
The most common cause of pain felt over the outside of the hip is gluteal tendinopathy and/or hip bursitis (also called lateral hip pain / greater trochanteric pain syndrome), which is linked to irritation around where the gluteal tendons attach onto the outside bony part of your hip (the greater trochanter).
One reason symptoms can hang around is that tendons can become sensitive to two broad types of load:
Tensile load: how much pulling or stretching the tendon can tolerate.
Compressive load: how much the tendon gets pressed or squashed against the bone and other tendons, particularly near its attachment (the “enthesis”).
A helpful way to think about compressive irritation is the bruise analogy: pressing on a bruise repeatedly doesn’t necessarily “damage” it, but it keeps it irritated. Taking pressure off usually helps it to settle.
Any movement that causes the gluteal muscles and tendons to stretch can also cause them to pull tight over or against the hip bone, increasing the pressure on the tendons and also on the bursae that sit under and between these tendons. This is not a problem for healthy tendons, but when injured tendons usually don't like this.
So, the goal of the tips below is simple: reduce the repeated compressive load on the outside-hip tendons (and bursae) while they’re sore, so symptoms calm down. Once they have calmed down, you can usually slowly ease into these normal positions and activities again – although it might be a good idea to permanently ditch some bad habits!
Tips for sitting when you have gluteal tendinopathy or hip bursitis
In the short term, while things are painful, it can help to avoid (or reduce time spent in) positions that stretch the outer hip area – then reintroduce them gradually later.
Sitting postures to avoid (or at least reduce) for now:
1. Sitting with your legs wide apart for long periods
If you regularly sit with your legs in a wide position, your muscles and tendons may gradually get used to that posture and become a bit stiff. We’re not talking about sitting with your legs just comfortably apart – we’re talking about taking them wide apart – think cowboys sitting in an old movie! It is also not a problem if you sometimes sit like this. It might become a problem if you do it for long hours while working at a desk, for instance.
The reason why this habit might cause trouble is that it will cause the muscles to pull tight over the outer hip and you may end up compressing the outside hip more if you then do activities that bring your legs into a narrower/more neutral position (like walking, cycling, or running).
Quick self-check:
Do you often sit with your knees far apart for long periods?
If yes, could you bring your feet/knees a bit closer together more often (without forcing it)?
👉 Now, you might think that this means tight muscles caused your injury, so then stretching them must be the best way to treat it. Please DON’T stretch that area to try and treat gluteal tendinopathy or bursitis – it usually just makes it feel worse. It usually works better to start with more gentle exercises and other things first, and there is not evidence that tight muscles actually cause gluteal tendinopathy.
2. Saddle chairs or “tucked-under” seating that encourages a wide-leg posture
Some chairs (including saddle-style chairs) encourage your legs to sit wider or tucked underneath you in a way that reinforces that wide position over time.
If your hip is currently sensitive and you find it complains a lot when you get up from sitting on your chair, consider limiting time in that setup for a while.
3. Sitting with your legs crossed
When you cross your legs, it creates a “stretch/compression” effect on the outside of the hip.
If you’re in a painful phase, it’s worth trying to avoid crossing your legs (or at least reduce how long you stay there).
4. Sitting in deep chairs
When you sit with your knees higher than your hips, it can cause a subtle stretch of the gluteal muscles. If your favourite soft sofa or couch is suddenly causing your hip pain to feel worse, this might be the reason. Some cars also have very low or deep seats which can cause trouble.
An easy solution (and cheaper than a new car 😉) is simply raising the seat a bit or sitting on a cushion if the seat can’t adjust.
5. Sitting-lying on your side on the couch/sofa
If you have a habit of watching TV in a position halfway between sitting and lying on your side with your feet sideways on the couch, then that might cause trouble – especially if the injured side is the one at the bottom.
The simplest solution is to switch over so you’re leaning on the other side. If this doesn’t work, you might have to watch Netflix while sitting upright for a while.
Standing also matters: Common “easy” postures that increase compression
The same compressive and stretch forces show up when you stand.
Standing with your legs crossed can put the outside hip into a stretched position that increases compression over the gluteal tendon.
Also, many people naturally stand by “hanging” off one hip because it feels easy and energy-efficient (you don’t have to use many muscles). But it also tends to place the hip in that stretched/compressed position.
What to try instead: Aim for a more “neutral” stance – standing with your weight evenly distributed between your legs rather than collapsing into one side.
The bigger picture
None of this means you can “never” use these postures again. The short-term goal is to reduce the irritation so that things calm down, and then gradually reintroduce compression as you return to normal life.
These posture changes can make symptoms feel more comfortable by taking pressure off the injured area. This will enable you to get going or continue with the rehab that aims to get rid of the outside hip pain for good.
So, to properly move forward, you’ll usually also need a plan that help restore your tendon’s strength and capacity for the activities you want to get back to. This is why posture tweaks are best seen as a supporting strategy, not the whole solution.
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
Maryke Louw is a chartered physiotherapist with more than 20 years' experience and a Master’s Degree in Sports Injury Management. Follow her on LinkedIn and ResearchGate.
